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Diabhal_Glas wrote: »Any Idea if you would be in a lot better a position in Australia/ NZ / USA?
You certainly would not be better off money wise training in the USA. Resident salaries are about $40-46k for 1st year rising up to about $56k by final year, no overtime, no extra weekend pay, deductions for white coats, parking etc. Obviously salaries are higher post-training in the USA to reflect this.
This issue is not really about money though. Most of my friends in the medical profession would be ok with a paycut if:- there were enough staff (both doctors and allied health) to properly care for patients
- there were enough staff to properly implement EWTD
- they didn't have to work unsafe hours
- they were trained properly
- they were supervised properly
- the rules and regulations for training weren't changed randomly (like surg SHO now being 3 years)
- they didn't have to fund registration fees for medical council and training bodies from their own pocket
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lonestargirl wrote: »
- there were enough staff (both doctors and allied health) to properly care for patients
- there were enough staff to properly implement EWTD
- they didn't have to work unsafe hours
- they were trained properly
- they were supervised properly
- the rules and regulations for training weren't changed randomly (like surg SHO now being 3 years)
- they didn't have to fund registration fees for medical council and training bodies from their own pocket
Yup. Medical Council is now one of the only non-medical majority councils in thr world. Needless to say, we have the new TRainee Registration nonsense from this unprofesssional and unqualified medical council. Still paying €500 a year for it, out of pocket (so around €1000 of actual gross earnings per year to fund a non-medical Medical Council).0 -
lonestargirl wrote: »You certainly would not be better off money wise training in the USA. Resident salaries are about $40-46k for 1st year rising up to about $56k by final year, no overtime, no extra weekend pay, deductions for white coats, parking etc. Obviously salaries are higher post-training in the USA to reflect this.
This issue is not really about money though. Most of my friends in the medical profession would be ok with a paycut if:- there were enough staff (both doctors and allied health) to properly care for patients
- there were enough staff to properly implement EWTD
- they didn't have to work unsafe hours
- they were trained properly
- they were supervised properly
- the rules and regulations for training weren't changed randomly (like surg SHO now being 3 years)
- they didn't have to fund registration fees for medical council and training bodies from their own pocket
FWIW, I agree wholeheartedly.0 -
Ah yeah, but does any one in admin give a crap, it all comes down to the bottom line. Money money money! No foresight, no concept, no responsibility! The joys of being a faceless bureaucrat.
Christ I'd love to have their mobile numbers so I could ring them if it was ok to stay in to resuscitate the severely septic patient in front of me, or to continue the laparotomy i started etc etc.
July will be fun when there are a multitude of unfilled jobs because of the idiotic scheming of this lot of unqualified, over opinionated, underachieving see pit of human endeavour and they can't get cover. I'll offer to do my own locum at a good price!0 -
Narkius, I actually did that before! Became ill while rostered to do a weekend shift of 32 hours straight. Was way too sick to be looking after anyone, could barely look after myself. Rang switch, explained the issue, said I was due to start in a few hours, and they cheekily put me through to the HR person in charge of medical recruitment-on Saturday morning-on their mobile!
There wasn't much they could say-I said I'd tried to find a replacement and there was no-one who could cover-and they had to take responsibility and find someone. And they did! After all-it is technically their responsibility to ensure that the hospital is appropriately staffed at all times-including weekends. Maybe more people should do this. Remind them what their job is.0 -
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There wasn't much they could say-I said I'd tried to find a replacement and there was no-one who could cover-and they had to take responsibility and find someone. And they did!
It's always been medical manpower's job to make sure services in a hospital are adequately staffed. It's simply out of habit that many NCHDs go to the bother of swapping calls, etc., . Basically, if you are on holidays or booked for leave, you should just be informing admin. They then should go and find staff to cover - and that is where it breaks down as they don't, and other members of the team pick up the slack.
Dump all the **** back on admin, they get paid to do it, but don't. It would then be pretty serious if they started asking e.g., an SHO on call to cover another SHO who was sick.
Regardless, the system has collapsed and hospitals which were already at near collapse from lack of medical staff, have tipped over entirely now.0 -
My GP tutor told us this week that he trebled his pay with overtime when he first qualified :eek:0
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dissed doc wrote: »Dump all the **** back on admin, they get paid to do it, but don't. It would then be pretty serious if they started asking e.g., an SHO on call to cover another SHO who was sick.
