Medical Training in UK or Ireland - future prospects?

bluewall

Like many people I'm about to take the GAMSAT next week. Ideally I would like to study grad med here in Ireland, but like many people I have also applied to the UK (for a mix of 4 year and 5 year medical courses) to try to maximize my opportunities.

In the highly theoretical scenario where I was lucky enough to gain places in both a medical school here in Ireland AND one in the UK, I am trying to figure out which would be better to choose in the long term.

Ideally I would prefer to train in Ireland and eventually work here. I gather that if I studied in the UK I would be obliged to do all of my post-grad medical training and specialisation over there (because it is too difficult to gain a place on the post-grad medical training programmes in Ireland coming straight from medical school in the UK) which means I could be committing around 10 years of my future to living in the UK including the initial 4 years at med school.

Basically what I am getting at here is that I would like to hear anyone's opinion on what they would prefer between studying in Ireland vs UK - bear in mind, it's not the actual study bit I'm worried about, but more so the career opportunities that occur thereafter..

If I eventually want to work as a doctor in Ireland, am I just better off getting into the system straight from medical school here? I would really like to avoid spending another 10 years in the UK if at all possible as I have already spent 6 years there studying and working.

On the other side, I have noticed a few doctors here on boards recently complaining that once they have done all of their SpR training in Ireland that they become unemployable because of lack of jobs. Is that really true generally speaking and if that is the case, am I stupid trying to plan my medical career that far in advance if there's a decent chance that I might not be able to practice here at the end of my training in any case!!??

I'm not asking anyone to look into a crystal ball here and make predictions, but I would like to hear from anyone with an informed opinion on the training opportunities and potential for reaching your desired career path in medicine via either an Irish medical school or one in the UK

Sorry for the long post here, and I hope it all makes sense! Cheers in advance for anyone who gives their opinion.

Susie-O-

Best of luck with the GAMSAT, i hope it goes well! I'm currently a 5th (of 6) year medical student here in Ireland, and I was recently at a 'So you want to be a Surgeon' talk in RCSI. Almost all of the SpRs from a wide variety of specialties said that doing your training here gives you a huge advantage when it comes to getting jobs/promotions - and also, which might be of help in you making your choice, there are a lot of consultants, both surgeons and physicians, who will be retiring in the next 10-15 years, thus opening up a lot of places for trainees...and several higher training schemes will be offering more places over the next few years to fill these gaps. There will also be more new consultancy posts! The short answer is, as far as I can gather, if you train here, you'll probably get work here, and can also go back to the UK, but if you train in the UK, you'll need to be damn impressive to get back here before SpR level! Hope that helps!

docbroc

If you got a place in the UK you would be better off taking it and staying put (assuming other commitments dont draw you back). Next year 600+ Irish medical students will graduate. This is >100% more than there are jobs available. The HSE is committed to increasing the number of consultancy posts indeed, however this is supposed to be at the expense of junior doctor positions. In other words - if they make room at the top, there is less room at the bottom. This means less training schemes and fiercer competition to get on the schemes. SPR's cost a lot of money for the HSE. They are limiting their numbers every year.

I have recently interviewed for a consultancy post. There were 35 fully qualified applicants for a single post in a single speciality. This is the only post that has come up in this speciality in the last 3 years. The next time a post comes up there will be 45 fully qualified applicants for it. This is one of the commonest specialities in the country. Plus it was was for a country hospital in the south west. The post went to someone who had done all their training in France.

The surgeons are lying to people like Susie because they are absolutely desperate for junior staff. They are in the process of changing basic surgical training to 3 years because of the staff shortage. 3 years of retractor-holding for 90 hours a week (imagine!) A few of my classmates have acheieved their exit exams in surgery. While its true there is less competiton for surgical places, not one of them is employed either. They get the odd locum job but thats about it.

My longwinded point is that you are better off staying put, even if you eventually want to work in Ireland. There are far more oppertunities and far far better training in the UK. Plus when you return you will be given more credit than people who have trained in Ireland. Also the lifestyle is much better (Ive worked in England) and your allowed to have a personal life. The NHS isnt perfect but its a damn sight better than the HSE mess.

Susie-O-

I'm fairly sure that SpRs and registrars would gain nothing from 'lying' to us - it was a full and frank discussion in RCSI about the future for medical students, they weren't trying to plug their own specialties or saying anything that they didnt back up with proper facts/evidence....

docbroc

Did they mention the changes to the BST?
The enormous drop out rates ?
The blatant discrimination against female trainees in job allocation ?
That you will have to re-interview each year for a different job ?
The horrors of working in peripheral hospitals ?
What its like to work sat/sun/monday straight ?
Not getting paid overtime ?

Maybe lying is too strong a word. Highly selective truth management under the watchful eye of your consultant would be a more accurate (and verbose!) term

Susie-O-

They actually did mention all of that stuff - they did not paint a pretty picture at all! that's why i'd tend to believe the one or two positive points they did make!

dissed doc

Susie-O- wrote: »

Best of luck with the GAMSAT, i hope it goes well! I'm currently a 5th (of 6) year medical student here in Ireland, and I was recently at a 'So you want to be a Surgeon' talk in RCSI. Almost all of the SpRs from a wide variety of specialties said that doing your training here gives you a huge advantage when it comes to getting jobs/promotions - and also, which might be of help in you making your choice, there are a lot of consultants, both surgeons and physicians, who will be retiring in the next 10-15 years, thus opening up a lot of places for trainees...and several higher training schemes will be offering more places over the next few years to fill these gaps. There will also be more new consultancy posts! The short answer is, as far as I can gather, if you train here, you'll probably get work here, and can also go back to the UK, but if you train in the UK, you'll need to be damn impressive to get back here before SpR level! Hope that helps!

