Junior Doctors and EWTD?

onetrueone

Just wondering (it being 2008 and all) about the chances of the EWTD (European Working Time Directive) being implemented in full in Ireland as regards Doctors hours in hospitals?

Do Junior Doctors still do Hours in excess of 48 hours per week?

Why don't junior Doctors refuse on Health and safety grounds to do hours in excess of 48 per week?

Surely with all the extra doctors coming on stream, the manpower will be available to cover all the hours without the doctors having hours in excess of 48 per week?

( I read on another blog that Doctors in Austrailia are rostered properly and don't do the kind of hours heard of in Ireland)

Thanks

Vorsprung

Do Junior Doctors still do Hours in excess of 48 hours per week?

Yes. 95% of them do.

Why don't junior Doctors refuse on Health and safety grounds to do hours in excess of 48 per week?

Hmmm...not sure. In my limited experience, we just get on with it. If we did work 48 hours per week, the whole system would shut down by Wednesday, with skeleton staff for Thursday and Friday.

Surely with all the extra doctors coming on stream, the manpower will be available to cover all the hours without the doctors having hours in excess of 48 per week?

No extra doctors coming on stream in Ireland anyway....

onetrueone

Thanks for the quick reply Big!

You say if the doctors didn't do the hours then the system would shut down.

Surely this is an open and shut case of exploitation by the Health authorities.

Surely the error rate goes through the roof if workers do in excess of 48 hours per week - whatever about other working environments but when patients are at risk???

Could the issue not be brought up at European level?

onetrueone

bigjimthefirst wrote: »

No extra doctors coming on stream in Ireland anyway....

Really???
What about the new Graduate entry places, the increased intake into undergrad Medicine?

What about the increased numbers doing medicine courses abroad (Eastern Europe etc)?

Fionnanc

Graduate entries not on stream yet and of course will be only interns when 1st qualify.
Long hours can be good for training and getting up experience levels.
Health and safety/EWTD can get stuffed. (on so many levels).
Exploitation? MAybe. Though we all new the hard work required when we signed on

Traumadoc

I do not think there will be enough intern jobs. There are not enough at the moment.

RobFowl

Traumadoc wrote: »

I do not think there will be enough intern jobs. There are not enough at the moment.

There were too few for the amount of graduates coming out in the early 90's , has it changed at all since then ?

eth0_

The HSE has a hiring freeze atm has it not?
The working time directive is impossible to implement in Irish hospitals atm. The resources simply aren't there.

It's a real pity the EU don't crack down hard on the Irish government over this. No one wants to be seen by a poor doctor who has been awake for 48 hours or more.

sam34

there are people within the hse saying that this has to be implemented in august 2009 come hell or high water - thats what our hospital manager is saying.
it's totally not feasible.

Vorsprung

onetrueone wrote: »

Really???
What about the new Graduate entry places, the increased intake into undergrad Medicine?

What about the increased numbers doing medicine courses abroad (Eastern Europe etc)?

As has been said earlier, more qualified doctors does not mean more jobs for doctors. The government have backed themselves into a big corner on this one, there simply won't be jobs for a lot of the graduate-entry students when they finish, and those who trained in the continental universities probably won't get jobs. There are 350 intern jobs in Ireland, there'll be 700 graduates in a few years. It simply won't work.

I can see a similar website being set up in Ireland in a few years unfortunately.

Traumadoc

I think it will be similar to the fiasco with physiotherapy recently where the numbers of graduates were increased - and a lot of graduates were left unemployed.
The problem with increasing the number of graduates is that you need to complete an intern year to get registered.

sillymoo

This is scaring the crap out of me. So when I finish college in 3 years I may not be able to get even an intern place? The first round of GEP's will be graduating in 2010. How will the HSE decide who to give intern posts to? Do you need to have blinding reslts and medals coming out your ears????


And I may as well forget the GP scheme then :mad:

onetrueone

I have posted my concerns re this issue before:
When I saw the numbers mentioned for training, I thought the mistakes of the UK doctor training fiasco could well be repeated here.

