Medicine career/ Doctor??

wellm8

Hi Guys. Im currently in 5th year and realy thinking of studying medicine when i do the leaving cert! Just a few things im unsure on.

1. Ive been thinking of UCD to go no reason realy ive just always seemed i like that college and people i know who've went there have realy enjoyed it but ive also heard trinity is great for medicine aswell?

2. Is it like england over here where you do your years in college then go off as a junior doctor for 2-3 years and then choose your area youd like to specialise in? Im realy confused on this point but im thinking id like to do something like an anaesthetist or a paediatric doctor and surgeon? But id love to try all the areas out you know?

3. Also what the HPAT realy like? I cant find much information on it like ive tried loads of places but cant get anything on it haha. Oh and whats salaries for doctors like nowadays as well?

I hope someone can help I'll be so great-full! Thanks very much

sleepyheadh

wellm8 wrote: »

Hi Guys. Im currently in 5th year and realy thinking of studying medicine when i do the leaving cert! Just a few things im unsure on.

1. Ive been thinking of UCD to go no reason realy ive just always seemed i like that college and people i know who've went there have realy enjoyed it but ive also heard trinity is great for medicine aswell?

2. Is it like england over here where you do your years in college then go off as a junior doctor for 2-3 years and then choose your area youd like to specialise in? Im realy confused on this point but im thinking id like to do something like an anaesthetist or a paediatric doctor and surgeon? But id love to try all the areas out you know?

3. Also what the HPAT realy like? I cant find much information on it like ive tried loads of places but cant get anything on it haha. Oh and whats salaries for doctors like nowadays as well?

I hope someone can help I'll be so great-full! Thanks very much

I'll try to give you a little bit of info.. hopefully it will be helpful;

1) Pretty much all the colleges that do Med in Ireland are of the same standard - some will try to argue that they are not but they are. Picking UCD or TCD for those reasons is a perfectly good.

2) Ill try to give you a time line.

(i) 5-6 years in your undergrad - depending on TCD or UCD.
(ii) After this you will do a year of intern year,
(iii) Then you apply for a BST (basic speciality training) programme 2 years,
(iv) After which you will apply for a HST (Higher Specialty Training) this will be anywhere from 4-6 years. Here is a really good link to the Medical councils guide - http://www.medicalcouncil.ie/Education/Career-Stage-Undergraduate/Your-Questions-Answered/

And another great link to the Royal College of Physicians in Ireland website. http://www.rcpi.ie/article.php?locID=1.6.197.415

These really are the best sources of info to prospective students but very few people cite them.

3) The HPAT really is a lottery. I did my HPAT twice, improved 30 points on the second attempt. I did a preparation course before both and they were good, simply for the sample/preparation questions that you get.

Malmedicine

Best bet. Whatever your nearest hospital is ring them up and see is there some sort of secondary student program. I know Mater had one dedicated one (going back about a decade here). Some other hospitals do as well . Sligo Regional Hospital definately has something similar as well. See could you get on it for a week over the summer.

These usually involve tours of the hospital and then some talks by Junior and Senior staff from all disciplines over the course of a week. See do you like the feel of it even.

In my opinion its the best job in the world when everything goes well but conversely it can be the worst when everything does not. The weird thing is these feelings can exist simultaneously on the same shift!!!! Best of luck.

Other piece of advice first week back go talk to your career guidance teacher about UCAS and applying to England. I know you'll be a fifth year but the Application would only be 13 Months away by then anyway.

wellm8

Malmedicine wrote: »

Other piece of advice first week back go talk to your career guidance teacher about UCAS and applying to England. I know you'll be a fifth year but the Application would only be 13 Months away by then anyway.

If you went and studied abroad in England would it be harder to get your internship back in Ireland or would you have to continue on in england till your like qualified?

wellm8

sleepyheadh wrote: »

I'll try to give you a little bit of info.. hopefully it will be helpful;

Thanks very much that was realy helpful

Just wondering are you studying medicine at the moment or are you thinking of it?

sleepyheadh

wellm8 wrote: »

Thanks very much that was realy helpful

Just wondering are you studying medicine at the moment or are you thinking of it?