Nonsense. This has been aswered before. Almost all the SpRs may *believe* that it gives a huge advantage, but the fact of the matter is that someone who left and trained in the US to speciality level would be far more likely to get those jobs whenever x, y, z retires, and sooner, than someone who spent 15 years completing SpR in surgery in Ireland.

Person A: residency, fellowship at Mayo Clinic, with a few years working as an Attending consultant

Person B: basic and specialist training in Ballybogland Hospital Of No Particular Importance = ultrafail at interview.

It comes down to publications and research, more than some misled belief in systemic HSE goodwill towards homegrown trainees, who are regularly cast aside for better qualified applicants from abroad.

You will get much better experience, and be a much better candidate if you have UK or US (or EU/Aus/NZ experience). Chances are as well you will be on the specialist register after completing the 6 year ST program in the UK, which is much shorter than the BST+Research+SpR system in Ireland.

It is unlikely there will be any new consultant posts, even if you wanted them, in the HSE. Any new jobs will be in the private sector, or else retirement-replacement posts in the few remaining university hospitals.

EDIT: they may be technically correct, in that you will be better placed to get a year 3 registrar post after finishing year 2. However, when it comes to consultant interviews, all that crap falls by the wayside as there are a tonne of better applicants on the open market incl. UK/EU.

dissed doc

Susie-O- wrote: »

I'm fairly sure that SpRs and registrars would gain nothing from 'lying' to us - it was a full and frank discussion in RCSI about the future for medical students, they weren't trying to plug their own specialties or saying anything that they didnt back up with proper facts/evidence....

RCSI want your money. They want you to commit to surgery training for 3 years so you will give them 3k per year = 9k for training, for e.g., 200? 300? people a year? They can bank on a net income of around 3 million per entry group over a 3 year BST cycle. At the end of it all, most will become GPs anyway.

Susie-O-

Dissed doc, you seem to get very worked up about these things. Just my opinion, I'm only sharing what I've been told.

bluewall

Many thanks for all the replies so far..

So, would it be fair to say the consensus is that if I had the option of med schools, the UK might be the better route to take at this point in time (docbroc and dissed_doc)??

Do you know what type of med you'd like to go into Susie-O? Are you worried at all about your prospects of progressing in the areas you'd like, going on what you know and what some others are saying about their experiences in the current system?

I have no idea at this moment which area I'd like to go into, but I'm just trying to make sure that I make an informed decision which goes beyond medical school - if I am lucky enough to have the choice between graduating into the HSE/NHS system!

Susie-O-

I'm currently interested in gastroenterology, or Intensive care medicine, and since they're both medicine options rather than surgery, I'm probably looking at about ten years before consultancy after I graduate! Since I've no experience of the UK system, I'm only basing my advice on what registrars generally say - if you wanna work here, your best option is to train here! That's all I know! good luck!

tallaght01

Susie-O- wrote: »

I'm probably looking at about ten years before consultancy after I graduate!

Yea, good luck with that!

bluewall

Susie-O- wrote: »

I'm currently interested in gastroenterology, or Intensive care medicine, and since they're both medicine options rather than surgery, I'm probably looking at about ten years before consultancy after I graduate! Since I've no experience of the UK system, I'm only basing my advice on what registrars generally say - if you wanna work here, your best option is to train here! That's all I know! good luck!

Thanks for your help anyway and best of luck with it yourself!

While we're on the topic.. an uncle of mine is a consultant gastroenterologist in one of the Dublin hospitals. In order for him to become a consultant in Dublin he had to move to the UK for 10 years to work/specialise and ultimately wait for a post to become available. I suppose that's par for the course these days!

dissed doc

Susie-O- wrote: »

Dissed doc, you seem to get very worked up about these things. Just my opinion, I'm only sharing what I've been told.

Not worked up, but you need a reality check.

In the past 30 years there have been around 13-15 thousand medical graduates from all universities in Ireland.30 years is usally the professional workign life of a consultant.

There are 1300 consultants in Ireland today.

Look around your medical school class. 9 out of every 10 medical students will NEVER be a consultant in Ireland.

Susie-O-

I just feel like there are a lot of people being quite cynical and bitter about the situation for medical graduates, and I think it's bad to give off this impression to prospective students! I'd much rather be optimistic!

RobFowl

Susie-O- wrote: »

I just feel like there are a lot of people being quite cynical and bitter about the situation for medical graduates, and I think it's bad to give off this impression to prospective students! I'd much rather be optimistic!

It's fairly grim at the moment Susie.
GP's are finishing their training and there are almost no vacancies so short term work or non at all is the norm.
NCHD posts are being cut and even still the conditions are so bad they cannot fill all the vacancies.
The new consultants contract is being implemented in piecemeal fashion and the HSE in particular seems to be at war with medics in general.
Maybe things will be different in 5-10 years but TBH if I wasn't in masses of debt from setting up a practice I'd almost certainly be off to the UK (and might yet anyway if the HSE CEO's plan to scrap all GP's contracts remains policy).