(Other post) *********

Has anyone considered the strong possibilty that there will be an oversupply Of Medical Graduates soon?

Does anyone know the details of any planning and provision for extra intern places to cope with the increased demand?

I think these points should be considered by anyone thinking of Graduate entry Medicine especially since;

a) Mary Harney is at the helm of the Heath service.

b) Health budgets are under huge pressure.

c) Call me cynical, but swathes of unemployed doctors would serve to be a convenient stick which the Govt/HSE could use to beat the Medical profession into submission.

I am considering Graduate entry Medicine (I'm a Pharmacist) but I am wary of getting myself into huge debt - only to find having completed the course to be unable to get an internship !

http://news.bbc.co.uk/2/hi/health/4741489.stm

onetrueone

Continuing on PHoenixIRE said

"Yeah, that could be a worry. I do know that as it stands now there is enough intern places to facilitate anyone who wants to do an Irish internship, whether they be from the graduate or undergraduate courses: the UCC FAQ says as much. And with the enlargment of UL's course curtailed and an alleged drop off in the number of international students applying (again, from the UCC FAQ) I'd wager we'll be ok. I'd wager 48000 euro to be exact"

from the UCC website:

What are the career prospects for Medical students?

While UCC does not guarantee pre-registration (intern) places for its graduates, we can state that, currently, virtually all of our graduates, who wish to do so, get their intern year positions in Ireland. Thereafter, many do leave but it must remembered that a very significant proportion of our graduates are currently FROM overseas and wish to complete their training closer to home. Currently, more Irish graduates complete their training in Ireland than ever before and there are distinct shortages in certain geographical and specialty areas (the introduction of Graduate Entry to Medicine and the expansion in direct entry numbers was based on a medical manpower survey). The Health Services Executive (HSE) is currently looking at the number of training posts in Ireland and it is to be hoped that these will be tailored to optimally manage the increased numbers of EU graduates. Finally, it is important to note that overall, a proportion of this increase in Irish/EU students is being offset by a decrease in non-EU entrants. The net increase in medical graduates who will require postgraduate training within the Irish Health system will, therefore, not be as great as it may seem".

Two concerns here, Firstly I have absolutely NO FAITH in THE HSE's ability to provide these extra places - that's born out by their ineptitude in every other matter, more importantly Harney has said she needs to shave 900 million of the Heath budget next year, how high up do figure Medical Graduates will list on her priorities?

Secondly, the assumption that there will be decreased demand from non-EU applicants is false. In the UK the authorities tried to give first preference to EU applicants for their Doctor training but this decision was overturned in the courts.

Shane-1

I should have stuck with arts, that way at least I'd have been expecting unemployment

onetrueone

sillymoo wrote: »

How will the HSE decide who to give intern posts to? Do you need to have blinding reslts and medals coming out your ears????

:mad:

No, just being the Son/Daughter/Relative of an eminent Professor of Gastroenterology will suffice.

sillymoo

onetrueone wrote: »

No, just being the Son/Daughter/Relative of an eminent Professor of Gastroenterology will suffice.

Well the only way I can do that now is to marry one - anyone know a nice Professor of Gastroenterology that would like to marry a young whippersnapper???

onetrueone

Getting back to the EWTD, there was some news recently from Europe that EU Ministers have voted to end countries opt out of the EWTD.

I'd like to know the likely impact of this for Ireland and more specifically the likely implications for Junior Doctors in Ireland?

http://news.bbc.co.uk/2/hi/uk_news/politics/7786825.stm

Vorsprung

onetrueone wrote: »

Getting back to the EWTD, there was some news recently from Europe that EU Ministers have voted to end countries opt out of the EWTD.