I'm studying at the moment.

wellm8

sleepyheadh wrote: »

I'm studying at the moment.

Whereabouts are you studying? How are you finding the course?

sleepyheadh

wellm8 wrote: »

Whereabouts are you studying? How are you finding the course?

Tcd, yeah it's really good..couldn't imagine doing any other course at this point.

drzhivago

wellm8 wrote: »

If you went and studied abroad in England would it be harder to get your internship back in Ireland or would you have to continue on in england till your like qualified?

Internship would be difficult but jobs further down the line would not

drzhivago

sleepyheadh wrote: »

I'll try to give you a little bit of info.. hopefully it will be helpful;

1) Pretty much all the colleges that do Med in Ireland are of the same standard - some will try to argue that they are not but they are. Picking UCD or TCD for those reasons is a perfectly good.

2) Ill try to give you a time line.

(i) 5-6 years in your undergrad - depending on TCD or UCD.
(ii) After this you will do a year of intern year,
(iii) Then you apply for a BST (basic speciality training) programme 2 years,
(iv) After which you will apply for a HST (Higher Specialty Training) this will be anywhere from 4-6 years. Here is a really good link to the Medical councils guide - http://www.medicalcouncil.ie/Education/Career-Stage-Undergraduate/Your-Questions-Answered/

And another great link to the Royal College of Physicians in Ireland website. http://www.rcpi.ie/article.php?locID=1.6.197.415

These really are the best sources of info to prospective students but very few people cite them.

3) The HPAT really is a lottery. I did my HPAT twice, improved 30 points on the second attempt. I did a preparation course before both and they were good, simply for the sample/preparation questions that you get.

God bless your optimism regarding the timetable/duration of training
You have quoted the minimum years BUT very few get through on minimum years
Average age graduation med student is 25, average age consultant appointment (if staying in hospital medicine) is 41

sleepyheadh

drzhivago wrote: »

God bless your optimism regarding the timetable/duration of training
You have quoted the minimum years BUT very few get through on minimum years
Average age graduation med student is 5, average age consultant appointment (if staying in hospital medicine) is 41

Well obviously, it would get pretty messy if you didn't just state the min..it makes it a lot clearer for the op, instead of having to explain for each case

And anyway I don't think the op was looking for the time it takes to be appointed a consultant post, they where looking for a timeline of when specialisation takes place..

drzhivago

sleepyheadh wrote: »

Well obviously, it would get pretty messy if you didn't just state the min..it makes it a lot clearer for the op, instead of having to explain for each case

I disagree- respectfully and without sarcasm BUT

It doesn't make it clearer and can add to the disillusionment with medical careers when people think they will be a specialist in X years when actually it is X + 5,6 or even 9 more than the minimum in a lot of cases

People should have all these facts up front and may then be able to make informed decisions about where they pursue training for a specific career with options being
UK
Australia
USA or if language capable EU would also be an option in some specialties

sleepyheadh

drzhivago wrote: »

I disagree- respectfully and without sarcasm BUT

It doesn't make it clearer and can add to the disillusionment with medical careers when people think they will be a specialist in X years when actually it is X + 5,6 or even 9 more than the minimum in a lot of cases

People should have all these facet up front and may then be able to make informed decisions about where they pursue training for a specific career with options being
UK
Australia
USA or if language capable EU would also be an option in some specialties

Ok so should I have added in if the op wanted to do ty? If they had to repeat there leaving or the hpat.. I then should have gone into whether they decide to do a M.sc or a phd like you can do in Tcd or nuig - that would add another 1 and 2 years respectively.

You are right people should have all this info and they will have it all.. But when you are in 5th year it's not really that important. Besides the op never mentioned consultancy. They only wanted to know when specialist occurs.

Maybe you could describe the timeline you would give?

drzhivago

sleepyheadh wrote: »

Ok so should I have added in if the op wanted to do ty? If they had to repeat there leaving or the hpat.. I then should have gone into whether they decide to do a M.sc or a phd like you can do in Tcd or nuig - that would add another 1 and 2 years respectively.

You are right people should have all this info and they will have it all.. But when you are in 5th year it's not really that important. Besides the op never mentioned consultancy. They only wanted to know when specialist occurs.

Maybe you could describe the timeline you would give?