Regardless, the system has collapsed and hospitals which were already at near collapse from lack of medical staff, have tipped over entirely now.
+ 1 times a million
Some of the **** some medical admin staff give doctors is a joke. Heard a story (1st hand) off a guy who worked in a country hospital close to dublin - Medical Admin would bleep him at 5pm post call to check he was still in the building, there was no knocking off a bit early even if you had not slept in 32-36 hours and if the job was a bit quiet. In my intern year, doctors who were doing the on-call roster were charged with ensuring the shift was done, even if they were sick, not Medical Admin. I often wondering what would happen if that particular staff member lying on a trolley in ED (God forbid).
Look forward to some Medical Admin staff (nationally and locally) earning their money over the next couple of years as doctors emigrate in search of better conditions and training.0 -
Look forward to some Medical Admin staff (nationally and locally) earning their money over the next couple of years as doctors emigrate in search of better conditions and training.
I'd love to be a fly on the wall. We do rotas for them, we try to facilitate our colleagues at all times. Let's just pay it forward to our friendly admin staff and let them worry about. We can only one call every 5 days now according to the HIGH COURT-how does that work with a roster of 5-6 SHOs, when one is on leave, or one on study leave, or whatever. What about Regs, even fewer of them around-surgery, how's it going to work.
Let the Pr*%ks earn their crust. I'll await their phone calls,-
Admin: Hi, there's no one to cover sat or sun because the other doc is out ill, could you do it?
Me: But I've already done a 24 hr shift and I can't break the law..
Admin: What law?
Me: EWTD, High court stipulation, you know the one you guys have tried to ignore for 11years and only because it presented you with a way of reducing our wages, and protecting your jobs taht you tried to bring it in.
Admin: eh?
Let's not give them an inch and make em sweat. Thet've got what they want, we've 'cooperated', lets see them cope.0 -
Interesting thread...unfortunately despite some scepticism from some initial respondants basically every point made by the original poster is true
I would just put in the little proviso that if your heart was set on a career in GP in Ireland then go ahead and do medicine, if it's hospital-medicine then pay close attention to threads like this one
A big part of the problem lies with the hospital system, especially for those trying to train in a specialty where you can train for 10-15 years and then have no consultant job at the end of it and then be forced into emigration after spending a good portion of your life so far here in Ireland. All the crappy work conditions etc might be worth putting up with if there was light at the end of the tunnel but for many that light is forced emigration
But if you do GP you'll only work in the hospital system for 3-4 years and then have a lifetime in GP land (where there are also many systematic problems, don't get me wrong but that's another story)
and hopefully by the time current med school entrants get around to applying for GP training they will have overhauled the ridicualous unfair selection process for GP training here
and yes, I have seen/heard about similar incidents outlined above that sound shocking but unfortunately am not one bit surprised0 -
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Interesting thread...unfortunately despite some scepticism from some initial respondants basically every point made by the original poster is true
I would just put in the little proviso that if your heart was set on a career in GP in Ireland then go ahead and do medicine, if it's hospital-medicine then pay close attention to threads like this one
A big part of the problem lies with the hospital system, especially for those trying to train in a specialty where you can train for 10-15 years and then have no consultant job at the end of it and then be forced into emigration after spending a good portion of your life so far here in Ireland. All the crappy work conditions etc might be worth putting up with if there was light at the end of the tunnel but for many that light is forced emigration
But if you do GP you'll only work in the hospital system for 3-4 years and then have a lifetime in GP land (where there are also many systematic problems, don't get me wrong but that's another story)
and hopefully by the time current med school entrants get around to applying for GP training they will have overhauled the ridicualous unfair selection process for GP training here
and yes, I have seen/heard about similar incidents outlined above that sound shocking but unfortunately am not one bit surprised
How many GPs now had planned to do so when they entered medicine, or got to the point in college when they could make an informed (relatively) decision? I can't think of many in my class. I know a couple who were dead set on it and managed to get in early. The others, most are ex surgeons, or wanted to do an extremely competitive speciality, neurology, which had 0 reg spots available, and 5 research regs waiting to get back into clinical neurology.
GP for a lot of people is seen as a means of escape, that said, at times it seems an excellent escape route. Of course, I return to the ground when I discharge the mad marys, or the moany mandys, knowing that I don't have to deal with them everyday.;)0 -
and hopefully by the time current med school entrants get around to applying for GP training they will have overhauled the ridicualous unfair selection process for GP training here
Absolutely nothing will be overhauled. What will happen is regulation pushed through to allow non-"vocationally" trained GPs, i.e., the surgeons and medics looking for escape routes will complete a GP reg year and be eligible for GP specialisation.
