Suggestions for a Final year Med Student

nerrad01

Hi guys, just wondered what your opinion would be for a final year med student, if you had the chance to do it all again??

I'm obviously concerned about the state of the health system in terms of pay, hours and working conditions etc.

If you had the chance would you abandon ship and leave after intern year, or even sooner and try do your intern year in somewhere like australia or NZ (im not sure if this is even possible)

Im a grad med student so i have a hefty bank loan to think about paying back too....just wondered what suggestions people would have for a slightly less stressful working life than what is on offer in ireland with the current health system!

Thanks!

Just Like Heaven

http://www.boards.ie/vbulletin/showthread.php?t=2056670939

I wouldn't even do my internship here.

nerrad01

well that thread made for some truly depressing reading, has anybody on here completed their internship overseas and have any advice?

The HSE is essentially forcing new grads to emigrate, it also makes me sick thinking about the working conditions current doctors are living through.

Ryder

You would be crazy to pack it all in now. Intern life isnt so bad, and you get used to the hours. For all the hours and menial tasks, I enjoyed intern year - where else would you get to spend a year working with classmates, going out etc. Very good support and cameraderie. If you like the job, you will tolerate it. If not, then its best to go.

Pay is fluid. Consultant pay is still good as is GP. Tough economic times at present, but hopefully wont last forever.

Best advice is to find a senior doctor (registrar) next year, hopefully in the area you want to specialise in, and use him/her as a mentor. Thats all I would have done differently. A bit of advice and experience will make all choices a lot easier, and

SleepDoc

nerrad01 wrote: »

Hi guys, just wondered what your opinion would be for a final year med student, if you had the chance to do it all again??

I'm obviously concerned about the state of the health system in terms of pay, hours and working conditions etc.

If you had the chance would you abandon ship and leave after intern year, or even sooner and try do your intern year in somewhere like australia or NZ (im not sure if this is even possible)

Im a grad med student so i have a hefty bank loan to think about paying back too....just wondered what suggestions people would have for a slightly less stressful working life than what is on offer in ireland with the current health system!

Thanks!

I'd do my internship in Ireland. It's a cr@p but social year. Then leave. Australia, NZ, UK, wherever. Training, pay and conditions are far better elsewhere.

his_dudeness

Unfortunately, the state of play is that there are now just too many Irish/EU graduates from the Irish medical schools for the Intern posts available. So staying for the Intern year isnt even a guarantee anymore. Theres a deficit of about 80 places, and that's before Non-EU graduates from Irish Medical schools and Non-Irish-Medical-School graduates are taken in to account!

And moving on isn't so easy. as NZ, Oz all need Certs of Experience from an intern year before they'll properly entertain any applications.

Sorry to be the bearer of bad news.

Just Like Heaven

his_dudeness wrote: »

And moving on isn't so easy. as NZ, Oz all need Certs of Experience from an intern year before they'll properly entertain any applications.

What's the story with the US? Is it the same even if you have a strong USMLE score and have done electives in the states?

nerrad01

his_dudeness wrote: »

Unfortunately, the state of play is that there are now just too many Irish/EU graduates from the Irish medical schools for the Intern posts available. So staying for the Intern year isnt even a guarantee anymore. Theres a deficit of about 80 places, and that's before Non-EU graduates from Irish Medical schools and Non-Irish-Medical-School graduates are taken in to account!

And moving on isn't so easy. as NZ, Oz all need Certs of Experience from an intern year before they'll properly entertain any applications.

Sorry to be the bearer of bad news.

i thought every one eventually got an intern place after later rounds of matching?? hopefully my exam results will be strong enough that i dont have to worry about not getting a place.

Looks like staying for intern year is the safest bet and looking to move on after that! looks like it will be a long time before they sort this mess of a system out!

edit: its a good thing i actually hugely enjoy medicine or my decision to go back to do grad med would have been a big mistake! amazing how little the general public know about things!

nerrad01

fewtinsoffroth wrote: »

What's the story with the US? Is it the same even if you have a strong USMLE score and have done electives in the states?

from talking to the north americans on the course it still sounds extremely tough to get onto the residency programmes, i think its a lot easier to get into the like of surgery over here (if your willing to suffer the conditions)

ThatDrGuy

nerrad01 wrote: »

edit: its a good thing i actually hugely enjoy medicine or my decision to go back to do grad med would have been a big mistake! amazing how little the general public know about things!