The op said
" 2. Is it like england over here where you do your years in college then go off as a junior doctor for 2-3 years and then choose your area youd like to specialise in? Im realy confused on this point but im thinking id like to do something like an anaesthetist or a paediatric doctor and surgeon? But id love to try all the areas out you know?"

so without the sarcasm they don't mention TY or MSc or PHD
You can be helpful without being overly sarcastic

Ireland is not like England, OP needs to know that , in England they have run through training which does lead to realistic chance of consultancy so the time line you gave originally would work for all specialties in UK and would indeed be shorter

Ireland Does not have run through training
Ireland has competitive drop off from Intern - SHO, SHO - REG , REG - SPR and Major drop from SPR to consultant - which is not the case in UK/England

In Ireland Specialist = Consultant except in General Practice but to be on the SPECIALIST Register in General Practice one has to have completed specialist training

sleepyheadh

drzhivago wrote: »

The op said
" 2. Is it like england over here where you do your years in college then go off as a junior doctor for 2-3 years and then choose your area youd like to specialise in? Im realy confused on this point but im thinking id like to do something like an anaesthetist or a paediatric doctor and surgeon? But id love to try all the areas out you know?"

so without the sarcasm they don't mention TY or MSc or PHD
You can be helpful without being overly sarcastic

Ireland is not like England, OP needs to know that , in England they have run through training which does lead to realistic chance of consultancy so the time line you gave originally would work for all specialties in UK and would indeed be shorter

Ireland Does not have run through training
Ireland has competitive drop off from Intern - SHO, SHO - REG , REG - SPR and Major drop from SPR to consultant - which is not the case in UK/England

In Ireland Specialist = Consultant except in General Practice but to be on the SPECIALIST Register in General Practice one has to have completed specialist training

I think the op was looking for when you specialise..I.e when you branch off not become a consultant.

Please give me the timeline you would give for Ireland. And I wasn't being sarcastic when I mentioned ty and phd's, I was just making the point that if you didn't simplify the process it would be ridiculous.

But that's beside the point, I think the best thing for the op would be if you gave your timeline

drzhivago

sleepyheadh wrote: »

I think the op was looking for when you specialise..I.e when you branch off not become a consultant.

Please give me the timeline you would give for Ireland. And I wasn't being sarcastic when I mentioned ty and phd's, I was just making the point that if you didn't simplify the process it would be ridiculous.

But that's beside the point, I think the best thing for the op would be if you gave your timeline

As requested as best I can do in short term

This shows a comparison of USA / UK run through / Ireland fastest possible / more realistic and actual for most timelines of how the process works

Some training schemes are shorter than others so this is general and not specific and have tried to accommodate as best as possible with limited time

drzhivago

hopefully attached nowScreen Shot 2014-07-23 at 13.41.25.png

drzhivago

drzhivago wrote: »

hopefully attached nowScreen Shot 2014-07-23 at 13.41.25.png

If there is a better way to do this so is displayed in post would be grateful if someone would pm me how

Mod note, there you go

sleepyheadh

drzhivago wrote: »

hopefully attached nowScreen Shot 2014-07-23 at 13.41.25.png

Would you mind just quickly explaining that for the op just the Irish ones

drzhivago

sleepyheadh wrote: »

Would you mind just quickly explaining that for the op just the Irish ones

difficult explaining when the attachment is not visible BUT

Ireland shortest is where you graduate

• actually get an internship in Ireland (Not guaranteed)
• Competitiviely apply and get SHO Post AND successfully complete either MRCP (3 part exam) or MRCS (3 part exam) or MCEM (3 part exam) within this 2 year period - then eligible to apply fro SPR program
• Having attained post grad exams at earliest opportunity AND applied for SPR training post in teh relevant specialty AND been successful in compettion begin a training period that ranges from minimum of 4 - 6 years depending on the specialty
• Having completed the training program AND in the Surgical disciplines completed a Further 3 part Exit Fellowship exam one gets a certificate of completion of specialist training, can enter ones name on the specialist register AND Apply for a consultant post should one become available (NOTE LAST YEAR there were around 40 posts only across ALL specialties

NOTE THE ABOVE does not include any research periods which are mandatory on many schemes / Nor does it include any training abroad