Absolutely nothing however, will improve. It's simply reforming and reorganisation of the medical system to run a smaller amount of public hospitals. Most GPs by the time current students finish will be either younger, private practitioners, or else close to retiring. A stripped down GMS scheme will remain for those in Dublin or run down areas with > 20-25% unemployment (e.g., Finglas, Ballyfermot, etc., ).
They will have a continuous trickle down of people who are working abroad and want to return to Ireland - most of the them will end up in some sort of private sector hospital within 5 years.
There is no intention to replace 2 NCHD posts with 1 new consultant post. It's magical nonsense talk, so ignore it when you read it as justifcation for low medical staffing. They just want to cut the funding for the NCHD posts. People wlill go to UK, US, Aus/NZ, Can, and a few will return out of some sort of sentimentality, and this will continue to infinity.
Ireland = Saxony ex-GDR, circa 1991.0 -
Narkius Maximus wrote: »How many GPs now had planned to do so when they entered medicine, or got to the point in college when they could make an informed (relatively) decision? I can't think of many in my class. I know a couple who were dead set on it and managed to get in early.
these are the people I was aiming this comment at. But I agree, they are few and far betweendissed doc wrote: »Absolutely nothing will be overhauled. What will happen is regulation pushed through to allow non-"vocationally" trained GPs, i.e., the surgeons and medics looking for escape routes will complete a GP reg year and be eligible for GP specialisation.
how can you be so sure nothing will be overhauled?
We seem to be following the UK in a lot of the things we are doing and they are moving towards a 5 year GP training programme and they have stopped people doing a one-off registrar year
I can see it here where they may let people do a 2 year registrar training position if they have done adequate hospital medicine as a short-term stop gap when the GP shortage is critical. Longer term, and if GP is to be considered a proper "specialty", I don't think "escaping " surgeons and medics will get specialty recognisation with just a year of GP.
Also, apparently there is a shortage of GP's now but there are zero GP jobs out there at the moment....dissed doc wrote: »Absolutely nothing however, will improve.
Again, that's very pessimistic. I would be hopeful that if someone decent with actual experience of running a massive organisation got the job as head of HSE (and not a Professor of Paediatrics with all due respect to B. Drumm) they might be able to bring about proper change. That and getting the current govt/minister out..0 -
how can you be so sure nothing will be overhauled?
We seem to be following the UK in a lot of the things ......
Again, that's very pessimistic. I would be hopeful that if someone decent with actual experience of running a massive organisation got the job as head of HSE (and not a Professor of Paediatrics with all due respect to B. Drumm) they might be able to bring about proper change. That and getting the current govt/minister out..
My experience has lead me to that. It's being overhauled "downwards". Reduced salaries and worse conditions for doctors means doctors will not find the public service an attractive place to work; this suits the HSE which can then pay lower consultant locums on longer fixed term contracts e.g., 1 year at a time, without the responsibility of given longer contracts, or employing people in positions long enough to effect actual improvement. It's on the cheap. As consultants retire, services under them will be amalgamated (less so in e.g., St. James', Mater and other major teaching hospitals).
The only people who could run it well, would run it like a business, where the patient and healthcare is a cost; with politics thrown on top, they would be unlikely to fire the huge administrative and clerical overhead (e.g., 100k+ people). That is entirely the opposite system in the NL where people who use a service pay into it.
Basically, we have a large group of people paying little or no taxes for a health service, and another large group of people doing little or no work as a sort of "Advanced Occupational State Welfare" - they "work", but in effect are permanently unemployed people simply claiming a higher level of jobseekers benefits (ie.., the adminstrative overhead in the HSE).
There is no evidence, in my 8yrs+ of working in it, that
a) there is a push to get people from minimum wage up to pay for healthcare (e.g., Germany, Netherlands)
b) there is no push to reduce adminstrative overhead and increase medical staffing. The opposite is happening.
Therefore, what is happening, given how it's played out over the past few years, will continue to happen.0 -
dissed doc wrote: »As consultants retire, services under them will be amalgamated (less so in e.g., St. James', Mater and other major teaching hospitals).