You haven't done any medicine yet. That comes much later. First the psychological torture and secretarial duties. Then the social life assassination and sleep deprivation. Then the pocket bleeding and throat cutting. Then examination shake downs. Then the dot eat dog interviews. Then the soul destruction. Then the emigration. Then the medicine. Maybe.

nerrad01

ThatDrGuy wrote: »

You haven't done any medicine yet. That comes much later. First the psychological torture and secretarial duties. Then the social life assassination and sleep deprivation. Then the pocket bleeding and throat cutting. Then examination shake downs. Then the dot eat dog interviews. Then the soul destruction. Then the emigration. Then the medicine. Maybe.

i think i prefer to stay delusional for a while yet!

take everything

ThatDrGuy wrote: »

You haven't done any medicine yet. That comes much later. First the psychological torture and secretarial duties. Then the social life assassination and sleep deprivation. Then the pocket bleeding and throat cutting. Then examination shake downs. Then the dot eat dog interviews. Then the soul destruction. Then the emigration. Then the medicine. Maybe.

Made me smile.

his_dudeness

nerrad01 wrote: »

i thought every one eventually got an intern place after later rounds of matching?? hopefully my exam results will be strong enough that i dont have to worry about not getting a place.

Looks like staying for intern year is the safest bet and looking to move on after that! looks like it will be a long time before they sort this mess of a system out!

edit: its a good thing i actually hugely enjoy medicine or my decision to go back to do grad med would have been a big mistake! amazing how little the general public know about things!

Previously that was the case where everyone going through was assured of a place. I remember my own final med thinking "as long as I pass, I'll be ok..."

Unfortunately, the rise of GEMS has meant that the numbers graduating each year have increased year-on-year, while there has been little change in the actual number of post. Couple this with a (rightly so) more transparent application system that allows anyone apply (thus being EU employment law compatible) means that a squeeze is coming. They got through it by the skin of their teeth last summer but there are problems afoot this year, and will only get worse if more places aren't made available.

nerrad01

his_dudeness wrote: »

Previously that was the case where everyone going through was assured of a place. I remember my own final med thinking "as long as I pass, I'll be ok..."

Unfortunately, the rise of GEMS has meant that the numbers graduating each year have increased year-on-year, while there has been little change in the actual number of post. Couple this with a (rightly so) more transparent application system that allows anyone apply (thus being EU employment law compatible) means that a squeeze is coming. They got through it by the skin of their teeth last summer but there are problems afoot this year, and will only get worse if more places aren't made available.

it just gets better and better! from reading up on the paging doctor forum it seems near impossible to do your intern year in oz as an international student now, due to what they are calling the medical student tsunami over there. apparently university of queensland produces 500 grads a year now alone! :eek:

nerrad01

got an update from a friend in australia, that there is absolutely no chance of getting an intern spot over there, just incase any final years were wondering!

Agnieszka_88

The NZ graduates tend to leave for Australia after their intern year, so it's not that difficult to find a position as a junior doctor after doing your internship here. Australia is harder, they have enough of their own graduates.

Just Like Heaven

Dear oh dear.

Anybody know what it's like getting an F1 spot in the UK then?

ergo

nerrad01 wrote: »

it just gets better and better! from reading up on the paging doctor forum it seems near impossible to do your intern year in oz as an international student now, due to what they are calling the medical student tsunami over there. apparently university of queensland produces 500 grads a year now alone! :eek:

what about the irish medical student tsunami?

places for EU students have increased from 350 per annum (for years and years this was the cap) to 700 per annum and the fruits of this are now emerging

won't be long before we're all getting paid peanuts and scavenging around for jobs, that was Harney's dream and it's on track

Xeyn

ergo wrote: »

what about the irish medical student tsunami?

places for EU students have increased from 350 per annum (for years and years this was the cap) to 700 per annum and the fruits of this are now emerging

won't be long before we're all getting paid peanuts and scavenging around for jobs, that was Harney's dream and it's on track

We are very very short on numbers in this country. Getting more doctors is a necessity. Of course this needs to go hand in hand with more posts made available, but the bottom line is we are woefully understaffed. Poor training and career prospects mean a large percentage of doctors leave the country any way so producing more doctors may be a moot point in the end.

RobFowl

Xeyn wrote: »

We are very very short on numbers in this country. Getting more doctors is a necessity. Of course this needs to go hand in hand with more posts made available, but the bottom line is we are woefully understaffed. Poor training and career prospects mean a large percentage of doctors leave the country any way so producing more doctors may be a moot point in the end.