REGISTRAR YEARS

This column includes

• additional time spent beyond minimum as an sho
• additional years spent in non training Registrar grades
• Otherwise when get to SPR section follow down

REGISTRAR + Research

Same as above just more time spent at Registrar Grade to account for research time which for some may shorten SPR years by Maximum of 1


FINAL COLUMN - this is one most relevant for those in Surgical fields where periods of research and also fellowships abroad will be necessary to complete prior to being deemed eligible to apply for consultant post



Thus if one reads across from the Post graduate years columns on the left

At Year 9 the majority if not all in USA and some in UK are at ATTENDING/CONSULTANT level whereas this would be exceptionally rare in Ireland

At year 15 someone in US has 10 years working at good salary as consultant whereas in ireland they still may not have that salary level so saying Consultant in country X or Y is paid less than consultant in Ireland really is not fair comparison unless you take those details into account


SO for OP sake there is a lot more to this than you think

In USA you need to know from Med School what field you want to go into as you start that path in most cases from Day 1 forward as a doctor - OP mentioned 3 specific areas which really are mutually exclusive - time training in 1 ill not shorten time to cross over and complete training in another

In Uk you can choose run through or do general training where get experience in a few areas

In Ireland - general first - Then specialty field i.e. Surgery - Then specialist area i.e. Vascular Surgery or Urology

sleepyheadh

Thanks, but I still think that the timeline I gave will be of better use to the op at this stage.

RobFowl

sleepyheadh wrote: »

Thanks, but I still think that the timeline I gave will be of better use to the op at this stage.

I'm of a similar vintage to DrZ and no-one I know has become a consultant in Ireland having done less than 10 years post graduate training, most will have done 12-16 years

sleepyheadh

RobFowl wrote: »

I'm of a similar vintage to DrZ and no-one I know has become a consultant in Ireland having done less than 10 years post graduate training, most will have done 12-16 years

But again the op is in 5th yr and looking for some general info

RobFowl

sleepyheadh wrote: »

But again the op is in 5th yr and looking for some general info

The info from the medical council is (to be polite) aspirational.
In the real world it's simply not accurate.

brencork

That's a really nice comparative scale I must say.

As the initial OP is only in fifth year though, I think it's probably best to maybe try meeting some doctors. Any doctors I know, whilst very angry about some pay and conditions genuinely enjoy the job and wouldn't do anyhting else. I don't think there's a need to frighten off potential doctors!

I'd love to have the brains and the dedication to be a doctor!!

sleepyheadh

Ok once again, just to state the point which i am making. The Op was not asking how long till i become a consultant. They were asking at which stage does specialisation occur. Therefore, the medical councils info is perfectly good for that purpose.

People are being very pedantic, it really comes down to a few years here or there. I gave the general layout. Obviously, as with everything there will be some grey areas. But for the most part that is how the irish system is laid out.

Now you can argue as to whether, the process will take 9 years or 16years, but it doesn't really make a load of difference.

The medical council are not being "aspirational" as you put it, they are being pragmatic. They know the audience that this information is intended for and suiting the info accordingly.

Just Like Heaven

There was nothing wrong with the other posters sharing there opinion and experience on training either though.

You're all being pedantic

sleepyheadh

fewtins wrote: »

There was nothing wrong with the other posters sharing there opinion and experience on training either though.

Never said there was either!

his_dudeness

drzhivago wrote: »

Ireland Does not have run through training
Ireland has competitive drop off from Intern - SHO, SHO - REG , REG - SPR and Major drop from SPR to consultant - which is not the case in UK/England

This is no longer totally true.

Run through programmes have been introduced for surgery and anaesthetics, though the success of them is still to be determined. The HSE MET unit wants the other colleges to implement them too. And technically speaking, GP training is also a run through programme.

drzhivago

his_dudeness wrote: »

This is no longer totally true.

Run through programmes have been introduced for surgery and anaesthetics, though the success of them is still to be determined. The HSE MET unit wants the other colleges to implement them too. And technically speaking, GP training is also a run through programme.