I'd like to know the likely impact of this for Ireland and more specifically the likely implications for Junior Doctors in Ireland?

http://news.bbc.co.uk/2/hi/uk_news/politics/7786825.stm

I hear another opt-out coming over the horizon....;)

onetrueone

bigjimthefirst wrote: »

I hear another opt-out coming over the horizon....;)

Yes, but will they be allowed opt out of the opt out?

Doctors in residence, has there been any discussion of this EU development in the canteen?

sillymoo

onetrueone wrote: »

Doctors in residence, has there been any discussion of this EU development in the canteen?

They are all on call and dont have time to sit in the canteen

onetrueone

sillymoo wrote: »

They are all on call and dont have time to sit in the canteen

But a man's gotta eat?

tallaght01

sillymoo wrote: »

Well the only way I can do that now is to marry one - anyone know a nice Professor of Gastroenterology that would like to marry a young whippersnapper???

Will a soon-to-be-ex-paeds-registrar do? :P If that fails, I'm in the market for a helper monkey

I thinkt he EWTD is a great idea in principle. A lot of senior docs think it's a bad thing.

You don't learn as much in a 40 hour weeks, they say. No ****. But so what? I'd rather have less medical skills and a life.

I have no idea how they'll implement it. It's a bit late to start planning now.

Presumably we'll end up with shift work. 3 shifts per day over a 24 hour period. So, 2 out of every 3 days you'll be working anti social hours.

It's gonna be very interesting to see how it works. I'm steering well clear of working in Ireland til it's sorted though :P

tallaght01

onetrueone wrote: »

But a man's gotta eat?

I've certainly gone longer than your average Ethiopian without food or water in the line of work, when it's been busy.

sam34

tallaght01 wrote: »

Will a soon-to-be-ex-paeds-registrar do? :P If that fails, I'm in the market for a helper monkey

I thinkt he EWTD is a great idea in principle. A lot of senior docs think it's a bad thing.

You don't learn as much in a 40 hour weeks, they say. No ****. But so what? I'd rather have less medical skills and a life.

I have no idea how they'll implement it. It's a bit late to start planning now.

Presumbal we'll end up with shift work. 3 shifts per day over a 24 hour period. So, 2 out of every 3 days you'll be working anti social hours.

It's gonna be very interesting to see how it works. I'm steering well clear of working in Ireland til it's sorted though :P

i cant see how theyre going to implement it at all. apparantly you need ten people to make it workable, and thats the absolute minimum. many teams/services dont have those numbers available at all.

im also a bit concerned about the antisocial hours aspect of it.

sam34

tallaght01 wrote: »

I've certainly gone longer than your average Ethiopian without food or water in the line of work, when it's been busy.

QFT!
back in the days when i was an intern i was the skinniest i've ever been, due to running around all day and not getting the chance to eat half the time.

now that i'm a psychiatrist, things have changed somewhat

RobFowl

tallaght01 wrote: »

A lot of senior docs think it's a bad thing.

You don't learn as much in a 40 hour week

The old boys network have this attitude that I did so you should as well. i'm finished training but can safely say learned feck all on most of the long shifts i worked. Structured training with dedicated teaching is far more effective (IMO).
My worst was starting a shift on friday at 0830 and finishing at 1800 on the monday with 2 hours sleep.
Safe to say patient saferty was compromised !!!!!!
Not Pc to say but NCHD's in Ireland have to look at having 9-5 as a core working week (ie paid for 9-5 any way with everything else as overtime). It leads to poor training , excess hours and (if protected teaching was in place ) no improvement in knowlage base .

Traumadoc

RobFowl wrote: »

The old boys network have this attitude that I did so you should as well. i'm finished training but can safely say learned feck all on most of the long shifts i worked. Structured training with dedicated teaching is far more effective (IMO).
My worst was starting a shift on friday at 0830 and finishing at 1800 on the monday with 2 hours sleep.
Safe to say patient saferty was compromised !!!!!!
Not Pc to say but NCHD's in Ireland have to look at having 9-5 as a core working week (ie paid for 9-5 any way with everything else as overtime). It leads to poor training , excess hours and (if protected teaching was in place ) no improvement in knowlage base .