Arse about face, pretty sums up our future service needs planning.

Ryder

Xeyn wrote: »

We are very very short on numbers in this country. Getting more doctors is a necessity. Of course this needs to go hand in hand with more posts made available, but the bottom line is we are woefully understaffed. Poor training and career prospects mean a large percentage of doctors leave the country any way so producing more doctors may be a moot point in the end.

I think we have enough doctors. The problem is that we have a shortage of people to do jobs currently done by doctors...portering, form filling etc. The problem with training an excess of doctors is that there is a pyramidal system and if more junior jobs will just swell the base without changing the top...making it less attractive...and the cycle continues. HSE needs to take a step back (and the colleges) and redefine hospital roles

nerrad01

Ryder wrote: »

I think we have enough doctors. The problem is that we have a shortage of people to do jobs currently done by doctors...portering, form filling etc. The problem with training an excess of doctors is that there is a pyramidal system and if more junior jobs will just swell the base without changing the top...making it less attractive...and the cycle continues. HSE needs to take a step back (and the colleges) and redefine hospital roles

i know im going to go away once i can and a lot of the people i know plan on the same thing, why would you stay to be subjected to those conditions

Edible

Also in final year, the idea of there not being enough intern posts this year is slightly nauseating, especially since I'll have a massive graduate-entry loan
What would actually happen to the students who didn't get offered intern posts? are they completely f**ked or do you think they would automatically be bumped up the list for the following year, seeing as you can never work as an intern here if you're longer than two years out of college?
does anyone know of any other countries it would be possible to get an intern job or are they all in short supply?

also, anyone have any idea of the amount of extra graduates there will be this year compared to last year?

nerrad01

Edible wrote: »

Also in final year, the idea of there not being enough intern posts this year is slightly nauseating, especially since I'll have a massive graduate-entry loan
What would actually happen to the students who didn't get offered intern posts? are they completely f**ked or do you think they would automatically be bumped up the list for the following year, seeing as you can never work as an intern here if you're longer than two years out of college?
does anyone know of any other countries it would be possible to get an intern job or are they all in short supply?

also, anyone have any idea of the amount of extra graduates there will be this year compared to last year?

i know its extremely worrying, i think nz and aus would be out, maybe the nhs would be an option?? the repayments on the grad med loan are scary enough with an intern spot, the thoughts of no job dosent even bare thinking about!

his_dudeness

Edible wrote: »

Also in final year, the idea of there not being enough intern posts this year is slightly nauseating, especially since I'll have a massive graduate-entry loan
What would actually happen to the students who didn't get offered intern posts? are they completely f**ked or do you think they would automatically be bumped up the list for the following year, seeing as you can never work as an intern here if you're longer than two years out of college?
does anyone know of any other countries it would be possible to get an intern job or are they all in short supply?

also, anyone have any idea of the amount of extra graduates there will be this year compared to last year?

Unfortunately, if my understanding of it all is correct, you WON'T be bumped, but you will retain your centile score which you can bring to the following years application i.e. July 2014, as all you can do is hope that you'd rank better in that year than in your potentially unsuccessful 2013

None of this is helped by the fact that the HSE have now stopped allowing interns start an internship in January, which had been the case up until this Januray. There will only be single intakes in July from now forward.

There are approx 580 intern posts currently in Ireland.
There have been over 1100 applications for these posts
There is about 640 EU-graduates from Irish Medical Schools
There is about 40 EU-graduates from Non-Irish Medical Schools
There is about 210 non-EU graduates from Irish Medical Schools
There is about 60 non-EU graduates from Non-Irish Medical Schools.
(I use the term non-EU to mean those that require a work permit to work in Ireland. Anyone who requires a work permit is automatically ranked lower than those who do not, in keeping with EU law)

Graduates of the following countries are elligible to start an internship here in Ireland so it would probably be fair to say that Irish graduates would be elligble to apply to their programmess:
 Ireland  Lithuania
 Denmark  Malta
 Italy  Portugal
 Luxembourg  United Kingdom
 Poland  Norway
 Sweden

Agnieszka_88

his_dudeness wrote: »

Graduates of the following countries are elligible to start an internship here in Ireland so it would probably be fair to say that Irish graduates would be elligble to apply to their programmess:
 Ireland  Lithuania
 Denmark  Malta
 Italy  Portugal
 Luxembourg  United Kingdom
 Poland  Norway
 Sweden

