[IT article] Junior doctor 'unable to work on call due to poor English'

Vorsprung

A JUNIOR doctor working at Our Lady of Lourdes Hospital in Drogheda has such a poor command of the English language he is unable to work on call, according to internal correspondence.

The doctor is one of nine junior doctors working in the hospital’s anaesthetics department, which is severely understaffed after management was unable to fill all 14 anaesthetic NCHD (non-consultant hospital doctor or junior doctor) posts on offer earlier this summer.

The head of the hospital’s anaesthetics department, Dr Michael Staunton, in a letter to the clinical director of Louth Meath Hospitals Dr Dominic O’Brannagain in the past month, said that despite being on the medical council’s specialist register in his home country and Ireland, the doctor “is unable to work on call because of extremely poor English”.

Asked how the doctor worked at any other time of day if his English was so poor, the HSE issued a general statement. It said that in recent weeks it proposed to the council that a language competency test be given to all doctors seeking to work in Ireland. At present, the test applies to only non-EU doctors, but not doctors coming into the country from eastern Europe.

Earlier yesterday the council, as it launched its annual report, said it was “extremely concerned” about doctors from other EU countries working in Ireland who may not have the right language or clinical skills to do their jobs effectively.

The council has written to the Department of Health in recent weeks as part of a lobbying campaign aimed at amending EU law to enable closer scrutiny of doctors coming from other EU states.

Dr Staunton’s letter, which has been seen by The Irish Times, said that of the nine out of 14 NCHD posts in anaesthesia which the Lourdes hospital had managed to fill, four “require extremely close supervision and support”.

One of these is the doctor with extremely poor English and two of the others have “minimal experience with epidural anaesthesia”. Epidurals would be required regularly at the maternity hospital.

The hospital is not unique in having a shortage of junior doctors. Several hospitals have been affected this summer but Dr Staunton warned the present level of anaesthetic cover at his hospital “is highly unsafe for patients and staff”.

He said part of the reason for the shortage was excessive workload, cuts in the pay of junior doctors, changes in visa regulations, a reduction in the number of recognised training posts and an increase in the pass mark for the International English Language Testing exam.

Junior doctors rotate positions every six months. The junior doctors working in anaesthesia in Drogheda have six-month contracts which expire at the end of this year. They are needed to fill round-the-clock rosters.

The latest symptom of the the system which has alienated our own graduates from a) working in specialities working in ED, anaesthetics, surgery and b) in our own country.

On a lateral note, it doesn't bode particularly well for the HSE's plans to move surgical services to Drogheda if they have less than 2/3 of the NCHD anaesthetic complement.

frodi

This is the case for all medical professionals. Once you are an EU national and registered in the EU then the Irish equivalent has to recognise your qualification.

While the regulatory bodies cannot discriminate on the basis of language skills surely employers can do so on patient safety grounds as well as general health and safety of other staff.

Vorsprung

I think ethically you can run into a lot of problems as well - anaesthetists talk to patients before procedures, explaining the risks of the anaesthetics, as well as consenting them for any special procedures (eg epidurals, central line insertion, etc). If the doctor cannot communicate well the risks involved, I'd argue that any consent obtained is not informed consent. As such, I'd have a problem with them continuing in that position.

frodi

Would there be a case that a doctor would be acting unprofessionally by carrying out a procedure that the patient cannot give full unreserved consent to as they may not have understood properly.

Also in an emergency/urgent situation is patient care put at risk by any delay in having direction/instructions put thro an interpretor first.

How much does it cost to have a medical interpretor present 40 hours per week. (assuming that docs work a 40 hour week. )

Traumadoc

It is going to get a lot worse, - I wonder do the medical council know what the new rules are doing- hospitals will close in January and its not the obvious ones.

NUTLEY BOY

I am confused and probably a bit out of date.

The legal authority to practice medicine in Ireland is your registration on the Medical Council's register.

I thought that doctors seeking to go on the Irish register had to take an English language examination before registration if English was not their first language. Is this right or wrong ?

RobFowl

NUTLEY BOY wrote: »

I am confused and probably a bit out of date.

The legal authority to practice medicine in Ireland is your registration on the Medical Council's register.

I thought that doctors seeking to go on the Irish register had to take an English language examination before registration if English was not their first language. Is this right or wrong ?

Unfortunately if the doctor comes from an EU member state then they do not have to do the English exam. It's pretty disgraceful TBH and the Irish and British medical councils are making representations to made proficiency in English mandatory for EU graduates as well.

Traumadoc

Yes its a bit daft, In the UK (possibly here too) Austrlians, Kiwis and yank doctors have to do a very expensive english language test, while EU doctors (germans etc)do not.