Mandate graduate doctors do 5 years in Ireland post qualification?

jon1981

Triggered by this article:

http://www.independent.ie/irish-news/health/shortage-of-doctors-to-blame-for-irelands-breach-of-law-over-hours-imo-31079523.html

A SHORTAGE of junior doctors is a key issue in preventing Ireland from complying with maximum working hours under EU law, it has been claimed

With medicine probably being the most prestigious and expensive course (to the state) available to students , should we mandate that medical graduates do 5 yrs ( insert another figure) here in Ireland in a hospital before they can move and prevent brain drain. Given that students pay the same as any other student doing a less costly course I think this is pretty reasonable move.

thoughts?

ScumLord

Last time I was in a public hospital you could barely move for the Amount of medical staff in the place.

They have medical staff coming out their ears and they still can't get anything done, adding more bodies doesn't seem like it would be any benefit to the patient.

K4t

If they don't want to stay, let them go. The EU was designed to improve labour mobility, not restrict it. The jobs will be filled by willing migrant workers.

jon1981

Ok so from most peoples replies so far, you're not buying the shortage excuse? Are we saying is a scheduling issue? Bad management? I have friends doing courses in the UK (teaching) and part of the conditions of the contract involves them having to do a number of years in a school there, what's the problem with applying this to the medical profession?

Musefan

Yup. Clinical psychologists are mandated to complete 2 years in the HSE post qualification. As payback for their funded training.

Guy:Incognito

jon1981 wrote: »

With medicine probably being the most prestigious and expensive course (to the state) available to students , should we mandate that medical graduates do 5 yrs ( insert another figure) here in Ireland in a hospital before they can move and prevent brain drain. Given that students pay the same as any other student doing a less costly course I think this is pretty reasonable move.

thoughts?

How will you enforce this? Confiscate their passports?

Knasher

If it were down to me, I'd charge everyone for college, but pay off a part of their costs for every year they spend working in Ireland. For each year here 20% of it will be paid off, run off to America right after qualifying, fine, but you now have to pay back what it cost to educate you.

Luckily, I guess, it isn't down to me.

BoJack Horseman

OSI wrote: »

Apart from being illegal in the EU.

It isn't necessarily.

- Make medicine a full fee course.
- provide interest free loans.

If a graduate commits to working for a set term for the HSE, then waive the loan....

If the graduate skedaddles abroad, they have a loan to repay, the tax payer doesn't lose out.

Quid pro quo's like that would be legal.

jon1981

Guy:Incognito wrote: »

How will you enforce this? Confiscate their passports?

Seriously? What is wrong with expecting payback for what is a highly lucrative career funded at a pittance by the student?

seamus

On the face of it, yes, perhaps. But then you run the risk of a lot of other problems - hospitals full of junior doctors who have their head somewhere else and are going through the motions. Junior doctors who are incompetent and want to leave the profession completely but have this 5 years hanging over their heads.

Rather than having the desired effect of keeping good doctors in Ireland, you just make the quality of staff worse and effectively prevent good doctors from immigrating to Ireland.

Perhaps the aim should be to address the reasons why so many doctors leave or want to leave. Primarily criminally long working hours with no overtime and chronic understaffing of junior doctors in hospitals.

Most don't leave because they want to specialise in some obscure medicine or do the latest high-tech research. Most leave because they can go somewhere that they work 50 hour weeks for good pay and get treated like a human being.

Guy:Incognito

BoJack Horseman wrote: »

It isn't necessarily.

- Make medicine a full fee course.
- provide interest free loans.

If a graduate commits to working for a set term for the HSE, then waive the loan....

If the graduate skedaddles abroad, they have a loan to repay, the tax payer doesn't lose out.

Quid pro quo's like that would be legal.

How long does it take to be qualified, 7 years?You're basically making medicine a 12 year course then.

anncoates

ScumLord wrote: »

Last time I was in a public hospital you could barely move for the Amount of medical staff in the place.

They have medical staff coming out their ears and they still can't get anything done, adding more bodies doesn't seem like it would be any benefit to the patient.

That's not exactly a scientific overview of the problem, is it.

'I went down to Tallaght hospital. Seemed to be a lot of doctors walking around.'

Guy:Incognito

jon1981 wrote: »

Seriously? What is wrong with expecting payback for what is a highly lucrative career funded at a pittance by the student?

Nothing, as long as you do it for all courses. Why single out medicine?