There is no evidence, in my 8yrs+ of working in it, that
a) there is a push to get people from minimum wage up to pay for healthcare (e.g., Germany, Netherlands)
b) there is no push to reduce adminstrative overhead and increase medical staffing. The opposite is happening.
I don't think the amalgamation of some services is a bad thing. We have too many hospitals, too many (costly to run) A+E's eg. in Dublin alone and Brendan Drumm is dead right about that one
regarding a) I suppose there is the Health Levy but that's paid by people on €26K and above
regarding b) well that was always going to be difficult after the last minute deal Fianna Fail did with the unions pre formation of the HSE in 2002 whereby they guaranteed that there would be no redundancies as a result of the formation of the HSE. :eek: What was the point of forming the HSE again..?
Not sure how to row back on that one or how long that agreement lasted. I know the Minister has been trying to cut back on the bureaucrats but they are all expensive voluntary redundancies. Meanwhile her pursuit of the developers money/public/private mix has basically ruined (imho) what could potentially have been a decent healthcare system if the good times hadn't been wasted....Now who's pessimistic...?!?
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Just to get back to the original post:
Working in hospitals can be really draining and frustrating. There is no way of fully appreciating what it is like, until you are actually in the situation yourself. But your colleagues, consultants and workload make a huge difference as to whether you enjoy your work or not. I think the pompous arrogant consultant breed is slowly dying out. There will always be unpleasant hours, the constant non-medical jobs, the petty hospital jobsworths, the feeling that if nobody knows whose job it is, it is probably yours etc. I used to feel physically sick with tiredness after a night on call.
In general I think the intern year will be looked back on as your most enjoyable year. Yes the hours are crap and you are bottom of the feeding chain, but this has its own advantages. Nobody expects you to know much and colleagues expect to support you. The best thing is that all your college friends are around and want to socialise.
My little sister had ideas about doing medicine. I got permission for her to join me on a 24hr shift on a saturday to trail me as a medical SHO. We started at 9am and it began with three cardiac arrests. By midnight she declared that she had had enough and stomped off to bed. I tried explaining that there was no way of going to bed as I had both bleeps from midnight to 4am. She eventually went down the science route at college and still isn't sure what she wants to do yet.
So in summary, while I don't want to scare all the leaving cert students and med students completely, you have to be prepared to give up an awful lot of your life for a job that hopefully you might like.
(P.S. do GP and look forward to doing very limited call, not having a bleep and generally dictating where and when you want to work)0 -
Just to get back to the original post:
But your colleagues, consultants and workload make a huge difference as to whether you enjoy your work or not. I think the pompous arrogant consultant breed is slowly dying out.
In general I think the intern year will be looked back on as your most enjoyable year. Yes the hours are crap and you are bottom of the feeding chain, but this has its own advantages. Nobody expects you to know much and colleagues expect to support you. The best thing is that all your college friends are around and want to socialise.
So in summary, while I don't want to scare all the leaving cert students and med students completely, you have to be prepared to give up an awful lot of your life for a job that hopefully you might like.
(P.S. do GP and look forward to doing very limited call, not having a bleep and generally dictating where and when you want to work)
I was just having a think about all the negative stuff that had been on this thread and I have to say AMcD, you make some good points
true, the long hours are tough but yes, intern year, for a lot of people, is one of the most enjoyable years. It was for me anyway. There will be no other time when you will be working with so many of your friends from college,you will know and be known by everyone around the hospital, it's very sociable and that does somehwat make up for the long hours and crappy long shifts etc
re: consultants: The bad, pompous arrogant ones (and the few horror ones who intimidate, bully and harrass juniors) are few and far between, in my experience.
Looking back over the consultants that I've had the pleasure of working for, out of about 15 or 20 (as you rotate thorugh many junior docs jobs, and can work for 2 or more consultants in each job) I can think of between 5 and 10 consultants who have really inspired me, people I have really loved working for and learnt a lot from.
It's not all bad and hospitals can be great, fun places to work, even taking into account the crappy conditions/hours etc.0 -
Wowowow just came across this thread...how soul destroying!!
Is it really that bad?
At the open days i hear lots of student doctors saying its
so hard,long hours, reduced social life etc but its worth it...they rarely elaborated as to why they think its worth it...i wonder are they just saying that in a reassuring manner to themselves or is it actually worth it?