Jane5

Susie-O- wrote: »

I just feel like there are a lot of people being quite cynical and bitter about the situation for medical graduates, and I think it's bad to give off this impression to prospective students! I'd much rather be optimistic!

Susie, why would someone be "optimistic" for the sake of it? That's silly.

The one duty I feel I owe to prospective students is this: to warn them not to do medicine. At all.

Do something else. Anything else. Especially if you are as set on staying in Ireland as the OP seems to be. The conditions are horrendous, and set to worsen. The pay is not all that. The prospects for advancement are minimal at best. You are expected to give up your sleep, self care, family, hobbies, everything. If you are a woman, give up the idea of having children. Now. No job security. Whatsoever. Treated like dirt. People I know have collapsed from exhaustion, died in car crashes after illegal shift lengths.

If you are that hung up on working in healthcare, and can get the points-do Speech and Language therapy, Occupational therapy, Pharmacy even-yes there has been some upheaval recently but still worthwhile. The working conditions are not even comparable to medicine, they are so vastly superior. Job security-much much better. Pay much better-most doctors will not make consultant level and hence will not achieve six figure pay levels.

If you want a good job, not too hung on healthcare, be a teacher, still very satisfying and good quality of life.

If you love science and biology, medical scientist/laboratory technician very good, guaranteed work, excellent pay and decent conditions.

RUN away from medicine. I wish someone had been honest with us when we started out. You can incur a lot of debt on the way that traps you in your NCHD role. Don't do that. This is my honest advice to you. I would never try and blow sunshine up anyone's ass for the sake of it. Med is not a good choice in Ireland.

Svalbard

UK, ftw.

Better medical education and post graduate training. Chances are you may end up going there for specialist training at some point so you might as well just start off in the system and plum for run-through training. It will be faster, the training will be better and you will be more likely to get a job - here, in the UK or elsewhere.

The one possible exception is GP training - you may be marginally better off to do that here, but that is by no means certain and there are plenty of UK trained GPs working in Ireland (as we are not training nearly enough currently).

Susie-O is wrong. She is not being optimistic, she's delusional.

bluewall

Jesus... I never thought when I started this thread I would be met with such depressing replies.

I'm already a healthcare professional, so a move to medicine is something I'm 100% about. I'm certainly not against going back to the UK, I'd just rather avoid it if possible. I have a place on hold in a med school there.

So I gather that the only plausible route at the moment (in the Irish system) would be perhaps to train as a GP? I have no doubt some one will jump out of the wood work now and say that training to be a GP/future prospects as a GP in Ireland are no use either!!

If there's anything else that any of you want to get off your chests with regard to a future career in medicine please don't hold back now.. forewarned is forearmed!!

docbroc

I think DocDanekas post sums up most of it.

Breezer

bluewall wrote: »

So I gather that the only plausible route at the moment (in the Irish system) would be perhaps to train as a GP? I have no doubt some one will jump out of the wood work now and say that training to be a GP/future prospects as a GP in Ireland are no use either!!

RobFowl wrote: »

GP's are finishing their training and there are almost no vacancies so short term work or non at all is the norm.

Actually this is something I'd be very curious about. I'll be finishing up my undergraduate training soon and my aim is to be a GP. From what I've heard and read, the current shortage of GPs in Ireland is only going to get far worse over the next decade or so, and steps (small ones, admittedly) are being taken to address this, the increased number of training places next year being a start.

So what exactly do you mean when you say there are no vacancies, RobFowl? It just seems counterintuitive. Go on, depress me, I'm able for it

Susie-O-

This has gotten ridiculous! Bluewall, I'm sorry you're getting such negative responses! I could tell you at least twenty registrars to talk to who are really positive about their current jobs, and their future careers, and I'm not exaggerating at all - send me a PM if you'd like me to tell you all about the RCSI meeting I was at and exactly what was said.

as far as I can see here, all your getting is doom and gloom from people who don't seem to be in medicine for the right reasons anyway....

It's really wrong and unfair to make the profession seem so terrible to someone who is clearly very interested in this as a career. The bottom line is, nobody knows how things would be by the time bluewall is finished internship. So stop being such miserable gits!

RobFowl

Breezer wrote: »

So what exactly do you mean when you say there are no vacancies, RobFowl? It just seems counterintuitive. Go on, depress me, I'm able for it

Most GP practices are a combination of GMS and private work. All state payments have been cut by 10-15% gross. This has resulted in most practices not being in a position to take new GP's on.

Setting up practice is difficult and costly and access to GMS contracts is quite restrictive for new entrants.

Also non GP trained doctors are allowed work as defacto GP's (although they are not allowed hold GMC contracts). This contrasts with the UK where all doctors working in General Practice are trained GP's.

The plan for the future is based on a cut of about 10% in state funding for Primary care but an increased number of doctors. So more doctors will be around but the total amount of money available for practices will be less. This is a challange to say the least and younger GP's especially are struggling to pay their mortgages etc at the moment.