In Australia they do not work the excessive hours we have to yet they are just as good if not better than the standard here - I really think it has a lot to do with the number of consultants - In nearly every hospital I worked in there were far more consultants than registrars.

The Cardiology in one 300 bed hospital had 8 consultant cardiologists and 3 registrars, 3 SHOs.

The Orthopaedic department had 16 consultants 1 senior reg, 4 regs 2 shos 2 interns

RobFowl

Traumadoc wrote: »

In Australia they do not work the excessive hours we have to yet they are just as good if not better than the standard here - I really think it has a lot to do with the number of consultants - In nearly every hospital I worked in there were far more consultants than registrars.

The Cardiology in one 300 bed hospital had 8 consultant cardiologists and 3 registrars, 3 SHOs.

The Orthopaedic department had 16 consultants 1 senior reg, 4 regs 2 shos 2 interns

Spot on there Traumadoc. More consultants leads to better care for patients, Those staffing ratios make far more sense than 1 sonsultanr a senior reg/reg/2 SHo's and an intern which I've seen far too often here.
The Irish NCHD's have to oirk 9-5 mon to friday and this severely limits flexibility. Partial shift or even full shifts would reduce hours to close to the EWTD and could be introduced rapidly. (Would lead to a cut in overtime though !!!! is that where the resistance is coming from and not totally the HSE??).

DrIndy

It comes down to saving money - more junior staff = less consultant salary. Anyone with any real political influence has VHI plan E so they can utilise the overpriced private sector.

The new HSE plan however is to save money by cutting overtime however - but this comprises of not paying unrostered overtime. There is nothing more disheartening or demoralising than to bust your balls to help patients then to be refused the overtime you worked. The gulf between the administration and the medical workforce is awe inspiring as the complete lack of understanding of exactly what we do and how we work.

I have 2 job offers to date in Queenland in Oz - both really good with a really welcoming team. I think I'll take them.

drzhivago

Traumadoc wrote: »

I do not think there will be enough intern jobs. There are not enough at the moment.

increasing intern places to 800 over next 6 years, currently 505-512 depending on year

drzhivago

sillymoo wrote: »

This is scaring the crap out of me. So when I finish college in 3 years I may not be able to get even an intern place? The first round of GEP's will be graduating in 2010. How will the HSE decide who to give intern posts to? Do you need to have blinding reslts and medals coming out your ears????
And I may as well forget the GP scheme then :mad:

all details about intern jobs will be released soon, some new system being put in place with increased number of jobs so you shoudl be OK for intern, its what happens after that that is important and if junior doctors numbers are cut then no prospects of jobs then why put all of you additional people through medical school in the first place

charlieroot

I could be wrong but I thought they cut the plan to increase further places as of the last budget?

drzhivago

charlieroot wrote: »

I could be wrong but I thought they cut the plan to increase further places as of the last budget?

nope stalled the rate of increase, plan still in effect, has caught some colleges out as they have hired lecturers based on increasing class sizes which wont happen when they thought but will happen but project forward a little

800 med students per year

800 internships (FOTTRELL REPORT)

4,600 junior doctor jobs going to 2,200 by 2013 (HANLY REPORT)

= Major unemployment (MY REPORT)

charlieroot

I don't really see how the hospitals could function with that kind of reduction in numbers unless there is a huge increase in consultants.

RobFowl

drzhivago wrote: »

nope stalled the rate of increase, plan still in effect, has caught some colleges out as they have hired lecturers based on increasing class sizes which wont happen when they thought but will happen but project forward a little

800 med students per year

800 internships (FOTTRELL REPORT)

4,600 junior doctor jobs going to 2,200 by 2013 (HANLY REPORT)

= Major unemployment (MY REPORT)

Medical Education in Ireland: A New Direction

Report of the Working Group on Undergraduate Medical Education and Training (the “Fottrell Report”)


A report not policy so no guarantee of these positions

Hanly report not official policy

Consultant numbers supposed to increase by the number of junior doc positions lost, thats the policy but none have yet been appointed !!!