There seems quite a defeatist attitude as in accepting things the way they are and not striving to change things
Is it honestly a constantly hostile and stressful environment are there no moments of enjoyment? It is a great opportunity to go abroad , an option that is not viable for many other people and their jobs.
The negatives mentioned are off putting but at the same time if i do decide to do medicine and if i get in they also spur me on
to never behave in such a condescending, rude and eh ILLEGAL manner as so many are apparently doing...0 -
Freakin4Leavin wrote: »Wowowow just came across this thread...how soul destroying!!
The negatives mentioned are off putting but at the same time if i do decide to do medicine and if i get in they also spur me on
to never behave in such a condescending, rude and eh ILLEGAL manner as so many are apparently doing...
As in everything, the opinion of few cloud the minds of many.
Simple thing is to get into medicine and not worry about anything else. Between now and then lots will happen, you will become less naive, you will become cynical, the world will seem a less cheery place but you will be doing what you want to do in life, you will enjoy (most) days at work, no day will ever be the same, you will be making a difference (albeit small, and sometimes not so beneficial), and all this things add up and you will be satisfied.
Don't worry about the future, don't worry about naysayers and ne'er-do-wells. Do what you want to do.
Oh, and I won't be this nice in person, unless you are tall, blonde and malleable!!!!!:D1 -
I already have a good base of cynicism to build upon worry not...Not being naiive all im saying is iv worked in a hospital: from first hand experience yes interns are made triple check endless medicine doses, fetch things, work long hours etc etc... but it is not the horrific place that it is made out to be here!!
The interns i met were relaxed, bit rushed but loving it...
This thread could put the most determined of people off of medicine!
The consultants and doctors i have come across are not the bullying cruel people that have been described here! Some are stern, scatter-brained, funny, kind, guarded, particular ,relaxed,bossy etc etc....and frankly the personal issues that one doctor might be going through shouldnt be used to paint an overly bleak picture of medicine...
In any career you can feel trapped and depressed and while the negatives outlined are true and take the picture of medicine down a peg or two from its "dream job" perception, it does not deserve to be taken right down from dream job to nightmare job...0 -
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whatever about interns, Registrars do NOT spend that many nights in the hospital! Nor are they forced to staff 'rundown country hospitals'. It's a bloody great career, there's no job you can have without having to put in considerable hours before making it to the top...and i dunno what OP's talking about, but most of my classmates will be between 22 and 24 when they qualify! Consultant by early 30s so! and if you don't like hospital hours, go be a GP!0
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Consultant by early 30s so! and if you don't like hospital hours, go be a GP!
Unlikely. The HSE has been employing a minimal number of consultants in most fields, and not replacing people when they retire or are on extended leave. What you may mean is : starting a US residency to do it all over again by early 30s. Specialist training posts for many surgical specialities are virtually impossible to get on; you may be waiting years between ending basic training, doing MD/PHD before even beginning the 5-7 years of specialist training.0 -
Freakin4Leavin wrote: »I already have a good base of cynicism to build upon worry not...Not being naiive all im saying is iv worked in a hospital: from first hand experience yes interns are made triple check endless medicine doses, fetch things, work long hours etc etc... but it is not the horrific place that it is made out to be here!!whatever about interns, Registrars do NOT spend that many nights in the hospital! Nor are they forced to staff 'rundown country hospitals'. It's a bloody great career, there's no job you can have without having to put in considerable hours before making it to the top...and i dunno what OP's talking about, but most of my classmates will be between 22 and 24 when they qualify! Consultant by early 30s so! and if you don't like hospital hours, go be a GP!
no offence to either of you, but neither of you have worked in a hospital as an NCHD
until you have, you are not in a position to make sweeping statements about it
the people that have answered here have been there and done that, and are recounting their experiences
some of it doesnt make for nice reading, but i would prefer people to be honest rather than sugarcoat it
susie- as an SpR, i did a whole year where i worked a 1 in 3on call rota, and it was in-house call
and yes, peopel do staff inadequate rural hospitals, and often not at their own volition... on rotational training schemes you are told where to go, and many have an obligatory "outside" year, where you will be sent to some place far away. its not optional.
is being an NCHD hard? yes
is it demoralising, dehumanising and downright humiliating? at times, yes it is.
would i do it again if i had my time over? in a heartbeat, yes i would.0 -
whatever about interns, Registrars do NOT spend that many nights in the hospital! Nor are they forced to staff 'rundown country hospitals'. It's a bloody great career, there's no job you can have without having to put in considerable hours before making it to the top...and i dunno what OP's talking about, but most of my classmates will be between 22 and 24 when they qualify! Consultant by early 30s so! and if you don't like hospital hours, go be a GP!
susie, with all due respect, you obviously don't have a clear idea of the facts here!