I've no problem with people paying for their college education, I was questioning the practicalities of the 5 year idea. As in, how do you physically stop them just leaving and not doing the 5 years.

jonasjones

IMHO college costs should be subsidized but should be repaid by the student if they leave the country within X amount of time. It isn't servitude, it's making sure that the tax payer isn't burdened by those who use the nation's resources and then leave without paying back. Further, the student receives what they paid for, they just don't get it for free. I feel like there is something similar in Australia but could be mistaken.

As an aside, I emigrated not long after finishing my degree so I have a good vantage point from which to make this comment.

jon1981

Guy:Incognito wrote: »

Nothing, as long as you do it for all courses. Why single out medicine?

I've no problem with people paying for their college education, I was questioning the practicalities of the 5 year idea. As in, how do you physically stop them just leaving and not doing the 5 years.

This:

medicine probably being the most prestigious and expensive course (to the state) available to students

not to mention it is a critical service to the public with a very tight supply of graduates!

BoJack Horseman

Guy:Incognito wrote: »

How long does it take to be qualified, 7 years?You're basically making medicine a 12 year course then.

No, they would enjoy free 3rd level education.
A job for 5 years....

And a golden ticket in life thereafter.

My hypothetical would still be a great deal for graduates.

Guy:Incognito

jon1981 wrote: »

This:

So we're singling out just the (probably) most expensive course from the governments perspective. Whats the 2nd most expensive and how close is the gap. Wheres the fairness in forcing a doctor to spend 5 years here over the guy in the 2nd most expensive course? Why not everyone over a certain cost?

coffee_cake

Instead of addressing why they leave they want to make it compulsory to stay in a job they hate
Atlas shrugged anyone

Guy:Incognito

BoJack Horseman wrote: »

No, they would enjoy free 3rd level education.
A job for 5 years....

And a golden ticket in life thereafter.

My hypothetical would still be a great deal for graduates.

They already get the free 3rd level education and the job seeing as we're crying out for doctors. All you're doing is removing their freedom to work where they like.

seamus

ScumLord wrote: »

Last time I was in a public hospital you could barely move for the Amount of medical staff in the place.

They have medical staff coming out their ears and they still can't get anything done, adding more bodies doesn't seem like it would be any benefit to the patient.

They have more administrative staff and nurses than the OECD average, and too few doctors. Nurses and admins are cheaper, but they can't get patients in and out as quickly as doctors can.

The issue here is of course, cost. We have too many large hospitals. But they still have to be staffed. So you bulk up on the cheaper admin & nursing staff to keep the numbers up and make it look like your hospitals are fully staffed.
But you don't have enough doctors.

So despite the place being swamped with staff, you can't get people through the system because everyone is waiting for a doctor to become available.

Technically, fixing the Irish health system is easy:
Close all of the smaller regional hospitals and concentrate major services in a small number of hospitals located in strategic positions.

Yes, it means that some people in remote parts of the country will be 30 minutes further away from the nearest hospital. And it means that someone who chooses to live rurally will die, whereas previously they would have lived. But nationally the quality of service will improve drastically. And that's the statistic that matters.

The only barriers to this are political.

denhaagenite

seamus wrote: »

Technically, fixing the Irish health system is easy:
Close all of the smaller regional hospitals and concentrate major services in a small number of hospitals located in strategic positions.

Yes, it means that some people in remote parts of the country will be 30 minutes further away from the nearest hospital. And it means that someone who chooses to live rurally will die, whereas previously they would have lived. But nationally the quality of service will improve drastically. And that's the statistic that matters.

The only barriers to this are political.

This is exactly what the government are doing at the moment.

ScumLord

seamus wrote: »

They have more administrative staff and nurses than the OECD average, and too few doctors. Nurses and admins are cheaper, but they can't get patients in and out as quickly as doctors can.

The issue here is of course, cost. We have too many large hospitals. But they still have to be staffed. So you bulk up on the cheaper admin & nursing staff to keep the numbers up and make it look like your hospitals are fully staffed.
But you don't have enough doctors.

I've had the pleasure of going public and private for the same condition. There seemed to be as many of the blue shirts as patients, I assume the ones in blue clothing are all doctors of some sort. 4 of them were in and out to me in A&E, in the ward there were 3 nurses. They had me on 3 different antibiotics. then of course there's the roving gang of doctors that come in and talk over you as if you were some sort of a plant in the corner.