As far as i am aware this is restricted to general surgery and not all surgical subspecialties

In the case of anaesthesia this is new and no one has completed yet

GP training as opposed to majority of other training programs was always a single level program i.e. people taken on at bottom and went through 3 years originally and now 4 in most if not all programs

Majority of other programs has SHO training schemes Basic Specialist Training and then higher specialist training so there was always a drop off between these two, will be interesting to see what happens if and when run through training comes for other specialities as I see two options

• dramatically reduce numbers coming in at what was SHO level as they will be carrying through the full program - this will mean significant competition at Intern level to get on training schemes with only option being emigration or non training jobsif one doesnt get scheme one wants OR
• Large numbers taken on schemes with run through training which will graduate lots of people at end with no jobs to go to, even with the small numbers coming off SPR scheems at present there are not enough cobsultant posts for them - increase that number will lead to unemployment or mass emigration

Realistically one should know at 3rd year SPR level where one is going to be the day the scheme finishes as leaving longer than this makes very difficult to secure US or AUS opportunities there is a significant lag time in organising these

A Neurotic

Can someone clarify what exactly is meant by run through training for me please?

Thanks.

his_dudeness

" Run Through" training is, in theory anyway, where one would commence training in a particular speciality at the lowest rung, and would progress through without the need for further interview, subject to attaining certain criteria, until they come out the top fully trained. It is an effort to remove the "gap year" in medical training and deal with some of the bottle neck caused by numbers trying to get on to specialty schemes.



It has been introduced in Ireland for all surgical training (trainees decide on a particular subspeciality after a first "core" surgical training year) and for anesthesia.

The UK have it for most specialities, except for surgery. There were major concerns at the calibre of trainee moving to what would have been the first SpR year without the benefit of the training picked up during gap years. The only surgical programme that still have runthrough (for intake in 2014 anyway) are cardiothoracics.

http://specialtytraining.hee.nhs.uk/


This is a comprehensive document giving the fine details of training in the UK

A Neurotic

Interesting. Thanks!

Xeyn

Not that I have any faith in anything rcsi does in it's training scheme implementations but as far as I know there is a culling after the second year in the 'run through' system for surgery so it's not actually a true run through program.

his_dudeness

We'll find out next July. The first crop of "runthroughs" only started their second year last month.

Xeyn

Indeed but as I'm currently workin with one he has stated that you have to be offered a 3rd year job. He has stated that he is leaving the country if he isn't. So it seems like they have merely streamlined the transition into spr and it is not a proper run through program. A true run through program exists in it's iterations in the US, South Africa and most other countries where you get on a training program and from the start you move towards a fellowship rather that the system here where many doctors are stranded in limbo and 'training' takes far longer than necessary.

Taco Chips

Say a person in this streamlined program doesn't get offered a 3rd year job. Then what happens? You're just expected to hang around?

Xeyn

From what this second year bst doctor was saying is that most of them have concerns are are merely told 'everything will be ok' whenever these concerns are brought up.
From my understanding if you are not offered a 3rd year job you are deemed not suitable for a career in your chosen speciality. I don't know if you can re enter the program at a later stage.
To be fair it's a new program so hopefully it will iron out its innumerable problems. It doesn't help those who are approaching that drop off point though.
Every decent consultant I've worked with admits there is absolutely no need for te training program's to be as long as they are.
What currently constitutes training in the bst can be done in a couple of months intensive actual training instead of what amounts to essentially majority service jobs currently.

RobFowl

Xeyn wrote: »

From what this second year bst doctor was saying is that most of them have concerns are are merely told 'everything will be ok' whenever these concerns are brought up.
From my understanding if you are not offered a 3rd year job you are deemed not suitable for a career in your chosen speciality. I don't know if you can re enter the program at a later stage.
To be fair it's a new program so hopefully it will iron out its innumerable problems. It doesn't help those who are approaching that drop off point though.
Every decent consultant I've worked with admits there is absolutely no need for te training program's to be as long as they are.
What currently constitutes training in the bst can be done in a couple of months intensive actual training instead of what amounts to essentially majority service jobs currently.

Would agree training schemes in some specialities are far too long, largely as it suits those in charge to have services delivered by doctors full trained but still labeled as trainee's for various reasons including cost..

jeonahr

What's the progression of salary like throughout the years of a doctor's career?