One cannot "go be a GP". There is a vocational GP training scheme one has to be accepted onto, in order for this to become a reality. There were approximately 100 places per year in the whole country for this scheme, and it was, and remains, extraordinarily highly competitive.
Many SpRs who wished to go back and be a GP were forced to work in 6 month posts such as Obs and Gynae, or Paeds (both have notoriously bad on call rotas) for years before getting on the GP scheme, and do locum GP work in their "spare time" to show commitment to the job. Their previous hospital experience was not recognised if they did eventually get accepted onto the scheme.
The percentage of NCHDs who make consultant in Ireland is small. It is uniquely insecure employment, being on temporary 6 month contracts well into your forties in many cases, moving house constantly, interviewing constantly.
Registrars spend MORE hours in the hospital and on call than interns. And all up and down the country, right now as we speak, they are staffing small rural country hospitals. SHOs are indeed forced to staff these outposts, as they are incorporated onto the "training schemes" so that these hospitals will have a chance to have staff at all. The on call rotas in these places are typically unbelievably onerous, and despite the "EWTD" that no one adheres to, can be 1 in 3 or 1 in 2 if someone is on holidays. This means well above 120 hours a week in some cases.
You are wrong about having to put in considerable hours in any job if you want to make it to the top. There is no other job where you are forcibly rostered on for shift lengths of 36 hours at a stretch with no sleep or meal breaks incorporated. This is the norm. It is mandatory. It is not for those who wish to make it to the top, but required for everybody. It is not optional or voluntary. If you do not work the illegal shifts rostered you will lose your job and quite possibly not get another, rendering some very expensive 6 years in college a total waste of time.
This is one that often gets trotted out, and it is a bit ridiculous. Yes, some jobs work late, or start early. And every so often, someone may have to stay on until nightfall. But in no other job, are you required and forced to work shifts of illegal lengths with no sleep breaks regularly, with no compensatory rest, for years and years on end. Pregnant NCHDs have been forced to work illegal length shifts too, as have many of us when ill, even if contagious! Many NCHDs have collapsed on duty from illness or exhaustion, and many have died in post call car crashes. Staying in the office till 11pm as a lawyer or banker really can't be compared to this.
Becoming a consultant in your early thirties-EXTREMELY rare. Intern year, two or three years as an SHO, registrar usually one or two years, SpR scheme (5-7 years) plus fellowship and research years-usually 12-15 years post graduate if one is one of the lucky ones and gets there all going smoothly. If not, then longer.
Remember, that 15 years is spent working sleep deprived for most if not all of it. Moving house every six months, and uprooting your family if you have one. On emergency tax every six months. Reapplying for jobs and interviewing every 6 months to a year. For years.
If I were you, kids, I would think SERIOUSLY about this before doing it. Shadow an SHO-not an intern-in a small rural hospital for an entire week, and a weekend on call. Be awake and with them every minute. Consider the job insecurity and physical discomfort (not to mention dangers of needlestick injuries-which increase in incidence with fatigue!). If you still think that there is just nothing else in the world that you could ever see yourself doing then, by all means, after making sure you know what you are getting into, go ahead. But would I do it again? No. You have to give everything up-socialising, family time, self care-by which I mean adequate sleep and time to exercise and relax, any hobbies or interests fall by the wayside. You have to give up everything for it. If you think it is worth that-go for it. But never say you weren't warned.0 -
Everything I said is info I was given by interns/SHOs/Registrars in the hospital where I work, so I didn't just randomly come up with it!0
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Everything I said is info I was given by interns/SHOs/Registrars in the hospital where I work, so I didn't just randomly come up with it!
Things to remember:
- only around 15-20% of your medical school class will make to consultant level
- over half will become GPs (and most of those indirectly, after 3-4 years of medical/surgical scheme training and unable or unwilling to continue the hospital slog for another 7-10 years).
If you want to see what the reality is, talk to the people on SpR schemes about how they got to that level - most if not all specialist training schemes have mandatory placements for 1 year or more in rural hospitals (e.g., Letterkenny, Sligo, etc., ), and when they will finish. Most will be looking at late-30s at the earliest, if they are there at all.