Privately I had one doctor throughout, one nurse managed the ward and I was on one antibiotic. The upshot of it all was that a week in a fancy private hospital was substantially cheaper than a week in a public hospital. I think public hospitals have become over concerned with bringing in more money to the point they do pointless extra work so they can increase the bill to private health insurers. Public hospitals have way more staff than they need because they're taking money off the foreign doctors. They have terrible efficiency and giving them more money and staff will only make this worse.

Public hospitals seem to treat health insurers like a cash cow, private hospitals treat them like customers.

Egginacup

jon1981 wrote: »

Seriously? What is wrong with expecting payback for what is a highly lucrative career funded at a pittance by the student?

And what of engineers or lawyers or music students who go off and make millions? What about the medical students who graduate but decide that being a doctor is not for them?

Fat Christy

If the hours and pay weren't so sh*tty for newly qualified doctors, maybe they might stick around!

shruikan2553

Maybe they should look at why so many are leaving.

Maybe some of them come back after awhile bringing new skills?

Electric Sheep

shruikan2553 wrote: »

Maybe they should look at why so many are leaving.

Maybe some of them come back after awhile bringing new skills?

Not if they have any sense.

Capercaillie

K4t wrote: »

If they don't want to stay, let them go. The EU was designed to improve labour mobility, not restrict it. The jobs will be filled by willing migrant workers.

Willing migrant workers who are of inferior quality.

Berserker

jon1981 wrote: »

should we mandate that medical graduates do 5 yrs ( insert another figure) here in Ireland in a hospital before they can move and prevent brain drain.

Sounds like people want to kick the can down the road to me. How about we give them to power to make decisions, instead of tying them in red tape, pay them properly and give them a better work life balance? They might consider staying for longer then.

Iwasfrozen

jon1981 wrote: »

Triggered by this article:

http://www.independent.ie/irish-news/health/shortage-of-doctors-to-blame-for-irelands-breach-of-law-over-hours-imo-31079523.html




With medicine probably being the most prestigious and expensive course (to the state) available to students , should we mandate that medical graduates do 5 yrs ( insert another figure) here in Ireland in a hospital before they can move and prevent brain drain. Given that students pay the same as any other student doing a less costly course I think this is pretty reasonable move.

thoughts?

No. That's the kind of thinking that led to the Berlin wall. This won't encourage doctors to stay it will just force the ones who do leave to stay abroad forever. Stupid idea tbf.

Lucas Castroman

ScumLord wrote: »

I've had the pleasure of going public and private for the same condition. There seemed to be as many of the blue shirts as patients, I assume the ones in blue clothing are all doctors of some sort. 4 of them were in and out to me in A&E, in the ward there were 3 nurses. They had me on 3 different antibiotics. then of course there's the roving gang of doctors that come in and talk over you as if you were some sort of a plant in the corner.

Privately I had one doctor throughout, one nurse managed the ward and I was on one antibiotic. The upshot of it all was that a week in a fancy private hospital was substantially cheaper than a week in a public hospital. I think public hospitals have become over concerned with bringing in more money to the point they do pointless extra work so they can increase the bill to private health insurers. Public hospitals have way more staff than they need because they're taking money off the foreign doctors. They have terrible efficiency and giving them more money and staff will only make this worse.

Public hospitals seem to treat health insurers like a cash cow, private hospitals treat them like customers.

There seemed to be as many of the blue shirts as patients, I assume the ones in blue clothing are all doctors of some sort.

Before offering your considered opinion on a topic perhaps you should be sure of your facts. Everybody in A+E wears scrubs so they could have been doctors, nurses, porters etc.

They had me on 3 different antibiotics.

Obviously they felt it was clinically indicated. Are you suggesting a public hospital makes money by putting a person on more drugs? If anything it costs them money.

I think public hospitals have become over concerned with bringing in more money to the point they do pointless extra work so they can increase the bill to private health insurers.

You've offered no evidence to support this.

Public hospitals have way more staff than they need because they're taking money off the foreign doctors.

Read the news, public hospitals have serious shortages of doctors. Also please explain the delusional workings of your mind - how do public hospitals make money off foreign doctors?

then of course there's the roving gang of doctors that come in and talk over you as if you were some sort of a plant in the corner.

Large public hospitals are teaching centres. Besides, I'm not surprised they ignored you given the waffle you spout.

K4t

Capercaillie wrote: »

Willing migrant workers who are of inferior quality.

And superior quality.