Breezer

RobFowl wrote: »

Most GP practices are a combination of GMS and private work. All state payments have been cut by 10-15% gross. This has resulted in most practices not being in a position to take new GP's on.

Setting up practice is difficult and costly and access to GMS contracts is quite restrictive for new entrants.

Also non GP trained doctors are allowed work as defacto GP's (although they are not allowed hold GMC contracts). This contrasts with the UK where all doctors working in General Practice are trained GP's.

The plan for the future is based on a cut of about 10% in state funding for Primary care but an increased number of doctors. So more doctors will be around but the total amount of money available for practices will be less. This is a challange to say the least and younger GP's especially are struggling to pay their mortgages etc at the moment.

Oh wonderful :rolleyes:

You seem to be quite knowledgeable on this, would you mind me asking if you're a GP yourself? And also, to bring the focus somewhat back to the Ireland vs UK debate, would you recommend GP training in the UK or in Ireland at the moment, based on those future plans? What about Northern Ireland? And is there anywhere I can go to find out more about this (I don't mean the GP training scheme websites, I mean the situation in general).

RobFowl

Breezer wrote: »

Oh wonderful :rolleyes:

You seem to be quite knowledgeable on this, would you mind me asking if you're a GP yourself? And also, to bring the focus somewhat back to the Ireland vs UK debate, would you recommend GP training in the UK or in Ireland at the moment, based on those future plans? What about Northern Ireland? And is there anywhere I can go to find out more about this (I don't mean the GP training scheme websites, I mean the situation in general).

I'm a GP all right and it is a great career choice (mostly) .

If you can get a training position in ROI it does give you some advantages in getting a substantive post mainly by giving you more contacts and knowlage of the way the Irish system works. That said it's a bit easiler to get a place in GB but quite difficult in NI. The quality of training is much the same just that it is more geared towards the NHS.

The issue with Ireland at present is that NCHD jobs have changed dramatically this year. The present CEO of the HSE has a stated policy of stopping all GP's state contracts and replacing them with a tender process. This is considered absolute nonsense by every GP I know BTW. It's also make it near impossible to run a practice with any semblance of long term planning.

@Susie Just because posters do not agree with your rose tinted vision of the Irish healthcare system does not mean they are in it for the wrong reasons

docbroc

Susie-O- wrote: »

This has gotten ridiculous! Bluewall, I'm sorry you're getting such negative responses! I could tell you at least twenty registrars to talk to who are really positive about their current jobs, and their future careers, and I'm not exaggerating at all - send me a PM if you'd like me to tell you all about the RCSI meeting I was at and exactly what was said.

as far as I can see here, all your getting is doom and gloom from people who don't seem to be in medicine for the right reasons anyway....

It's really wrong and unfair to make the profession seem so terrible to someone who is clearly very interested in this as a career. The bottom line is, nobody knows how things would be by the time bluewall is finished internship. So stop being such miserable gits!

All i can tell you is that I have been 10 years working in the Irish system (apart from a brief fling with the NHS). If you want a real picture of Irish Doctors I'd suggest you attend an IMO meeting instead. I think you would find it extremely informative. I don't think its anyone's intention to do anything other than warn about the all too harsh realities of life in medicine. If I was starting where you are starting today I would not do it over again. I lost a goodly part of my youth to medicine and what I have in return is bugger all. Dont get me wrong, i used to love what I did but the endless work, the total destruction of my personal life, the bullying and hypocrisy - they just kill you. At the end of the day I dont want to let other people down that path without at least the courtesy of a warning. Over the last two years things have seriously deteriorated in Irish hospitals and they are getting worse (Not that they were great to start with). Everyone I know is desperate to get out. I sincerely hope things are different for you Susie but I really doubt it.

PS If you could send me the names of these Registrars I'd be grateful . I have some magic beans to sell

Jane5

Susie
Use your head, love. If you got the points for medicine, I'm sure you can work this one out.

RCSI are privately run to the best of my knowledge. Hence, like all private organisations, they like money. If you want to do a course in RCSI, such as medicine, or pharmacy, it costs the big bucks. If you want to be a surgeon after you finish med school, you pay 3000 euros a year, for three years, just for the SHO part of the training. This is besides all the "mandatory" courses that they make you do and charge you for. The training is you, in a hospital somewhere else, for 100 hours a week, working hours you aren't always paid for, holding retractors and covering A&E for days on end.

So every bright eyed youngster they manage to convert into a surgical SHO makes them a minimum of 9000 euros.

Are you surprised then that they are all positive and upbeat about it all? And all "hey, gang, do it in Ireland!"?

HQvhs

Jane5 wrote: »

Susie
Use your head, love. If you got the points for medicine, I'm sure you can work this one out.

RCSI are privately run to the best of my knowledge. Hence, like all private organisations, they like money. If you want to do a course in RCSI, such as medicine, or pharmacy, it costs the big bucks. If you want to be a surgeon after you finish med school, you pay 3000 euros a year, for three years, just for the SHO part of the training. This is besides all the "mandatory" courses that they make you do and charge you for. The training is you, in a hospital somewhere else, for 100 hours a week, working hours you aren't always paid for, holding retractors and covering A&E for days on end.

So every bright eyed youngster they manage to convert into a surgical SHO makes them a minimum of 9000 euros.