There are around 500-600 new graduates every year, and the plan is to increase this number considerably. At the same time as speaking about removing two NCHD posts for every new consultant post, while ACTUALLY simply removing NCHD posts and making no new consultant posts, and fewer places on specialist training schemes, there will be a large amount of all new grads stuck at mid-level "staff grade". This is cheaper for the HSE, and the reality of where they want things to go.0 -
whatever about interns, Registrars do NOT spend that many nights in the hospital! Nor are they forced to staff 'rundown country hospitals'. It's a bloody great career, there's no job you can have without having to put in considerable hours before making it to the top...and i dunno what OP's talking about, but most of my classmates will be between 22 and 24 when they qualify! Consultant by early 30s so! and if you don't like hospital hours, go be a GP!
Nowhere in the above extraordinary statement have you mentioned that it is second hand information and that doctors you know told you this-it sounds as though you know it for a fact: quote "Registrars do NOT spend that many nights in the hospital!"
I would respectfully suggest that perhaps these guys may be a little naive and have only a nodding acquaintance with reality if they really did in fact tell you that one becomes a consultant in their early thirties and easily buggers off to GP land if one does not find hospital medicine to their tastes.
To be honest, your post was very dismissive and seemed to insinuate that NCHDs have it easy and are whinging over nothing. I don't know if you are a med student or what-if you are I hope for your sake that things improve for NCHDs soon, or you are in for a major surprise.0 -
So I just heard a little story form a big hopistal in Dublin. Due to decrease in the budget from the HSE, this hopsital has decided to take the vast majority of the NCHD budget to cover over the gaps (and the majority of consultants have agreed to it. No overtime, strict 39hrs, reduced numbers in A&E, clinics cut, electives cancelled, transfers refused etc etc etc.
Of course the only thing that will happen will be that an NCHD will be paid 39 hrs but expected to work 60+, including on call commitments.
I'm sorry but if this comes to pass it will truely be the death knell to medical and surgical training in Ireland. We will be a pure service industry clocking in and out, there will be little or no sense of duty or pride in what we do.
I think is the straw that finally broke the camel's back. I really thought I could do my training here (at least years 1-4SpR). I've already invested 5years post graduation in this country, including an research based M.D., but if the HSE gets their way, and there is no provsision for training then I am out. I'm gone. I really believe in a sense of duty, I really want to work here, pay taxes, repay the investment that was put into me, in my medical schooling and subsequent training. I always knew I'd leave for a fellowship, but didn't think I'd be leaving this early (bear in mind if I leave before SpR, my chances of being able to come back to work here are very slim, for reasons that frustrate anyone that has had to do it). So in a nut shell, I will be forced into emigration over the nest year or two.
I don't wish to scare the medical students, or people who wish to study medicine. Study Medicine, it's the best thing I think I could have possibly done, but open your eyes, listen to what is said from those who know.
I really hope this doesn't come to pass.0 -
Join Date:Posts: 11109
Narkius Maximus wrote: »
I don't wish to scare the medical students, or people who wish to study medicine. Study Medicine, it's the best thing I think I could have possibly done, but open your eyes, listen to what is said from those who know.
There are alot of newly qualified GP's out there struggling to find work as well. Also a direct result of the HSE/DOHC cutbacks.....0 -
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I have also been watching closely what I call the "jitters" going on in the health service - which is the budget changes and the airhorning by the HSE about cutting overtime pay across the board without cutting overtime.
I have also been watching the dynamics of the staff shortages of doctors are a result of this (this was previously unheard of). I am also very cynical and negative right now about future training opportunities in ireland.
Overseas is not neccesarily the panacea - the USA have some horrific T&C's when working as a doctor - but they should not scare off irish trained doctors because they're much the same with support. There are many jobs which are not really jobs but gap-plugging in Oz/NZ. The NHS is entirely run by pen-pushers and the assessments for getting on training schemes have a significant chunk composed of "scenarios" which involve "what would you do if you saw your consultant not washing his hands" or "what would you do if you saw your registrar seemed really tired" - these are relevant - but conformation ala George Orwell 1984 via exams in this with marks counting significantly is getting beyond a joke.
Its all about balance.
I'm now planning on staying on in Oz for more time because of this - another one for the emigration ship and contributing to ireland greatest export - its people.0
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