A Neurotic

jeonahr wrote: »

What's the progression of salary like throughout the years of a doctor's career?

Here are the HSE payscales for the different grades of non-consultant doctor:



(Incidentally, if anyone here could clarify who exactly the 'psychiatrist' scale applies to, I'd be interested to know)

Arbie

A Neurotic wrote: »

Here are the HSE payscales for the different grades of non-consultant doctor:



(Incidentally, if anyone here could clarify who exactly the 'psychiatrist' scale applies to, I'd be interested to know)

For clarity, there are multiple scales on that chart, including the older higher scales for reference and the latest one with pay cuts.

The current scale is directly after the job title dated from either 2010 (FEMPI cuts) or 2013 (Haddington Road cuts).

So the SHO scale is 38,839 - 54,746 and the Specialist Registrar scale is 60,404 - 71,888.

I think Psychiatrist refers to psychiatry registrars (who are in fact on BST and therefore SHO level but they don't have SHOs in psych) and then psych HST trainees are called Senior Regs.

A Neurotic

Arbie wrote: »

For clarity, there are multiple scales on that chart, including the older higher scales for reference and the latest one with pay cuts.

The current scale is directly after the job title dated from either 2010 (FEMPI cuts) or 2013 (Haddington Road cuts).

So the SHO scale is 38,839 - 54,746 and the Specialist Registrar scale is 60,404 - 71,888.

I think Psychiatrist refers to psychiatry registrars (who are in fact on BST and therefore SHO level but they don't have SHOs in psych) and then psych HST trainees are called Senior Regs.

So a first-year psych trainee straight out of internship will be on 9k more than their medical/surgical/etc SHO mates? I'd assumed the scale might apply to those who've completed their psych memberships or something. It's an odd fit either way really.

Arbie

A Neurotic wrote: »

So a first-year psych trainee straight out of internship will be on 9k more than their medical/surgical/etc SHO mates? I'd assumed the scale might apply to those who've completed their psych memberships or something. It's an odd fit either way really.

Yes, I think so. Psych trainees definitely have a different (and higher) payscale anyway: http://www.imt.ie/news/new-salary-scales-for-specialist-trainees-11-07-2014/

wrote:

"Salaries of trainees in the sub-specialties within anaesthesia, emergency medicine, medicine, obstetrics and gynaecology, paediatrics, pathology, public health, radiology or surgery will range from €30,257 (Interns) up to €68,980 in the ninth year of specialist training.

Trainees in the specialty of or sub-specialties within psychiatry will be paid from €30,257 (Interns) up to €72,540 in their ninth year. Trainees in both pay scales will be paid €71,888 in their 10th year if employed in a non-consultant role after completion of specialist training and award of Certificate of Satisfactory Completion of Specialist Training."

The IMO actually just announced that a new payscale is in place from this week and everyone gets a €1,000 annual payrise: http://www.imo.ie/i-am-a/nchd/public-sector-pay-increas/New-NCHD-salaries-1-April-2017.pdf

TessC

Originally Posted by A Neurotic View Post
So a first-year psych trainee straight out of internship will be on 9k more than their medical/surgical/etc SHO mates? I'd assumed the scale might apply to those who've completed their psych memberships or something. It's an odd fit either way really.

Originally Posted by Arbie

Yes, I think so. Psych trainees definitely have a different (and higher) payscale anyway:

Psych trainees on the same scale as everyone else right now. Prior to mid-2016, they were considered SHOs for BST until they completed their membership exams and then they moved onto the Registrar Scale.

Now, they're an SHO for year 1 (foundation) and year 2 (BST1) and then move onto the Reg scale until they complete BST. Being called Registrars from the get-go is more a naming convention.

I have never figured out who the Psychiatrist scale actually applies to. 'Tis a mystery.

Also, my understanding is that the 2014 run-through payscale never came into affect. I have a vague recollection that they tried to implement it for anaesthetics in one hospital and there was a backlash and threatened strike action and a HSE memo withdrew the implementation.

The IMO actually just announced that a new payscale is in place from this week and everyone gets a €1,000 annual payrise:

Excellent news, thanks for the heads up. I didn't know that was going to apply to us.