Are you surprised then that they are all positive and upbeat about it all? And all "hey, gang, do it in Ireland!"?

RCSI operates under the free fees scheme, although it is a private college and does not receive state funding.

I was at a similar event to the poster above regarding careers. They didn't paint a very pretty picture of Ireland or the UK. In fact the US and Australia were the most highly recommended.

I don't claim to know many doctors, but the vast majority of those I know spent at least some time training abroad. So I can only imagine that training abroad is beneficial to your career. In my opinion I think that having to go abroad at some point is an inevitability if you want to progress in medicine. Although I could well be wrong!

Susie-O-

Let me clarify, the registrars I spoke to did not go to RCSI, were affiliated to UCD/Trinity, and their associated hospitals, and please, PLEASE don't be so patronising as to call me 'love'. Just because I'm still a student and not jaded and a pessimist doesn't mean you can all rain on my (and all other positive medics who enjoy what they do) parades. I've never seen such negativity! You have one of the greatest jobs ever and all you want to do is whine about it, and stop people who may actually have a vocation for it!

dissed doc

Susie-O- wrote: »

Let me clarify, the registrars I spoke to did not go to RCSI, were affiliated to UCD/Trinity, and their associated hospitals, and please, PLEASE don't be so patronising as to call me 'love'. Just because I'm still a student and not jaded and a pessimist doesn't mean you can all rain on my (and all other positive medics who enjoy what they do) parades. I've never seen such negativity! You have one of the greatest jobs ever and all you want to do is whine about it, and stop people who may actually have a vocation for it!

Vocations are for the samaritans and the priesthood, not for medicine. As a physician, you are meant to always advocate for your patients (ignored when the trolley crisis was described years ago, when suicides were increasing), to always be enhancing your knowledge (but training grant cancelled), to always be pushing for better and better care (as more and more funding is cut for services).

Any of the docs here who have been out in the Irish system for > 5 years know exactly that the system in place and that the opposite is happening. If you are an uncritical thinker, with a "vocation", perhaps you are the ideal punching bag for HSE management. They don't like people who step out of line and think for themselves or demand better for their patients. They want committee-driven tick-box doctors.

As regards specialities: as we are trailing the UK by 10-15 years, it's likely that GP is the best one to get into, and fully private at that. GMS is as good as buried. Per-service and numbers based systems in the UK are workign well. I know of several new GPs who have not bothered with "vocational training" (there is that word again) or GMS, and seem to be doing a lot better, happier patients, and better working life in fully private services.

Susie-O-

dissed doc wrote: »

Vocations are for the samaritans and the priesthood, not for medicine.

Haha, that just proves my point.

Vocation
–noun
1.
a particular occupation, business, or profession; calling.
2.
a strong impulse or inclination to follow a particular activity or career.
3.
a divine call to God's service or to the Christian life.
4.
a function or station in life to which one is called by God: the religious vocation; the vocation of marriage.


So you were half right. But medicine is definitely something that you need to have a calling for, no? And I wonder about all of you who are bitching about the length of time it takes to get to consultancy! so what? You're still a doctor, being paid pretty damn well (admittedly not as well as in times past), doing something you should enjoy and find rewarding. Please stop the attacking, I'm as entitled to my opinion as everyone else.

docbroc

Maybe your right. We should focus on the positives.

The HSE Benefits scheme

Weight loss - Constant stress plus no lunch breaks: The HSE diet
Savings - Working all day everyday with no time off : save a fortune
Divorce - Not a problem when your significant other dumps you as your sent to work in ballybog for a year
Easy access to prescription anti-depressants : Boy will you need them !
Stress- free holidays : plowing through stacks of paperwork for free
Increase your skills - do nurses jobs for them so they can work 35 hours a week
Travel the world as your forced to emigrate

The list goes on .............

sam34

Susie-O- wrote: »

and please, PLEASE don't be so patronising as to call me 'love'

likewise, please dont be so rude as to call those who are telling the (unpalatable) truth "miserable gits"

Susie-O- wrote: »

So stop being such miserable gits!

Jane5

well Susie, won't be calling you love anymore!

Since you seem to feel that us trying to warn you about what you've gotten into makes us "miserable gits", well ,allow me to warn you, you are about to get your ass handed to you in your intern year!

You actually have no idea what's waiting for you do you? Have you actually even ever been awake for 37 hours straight? Let alone worked in a stressful environment with sick and dying people for that long-with NO sleep or meal breaks? Or worked with the winter vomiting bug-yes, despite being infectious, you are required to attend work, many collapsed and were hooked up to an IV-and people brought them scripts to sign while on a trolley!

Have you ever gotten a needlestick from a cardiac arrest while in the middle of a 56 hour weekend with no sleep allowed? And waited 30 hours to hear their HIV status? I have. It's scary. You have to keep working though, as though nothing had happened. No-one gives a crap.

Now you may not want to believe these things that we are telling you, but they're true. Don't trot out that vocation crap, people who tell you your job is a vocation usually mean that they want you to do a lot of it for free, under crappy circumstances, because it's "a calling", and not, you know, a job, which is subject to employment legislation and therefore has limitations on how crap you can treat your employees. Bull****. No angel Gabriel came to me in the night telling me it was my sweet sacred path to become a doctor. I did it because I thought it might be interesting, and secure employment-one of those assumptions was wrong, and the interest has not been worth what I had to give up for it.