Be afraid !!!!!

drzhivago

RobFowl wrote: »

Medical Education in Ireland: A New Direction

Report of the Working Group on Undergraduate Medical Education and Training (the “Fottrell Report”)


A report not policy so no guarantee of these positions

Hanly report not official policy

Consultant numbers, policy is to increase but none have yet been appointed !!!

Sorry to disagree all Government Policy including Hanly, has been repeated over and again in meetings with relevant bods

There have been increased consultant numbers look at Comhairle na Nospideal reports on Consultant staffing, This function now taken over by HSE

Goes back to Fitzgerald report plan was for 1500 consultants and 1500 juniors, they did get to 1500 consultanst but b the time they did there were 3800 juniors

Hanly report is for 3,200 Consultants and 2,200 juniors dont know how to reassure you Fowl but is most definitely govt policy

RobFowl

drzhivago wrote: »

Sorry to disagree all Government Policy including Hanly, has been repeated over and again in meetings with relevant bods

There have been increased consultant numbers look at Comhairle na Nospideal reports on Consultant staffing, This function now taken over by HSE

Goes back to Fitzgerald report plan was for 1500 consultants and 1500 juniors, they did get to 1500 consultanst but b the time they did there were 3800 juniors

Hanly report is for 3,200 Consultants and 2,200 juniors dont know how to reassure you Fowl but is most definitely govt policy

Sorry to be cynical but
O Higgan's 1999 report on breast cancer was officially policy but never implemented and now superceeded
Primary care strategy 2003 ? still officially policy but never funded and no plans to do so
Mens heath report 2008 officially policy but not funded and no plans to do so
HSE service plan for 2009 based on figures out of date by the time it was published still officially policy but Drumm has admitted will not be implemented

drzhivago

RobFowl wrote: »

Sorry to be cynical but
O Higgan's 1999 report on breast cancer was officially policy but never implemented and now superceeded
Primary care strategy 2003 ? still officially policy but never funded and no plans to do so
Mens heath report 2008 officially policy but not funded and no plans to do so

Cynical is fine, they have actually started funding the increased places and have a timetable for when extra places go to what school, now delayed by two years from tis budget

That never happened with primary care or o Higgans report

dont know about mens health although glad that we are getting some interest soemwhere

DrIndy

RobFowl wrote: »

Medical Education in Ireland: A New Direction

Report of the Working Group on Undergraduate Medical Education and Training (the “Fottrell Report”)


A report not policy so no guarantee of these positions

Hanly report not official policy

Consultant numbers supposed to increase by the number of junior doc positions lost, thats the policy but none have yet been appointed !!!

Be afraid !!!!!

I was a member of the Fottrell committee and am so disappointed that what was a heavyweight group with international backup that produced a great report should be decimated so rapidly. All it takes is some cherry picking (like denying the cost heavy features) and the whole thing becomes disjointed.

This is linked to the Buttimer report

http://www.dohc.ie/publications/buttimer.html

MedGraduate

Hi, I am graduating in Riga, Latvia which is EU member state in June and after reading the posts I would say there is little point for me to try getting the internship place in Ireland, is that right?
Or would anyone have any suggestions what is the best thing to do as I am willing to come to Ireland to live. Thanks

NickCarraway

MedGraduate wrote: »

Hi, I am graduating in Riga, Latvia which is EU member state in June and after reading the posts I would say there is little point for me to try getting the internship place in Ireland, is that right?
Or would anyone have any suggestions what is the best thing to do as I am willing to come to Ireland to live. Thanks

I would suggest completing your internship or equivalent in Latvia first, then coming to Ireland to apply for SHO posts.

MedGraduate

NickCarraway wrote: »

I would suggest completing your internship or equivalent in Latvia first, then coming to Ireland to apply for SHO posts.

