Doctors may face two years' work in public hospitals

Ihaveanopinion

From today's irish times

http://www.irishtimes.com/newspaper/ireland/2011/0627/1224299634188.html#.TgipZk0_MYc.facebook

Looks like indentured servitude may be coming in for future medical graduates

dissed doc

Ihaveanopinion wrote: »

From today's irish times

http://www.irishtimes.com/newspaper/ireland/2011/0627/1224299634188.html#.TgipZk0_MYc.facebook

Looks like indentured servitude may be coming in for future medical graduates

Super idea. Instead of icnreasing the number of specialists (who's Irish salaries are currently rank around the middle in the EU) and providing a properly staffed service, retain people who are trainees and not qualified to deliver healthcare independently, and give them no supervision.

We might be short of trainees, but we are massively short of the specialists/attendings/consultants that deliver the actual healthcare as in the US/UK/Germany/France/Netherlands, etc.,.

bleg

Isn't this just kicking the can down the road? Double the amount of interns... some fun training all those up.

sparks24

where do most newly qualified doctors from ireland go anyway?

Ihaveanopinion

the news stories will tell you that all newly qualified doctors high-tail it down under. The reality is that they don't. While some do go abroad, most go for a year and then return. There might be 450 interns every year - or whatever the number is - but there are far more SHO/Registrar jobs. An awful lot of them are non-training posts, that dont benefit a 'doctor-in-training' in anyway.

Those jobs are typically, but not always, in out of the way places that most people are not thrilled to go to.

Basically, the interns become SHOs and there are far more SHO jobs than interns - interns go for training jobs and have no interest in non-training jobs - rightly so

drzhivago

This is a very tricky area in the first instance matching supply and demand at multiple levels of the recruitment chain in the Irish Health service

First
(production of medical students) versus demand for intern places - Historically there has always been an oversupply of medical students and we have trained graduates to emigrate (as fowl can attest from our own experiences) - IRISH SOLUTION - DOUBLE the number of medical students to subsidise the health services of UK/USA and Australia

Second

Only in recent years has SHO grade been a proper training grade (when fowl and I were at this level there were 8 Surgical SHO posts in Dublin on training scheme per year) thus large numbers emigrated at this level to get into training posts in good institutions abroad with realistic chances of promotion - IRISH SOLUTION - convert every SHO post to a nominal "training post" and rotate people through Naas/wexford/bantry/roscommon etc (Choice Roscommon versus Prince Alfred Australia, MAss Genral in Boston or Kings and Tommys in London HMMM, what a choice)

THird

Maintain a registrar grade (Non training post in ALL CASES when I was a registrar- changed a little now) when your near neighbour has abandoned registrar in favour of Specialist Registrar or now Specialty registrar posts where all are credited for training IRISH SOLUTION - convert Registrar posts nominally into "training posts" to overcome the difficulty of recruiting overseas NCHDS on temporary registration -- SEE CHOICE for SHO posts

Fourth

Reduce Working week - theoretically need more working doctors to cover same hours rpimarily should be specialists to provide the service a la Hanley report et al IRISH SOLUTION - create a lot more non training service posts and begin overseas recruitment -- Every time there is a shortage look overseas and try to con (sorry recruit) overseas doctors to come here fro the wonderful working conditions!!!! and training!!

Fifth

Reduce working hours to improve working conditions - IRISH SOLUTION - reduce hours on paper, maintain ludicrously long hours on reduced salary and dont pay overtime - CHOICE - Move to australia with very short working hours, be paid for all hours worked, get trained with realistic prospect of employment at end of training program on decent money HMMMMM

Sixth

Reduce working hours to improve working conditions -IRISH SOLUTION Colleges respond by saying training duration must Increase - CHOICE - Remain in ireland with all hurdles for an Irish Doctor to navigate (not to mention what non national doctor must face) and spend 12-15 years rotating around country away from your family in penury (have to pay own accommodation costs in second site if family dont move lock stock and barrel for each rotation) OR Go to UK to work in large centres, remain within small region and be in specialist post in less than 10 years or go to US be absolutely penniless but a specialist within 5 years HMMMM

While I agree with the concept of having to give something back to the system I feel there must be some give and take here and at the moment I dont see where the give is and how it will benefit someone to spend 2 years in solitary confinement in Bantry, Kerry, Donegal or the North East unless working conditions and training dramatically improves

NCHD Average duration to become consultant if stay in Ireland 12-17 years

Numbers graduating medical School per year now 600 ( In my time 305)

If all stayed in System the we should have Min 12*305 Irish NCHDS Max 17*600 - I know oversimplistic but the fact is that the problem of large numbers of Irish grads leaving the country has not been addressed because so many NON Eu trained doctors have come here historically, as that migration has slowed the deficits have arisen, they are not coming because the options are better for them elsewhere

It Would be good if the informed readers here could come up with some suggestions for HSE Minister Department of HEalth in Bullet format regarding recruitment and retention of Irish graduates and also recruitment and retention of overseas graduates to improve the current situation
Fly by night recruitment trips to India or PAkistan are a waste of time if the bodies going on these trips dont even understand the limitations that apply such as

1- The doctors will have to undergo Garda Clearance which will take 4-5 months when they are overseas
2- The doctors will have to have documentation checked/verified by Irish Medical Council - Also takes 3-4 months when overseas and longer around this time every year
3 - These doctors will have to sit PRES exam ( we all have to sit USMLE when going to US as would they so I am unsure why the government are creating emergency legislation or loopholes to avoid this ) - But exam rarely held, only held here and very costly for someone on a low income with no sponsorship for this in advance



Come on boardsies where are your suggestions

dissed doc

1. Reduce number of medical school places
2. Triple the number of consultant posts and double the salary, with a 4 day work week
3. Convert bits and peices of jobs to 5 year direct training posts and each one numbered and allocated to a consultant post.

Assuming of course, there is to be a state system, which there isn't, because it didn't work in the UK, NL, DE or other countries.

We have plenty of graduates, but no long term benefits for them to stay and work as specialists. This is the opposite to many other countries, which do a lot to attract trained specilaists.