Honey, do yourself a favour, come back here after your intern year. Stop making a fool of yourself pontificating about things you have not experienced and know nothing about.

Jane5

Oh, and as for being paid so "damn well", I am making much less than if I had just become a teacher, I would have been way further up that payscale by now. And as I have no job security, my low pay is FA comfort. Not even a good mortgage risk.

ergo

interesting thread, and some very helpful replies posted by many different people with lots of varied experience of both the Irish system and abroad in different specialties - so to OP and Susie and anyone reading - ye are very lucky to have this insight

re the original question - I think it depends what you want to do and would you be happy to live in the UK forever? I don't think going to the UK will mean you won't be able to get back into the Irish system at junior doctor level - selection processes are becoming more transparent and all EU (?and more) are treated equally as far as I know

then again, what specialty you decide you want to do will probably determine whether or not you'll ever be able to live in Ireland ie. get a permanent job or have to look elsewhere - if it's something like Psychiatry or possibly Anasethetics there might be jobs but on the other extreme for something like Urology I suspect there are very few jobs. And then for GP apparently there's a big shortage of GP's, we have the among the lowest ratio of GP's to patients in the EU but there is no work right now for GP's because practices can't afford to take on new young GP's and all the uncertainty with cuts in funding and private patients attendences greatly reduced

last night I was out and I bumped into an old classmate of mine, she's about to complete her medical Spr scheme next year - really worried about the lack of consultant jobs coming up. Four years ago I rotated through the same specialty and worked for a fantastic spr who was just in her final year of training - I asked my friend if that Spr had gotten a (consultant) job yet - no she hadn't - 4 years later. I've heard of fully qualified spr's working shifts as locum intern to pay the bills. These are the realities at the end of a long career training pathway, the path you're about to start on. We're not being miserable for pointing this out

RobFowl

Susie-O- wrote: »

You're still a doctor, being paid pretty damn well (admittedly not as well as in times past), doing something you should enjoy and find rewarding. Please stop the attacking, I'm as entitled to my opinion as everyone else.

Hi Susie-O
I'm a bit long in the tooth so bear with me. I qualified in the early 90's from a class of 120. 7 of these are now consultants in Ireland. A similar number have left medicine.
I was one of the last who got paid full rates for the first 40 hours, 1/2 time for the next 32 and nothing after that. My worst experience was an 84 hour shift with 3-4 hours sleep in total.
Things improved after this largely due to a boards poster DrZ.
Unfortunately things are going backwards. The mater have announced they will not pay "unrostered overtime" except for transplants or "national emergencies". Believe me if you work there you will do alot of unrostered overtime. Training has been cut back with no funded training outside that provided by the HSE directly.
Every new consultant position will be provided at the expense of an existing NCHD one so for every new Consultant there will be one less job for students graduating to apply for (and they are increasing the number of graduates).
Don't get me wrong I'm a GP and I love my job. But the HSE is a nightmare to to work for. They view Doctors as "vested interests" and see us as a threat rather than a resource.
I would probably do medicine again but I would not be working in the Irish system if I knew then what I know now.
I'm sorry to be negative but the present system literally stinks at almost every level. Patients are great but the hierarchy is rotten. The HSE is a mess. Leadership from Doctors professional bodies is patchy. Training is poor compared to other countries in most specialities (thats being kind BTW). GP training is quite good but hard to access and once trained the job prospects are limited.
By all means go forward and hopefully prove all us naysayers wrong but do listen to all opinions and look at all the evidence (good and bad).

studentdoc

Susie-O- wrote: »

Best of luck with the GAMSAT, i hope it goes well! I'm currently a 5th (of 6) year medical student here in Ireland, and I was recently at a 'So you want to be a Surgeon' talk in RCSI. Almost all of the SpRs from a wide variety of specialties said that doing your training here gives you a huge advantage when it comes to getting jobs/promotions - and also, which might be of help in you making your choice, there are a lot of consultants, both surgeons and physicians, who will be retiring in the next 10-15 years, thus opening up a lot of places for trainees...and several higher training schemes will be offering more places over the next few years to fill these gaps. There will also be more new consultancy posts! The short answer is, as far as I can gather, if you train here, you'll probably get work here, and can also go back to the UK, but if you train in the UK, you'll need to be damn impressive to get back here before SpR level! Hope that helps!

Susie-O- Im a final med who was also at this RCSI-Surgeon talk. The overwhelming theme that I got from all SpRs who spoke that night was of the "bottle-neck" at the end of training trying to get onto SpR schemes and trying to make consultant.
We were repeatedly told that night that though training in Ireland is excellent job prospects are not! We were told to expect to go abroad and stay abroad for quite a long time at the end of your training and especially while awaiting consultant posts which are few and far between. The reality as we were told that night is that many go abroad and do not get the opportunity to return ever!
It is not enough to be optimistic because you enjoy what you do! I love what I do, Im a graduate who came back to do medicine with a massive loan on my head because of it! But that does not take away from the fact that the truth of the matter for irish doctors is dismal working conditions, poor career prospects, and overall a really awful place to try and practice medicine!!
I would not advise anyone to do medicine without having all the facts at their disposal! And it is unfair to anyone to tell them that the other posters here are painting a negative picture! they are painting the truth.Your rosy spectacles are not accurate!

bluewall

The reason for starting this thread, aside from looking for people's opinions on the differences between medical training in Ireland and the UK based on their experiences, was to ultimately see if those opinions given could help me make a more informed decision about my future in medicine beyond medical school. My only real goals from such a career (beyond the obvious altruistic reasons why most people get into medicine) like everyone else I'm sure; is to have a good quality of life and to earn a good living. Based on what people are saying in this thread maybe you could call me naive for wanting such things, but again this is why I started this thread in the first place - to find out about these things!