Thanks for quick reply)
Internship in Latvia is 5 to 6 years depending on what you are at) As you can imagine it is very long period of time and would not be suitable as I am in a relationship with somebody living in Ireland.
Would there be a slim chance getting a place in ROI? what do you think?

NickCarraway

MedGraduate wrote: »

Thanks for quick reply)
Internship in Latvia is 5 to 6 years depending on what you are at) As you can imagine it is very long period of time and would not be suitable as I am in a relationship with somebody living in Ireland.
Would there be a slim chance getting a place in ROI? what do you think?

Very slim. At the moment graduating students out number intern places. However a lot of our graduates are not EU citizens so I think an EU citizen should, legally, be offered the job before a non-EU citizen. But intern placement is usually coordinated by the medical schools and I wouldn't be surprised if they gave preference to their own students first, whether or not they are EU citizens. I do know of one person who got a one off internship in Dundalk and I think this was organised directly with the hospital.
My advice would be to contact the medical schools (there are 6 but Limerick do not yet have a graduating class) and ask them. Then try contacting individual hospitals. Note the hospitals most likely to have spare places will not be big, city based hospitals. Also if you do come across a place make sure it is recognised by the IMC for the purposes of medical registration. In any event no university or hospital will likely be able to give you a definite answer until after the other interns are placed (early to mid June) and you would probably have to be able to start at short notice.

MedGraduate

NickCarraway wrote: »

Very slim. At the moment graduating students out number intern places. However a lot of our graduates are not EU citizens so I think an EU citizen should, legally, be offered the job before a non-EU citizen. But intern placement is usually coordinated by the medical schools and I wouldn't be surprised if they gave preference to their own students first, whether or not they are EU citizens. I do know of one person who got a one off internship in Dundalk and I think this was organised directly with the hospital.
My advice would be to contact the medical schools (there are 6 but Limerick do not yet have a graduating class) and ask them. Then try contacting individual hospitals. Note the hospitals most likely to have spare places will not be big, city based hospitals. Also if you do come across a place make sure it is recognised by the IMC for the purposes of medical registration. In any event no university or hospital will likely be able to give you a definite answer until after the other interns are placed (early to mid June) and you would probably have to be able to start at short notice.

Thanks a lot for the info, will be contacting the hospitals and schools.
Would you mind if I contact you again when I get talking to the hospitals?

NickCarraway

MedGraduate wrote: »

Thanks a lot for the info, will be contacting the hospitals and schools.
Would you mind if I contact you again when I get talking to the hospitals?

No problem. Good luck:)

Below is a link to wikipedia page about the Irish medical schools.

http://en.wikipedia.org/wiki/Medical_school#Ireland

This link is to the Health Service Executive page. It shows a map of Ireland so you can search hospitals by area.

http://www.hse.ie/eng/HSE_FactFile/County_Information/

Señor Juárez

eth0_ wrote: »

The HSE has a hiring freeze atm has it not?

Maybe I'm just stating the obvious, and it's something that the HSE hasn't realised yet...

but...

wouldn't reducing staffing average hours, and hiring more people, cost the same amount?

DrIndy

hence their plan - on paper reduce the working hours - and just not pay the overtime which will be worked regardless.

heinous.

Señor Juárez

Could you then simply refuse to work more than the hours you have down on paper as being worked? Surely you'd be legally correct in doing so, too.

DrIndy

we would be legally correct - but not ethically or morally.

You cannot "knock off" if someone is bleeding out in front of you - even if the HSE says its kosher to have the free 1 hour lunch break i have never hand in 4 years.

hence we are open to exploitation and abuse - because we will still treat sick people despite our working conditions.

Jane5

Well an alternative is to do the emergency work and then request time in lieu. If it is not given then take it after informing HR in writing, keeping a copy for yourself and giving them reasonable notice to arrange for cover.
Many other health professionals use time in lieu instead of overtime and it works very well.
As an aside, does anyone know why the Facebook NCHD group was shut down? I was about to join!