You forgot Germany, Austria, France, Greece, Spain and all the other EU-countries. Basically, if you don't need a work permit for that country, you are theoretically eligible for an internship. I say theoretically because they might require language certificates and maybe some additional exams (Germany used to, it was supposedly illegal according to EU-law, so they shouldn't anymore, but who knows).

his_dudeness

Agnieszka_88 wrote: »

You forgot Germany, Austria, France, Greece, Spain and all the other EU-countries. Basically, if you don't need a work permit for that country, you are theoretically eligible for an internship. I say theoretically because they might require language certificates and maybe some additional exams (Germany used to, it was supposedly illegal according to EU-law, so they shouldn't anymore, but who knows).

No, I didn't forget them.

The medical degree awarded in Germany, France etc is felt to be sufficient to start work at an Irish-SHO-equivalent level.

The Irish Medical Degree, and those of the UK and the other countries listed, require a certificate of experience before you are fully "qualified" - a certificate which requires a successfully completed intern year.

To apply to work in Germany etc, you need to be able to show this certificate of experience.

In a vice-versa manner, German graduates etc are inelligible to apply for an internship in Ireland.

I am open to correction if someone with better german than me can decipher the last link.

http://ec.europa.eu/internal_market/qualifications/docs/guide/users_guide_en.pdf
http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2005:255:0022:0142:en:PDF
http://www.baek.de/page.asp?his=4.3575.9119

highcream

nerrad01 wrote: »

i know its extremely worrying, i think nz and aus would be out, maybe the nhs would be an option?? the repayments on the grad med loan are scary enough with an intern spot, the thoughts of no job dosent even bare thinking about!

from what iv been reading the US is a good option but there are tons and tons of hoops to jump through.I also believe its getting harder and harder for non US citizens to get in over there-except in non competitive specialties like family med.Id guess u could do that there and then come back and work as a GP in ireland,but it would be a long road

Agnieszka_88

The medical degree in Germany is awarded after six years, the last year is similar to the Irish internship. The main difference is that the final exams are written after this practical year, then and only then can you get the Approbation (become a certified doctor). You could try and apply through a German university (if you are fluent in German) to be taken into the programme as an exchange student for their practical year, which is basically the same as the intern year here, but I'm not sure if the HSE would recognize it. They should, as the European directive about equivalence of European medical degrees requires it, but it might be a long bureaucratic battle.
I've met two UK students that came to study/do the internship in Halle, just for the practical year, so it is possible, but I can't give you any details about how they managed to solve this whole bureaucratic mess.

As a final note, it is definitely a possible solution, but I don't know if it's really worth all that stress on top of everything.

Ryder

Perhaps naive, perhaps not, but I find it hard to see a scenarion where and EU graduate of an Irish medical school will be left in limbo next July. The medical schools/HSE have known about this - at least since last year. Potential scenarios include changing the curriculum to include that final certificate year and/or creating more spaces.....I dont KNOW, but I suspect that Irish graduates will be sorted in July

Vorsprung

Not even last year Ryder, the looming shortage of intern places was predicted more like 3-4 years ago (look up DrZhivago's posts on the subject).

It's another classic by the HSE, perhaps a move to drive wages down with the increased demand for places. But as with many of their plans, it's penny wise but pound foolish as we potentially lose many of these graduates to centres in other countries.e

RobFowl

Vorsprung wrote: »

Not even last year Ryder, the looming shortage of intern places was predicted more like 3-4 years ago (look up DrZhivago's posts on the subject).

It's another classic by the HSE, perhaps a move to drive wages down with the increased demand for places. But as with many of their plans, it's penny wise but pound foolish as we potentially lose many of these graduates to centres in other countries.e

And as of today the Troika have reported that we have too few "foreign" doctors here so things will presumably get worse if they stay around....

Ryder

My memory of working in Ireland is that we couldnt fill the NCHD posts.....so Im not sure where all the foreign doctors are. Also, are the current entry requirements too stringent?...I didnt think so

I agree that the expansion of medical places is designed to create a surplus and competition. Has it so far? Theres a lot more steps to create a specialist surplus, primarily reducing the hours and duration, as most people will filter into shorter or less competitive careers. Thats really why I think that the medical schools cant stand over a scenario where they are churning out partially trained doctors (no intern post), in the case of graduates,,,thousands of euros lighter. The only thing certain is that this couldnt have come at a better time for the IMO...I suspect they are busy rescripting tomorrows presentation....