With the plethora of unsatisfied, disgruntled and clearly disillusioned doctors out there how has there not been some sort of a more recent uprising against the HSE? It quite honestly sounds like a better idea to be a bin man rather than work in the current Irish hospital system (going by this thread).

Jane5, with such a depressing outlook where is the light at the end of the tunnel for you and how do you intend on getting to it? If all of your colleagues are in similar positions, is the only real alternative to leave the country and if that is the case is the quality of life really that much better elsewhere?

dissed doc

bluewall wrote: »

The reason for starting this thread, aside from looking for people's opinions on the differences between medical training in Ireland and the UK based on their experiences, was to ultimately see if those opinions given could help me make a more informed decision about my future in medicine beyond medical school.

I think your thread was essential, as many med students are at a young age (I know I was) and only see forward to the next exam, with little understanding of long term objectives. The older Americans in the class usually have much more forward thinking, but they are typically coming into college here from the age of 22-23 or even older.

There is no uprising because by and large doctors do not respect each other and instead are lead to competing with each other to prevent any large unionised presence. Doctors are generally above average IQ and earning power. If they all ganged together, most governments would be ****ed as you can't buy off people who actually work based on principals and morals and not looking for bailouts.

Sorry for going off in a tangent - there is a point. The antitrust issues in the US prevent most doctors for literally "ganging up" and dictaing health policy. Most of the US movements in health care (including the current changes proposed by Obama) are geared towards non-medical areas extractign as much money from out between doctor and patient. The result is competition, and separation of identity and ultimately control as incomes can rise and fall each year.

In Europe, countries with strong doctors union tend to have the "good" healthcare systems - Germany, netherlands, France, etc., . In ireland, we are a derivative of the US system, and becoming even more so.. The result will be no uprising, but simply open competition: GPs are now allowed advertise for services - this was illegal until the recent Medical Practitioners Act. Thhere will be no "godlike" consultant in 10 years, save for a few academic positions. It will be entirely private and kill or be killed. This does not make for a pleasant work environment, when your colleagues are lookign for you to make a mistake and vice versa.

So far, many non-Dublin hospitals have been struggling to staff their rotas. There is no uprising because it's not in Irish culture to do it: the people who would uprise, uprise themselves onto a Ryanair flight to the UK, or elsewhere.

straight_As

Guys, thank you so much for this thread.

I'm doing the Leaving Cert atm, and I want(ed?) to do med.

But after reading this, holy fuck. I mean, I love the idea of the job, and I think the career would be unbelievably interesting, but I'm really starting to wonder about whether or not it is actually worth it.

I know that sounds selfish. But I have to be. I don't think I'd have the stomach to work in this system. I wouldn't be able to help patients if I was without sleep for 3 days. I don't think I could do it. I'd make mistakes. Patients would suffer. How could I argue myself as working for the patient if I accepted abject conditions which endangered the patient. It terrifies me.

Aswell, I want to have a family, a life. The opportunity to travel(?) sounds ok for the first few years, but I mean, after that? How could I possibly ask a partner to just pack up their career and move abroad just because I need to train. Is it possible to have a family, and more importantly, be part of your family, i.e., see your kids grow up, have time to love people?

This thread has screwed me up. I could pretend and say, 'oh this makes me want it more', but that would be bull. I've never been so confused.

That puts my last five years' dreams into perspective.

ergo

straight_As wrote: »

I know that sounds selfish. But I have to be. I don't think I'd have the stomach to work in this system. I wouldn't be able to help patients if I was without sleep for 3 days. I don't think I could do it. I'd make mistakes. Patients would suffer. How could I argue myself as working for the patient if I accepted abject conditions which endangered the patient. It terrifies me.

.

don't let this one reason (long hours) be the main thing that puts you off. the EWTD should be fully enforced by time you come through so hopefully not working longer than 13 hours in a row......hopefully.... Or go to AUS for a 40 hour week. for info google EWTD or search boards - I have to run to work!

tallaght01

straight_As wrote: »

Guys, thank you so much for this thread.

I'm doing the Leaving Cert atm, and I want(ed?) to do med.

But after reading this, holy fuck. I mean, I love the idea of the job, and I think the career would be unbelievably interesting, but I'm really starting to wonder about whether or not it is actually worth it.

I know that sounds selfish. But I have to be. I don't think I'd have the stomach to work in this system. I wouldn't be able to help patients if I was without sleep for 3 days. I don't think I could do it. I'd make mistakes. Patients would suffer. How could I argue myself as working for the patient if I accepted abject conditions which endangered the patient. It terrifies me.

Aswell, I want to have a family, a life. The opportunity to travel(?) sounds ok for the first few years, but I mean, after that? How could I possibly ask a partner to just pack up their career and move abroad just because I need to train. Is it possible to have a family, and more importantly, be part of your family, i.e., see your kids grow up, have time to love people?

This thread has screwed me up. I could pretend and say, 'oh this makes me want it more', but that would be bull. I've never been so confused.

That puts my last five years' dreams into perspective.

By the time you qualify, the hours will be better, but the conditions probably won't. BUt if you go straight in from school, you'll be competing for top jobs against GAMSAT graduates, who generally aren't as good as those who do the straight undergrad.

So, I think the picture may be a BIT better by the time you would be working.

docbroc

ergo wrote: »

don't let this one reason (long hours) be the main thing that puts you off. the EWTD should be fully enforced by time you come through so hopefully not working longer than 13 hours in a row......hopefully.... Or go to AUS for a 40 hour week. for info google EWTD or search boards - I have to run to work!

Nonsense. My current intern started medical school in 2005 - the year the Working Time Directive came into force. 5 years later and she did over a hundred hours last week (under duress - not from me and was paid for 48 of them. The HSE has conspired with the IMO to re-brand working time "study time". Thus if you work 80 hours a week - only 48 hours of it is actually work - the rest of it is training. Any difference ? Nope but it means that once again employment legislation doesnt apply to us. Thanks IMO - I dont remember voting on that ? When you graduate in 5 years working conditions will almost certainly be worse. The Irish are far to incompetent to run any large organisation be it government or health service. The EWTD has been ignored for 5 years , it will be ignored in another 5 years. The average working hours have gone up significantly for some sectors too - particularly SHOs who are forced to cover to absent interns ( for no money). Its a short leap until the HSE re-brands study time as free time and then I doubt we will even get the 8 hours overtime we do now.

tallaght01

docbroc wrote: »

. My current intern started medical school in 2005 - the year the Working Time Directive came into force. 5 years later and she did over a hundred hours last week (under duress - not from me and was paid for 48 of them. The HSE has conspired with the IMO to re-brand working time "study time". Thus if you work 80 hours a week - only 48 hours of it is actually work - the rest of it is training. Any difference ?

That's ****in disgusting, but I figured they'd get around the EWTD somehow. HSE are just scumbags.

Svalbard

I'm starting to get worried that this thread is turning people off medicine, so here's the positive spin on what has been said so far - medicine is a great career, just not in Ireland. To the OP, it doesn't really matter if you do your undergrad in Ireland or UK, so go with personal choice. But if you do study medicine be prepared to emigrate as soon as you graduate, then you will be better off.

tallaght01

Svalbard wrote: »

I'm starting to get worried that this thread is turning people off medicine, so here's the positive spin on what has been said so far - medicine is a great career, just not in Ireland. To the OP, it doesn't really matter if you do your undergrad in Ireland or UK, so go with personal choice. But if you do study medicine be prepared to emigrate as soon as you graduate, then you will be better off.

I LOVE my job (I do public health) but wouldn't work in Ireland. When I come home it will be with a view to working outside the HSE with an aid agency or Irish aid.

I do have a great job though

sam34

Svalbard wrote: »

I'm starting to get worried that this thread is turning people off medicine...

i may be partly responsible for that, so let me qualify what i have said on this and other threads...

yes, the conditions here are crap, and are likely to get worse

yes, the HSE treats us as if we are scum of the earth and not worth their while bothering with

but........

notwithstanding all that, i love my job. when you cut out the crap, the bureaucracy, the sh*te conditions, you get to the core clinical work, which i adore.

given the chance, and knowing what i know now, i would still do it all over again in a heartbeat.

RobFowl

Svalbard wrote: »

I'm starting to get worried that this thread is turning people off medicine, so here's the positive spin on what has been said so far - medicine is a great career, just not in Ireland.

I agree completely. I'm a GP in Ireland but if I was free to move abroad now I would. The HSE and the DOH seem at war with doctors in particular and terms and conditions are getting worse and worse.
As a career though medicine is fabulous, satisfying and challanging BUT Ireland is not a good place to work at the moment and probably for the next 5 years at least.

DrIndy

I do like being a doctor. I like to joke with my patients, settle their fears and see that through all their worries and pain - I can still make them laugh.

I like interacting with families and also being my patients advocate is getting them treated quickly and effectively and stand up for them against other teams and staff if needed.

I love the pace, the excitement of getting to the bottom of things and making people better.

However, medicine is not about sunshine, lollipops and rose-scented-farts. Its a grind, its awful and stressful sometimes and its is not good to be a doctor in ireland right now. Lets face it - it was NEVER good to be a doctor in ireland - but the salary and overtime compensated this somewhat.

Irish doctors are internationally sought because we have a very high academic standard and a very strong work ethic which makes other countries favour us to work there.

I'm staying on in Oz and watching closely what is happening. I hope it improves or I won't be back.

Psychedelia

thank god for the last page of this thread!

at least there is something good to be found!!

I'm in leaving cert and possibly naively want to do medicine.
the prospect is however becoming scarier everyday as accounts of reality accumulate.
i'd love to go abroad to do medicine but i didn't get accepted for UK and going to the continent would involve gaining fluency in another language which would take how many years?!

so after completing your six years in college, is it possible to escape somehow???