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29-03-2018, 00:19   #16
julie101
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Interesting take. Are you a doctor yourself? Did you do grad med route?

>100k seems a lot of debt if studying in Ireland? Did your friend study abroad?

Where would you say has the best options for emigrating?
Gradmed costs this between fees and living expenses if you look it up. Banks used to give this all in a loan hence people with huge debts.
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29-03-2018, 14:33   #17
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If you think it's appropriate for trainee doctors to porter patients, then your probably the wrong person to have a discussion with about training in this country.
Brendan, if you think it's all about the money, prestige and avoiding 'scut work', you really should have researched medicine yourself before rushing into it because it clearly doesn't suit you.
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29-03-2018, 18:08   #18
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Brendan, if you think it's all about the money, prestige and avoiding 'scut work', you really should have researched medicine yourself before rushing into it because it clearly doesn't suit you.
Interesting you haven't argued any of my points.

Why are nchd doing non medical tasks like portering, phlebotomy, Canulation, changing patients, bladder scans etc?

Do you think these tasks are appropriate training?

Do you think Irish training is the same standard as north American?
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29-03-2018, 18:50   #19
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Have to admit, some of whats been said here is amusing. Im a final year med student (grad entry via UL) am 26 and will finish in a month with 64k in debt from paying the fees.

Firstly, in addressing the cannulation, catheters etc, yes some of that is expected as a doctor, we arent trained in this stuff to completely ditch it once we hit the wards. Interns Ive worked with have been responsible for cannuation and venepuncture, putting in catheters. Nurses do have an input on some of those roles too, Ive met nurses in ED that were fantastic at those skills and could put doctors to shame, but its where the needs arise. Theres no shame in doing these tasks just because we are doctors, thats ludicrous. That sort of mentality fuels the lofty attitudes held by some that because as doctors we are better than that. Admittedly, the jobs nurses have to do are broad, some less pleasant than others and some I would not like to do, but if they need help, Im not going to shy away just because I ve got three degrees after my name and a huge debt. Arrogance like that just breeds an equal response back by staff on the wards.

Secondly, the comparison of training in the US to Ireland is just frustrating. I get that people can train as surgeon in under 5 yrs in the US but they are different systems, and regardless, as an SpR said to me, experience is what counts. So while our system is not the best, its not producing incompetent doctors (Im hopefully one of that cohort in a few months), I find that insulting to those of us that are in the system as it undermines our capacity and training. Opinions may exist, but if you dont have evidence to susbtantiate those wild claims, then its just mere conjecture.

As for going back to college and doing medicine GEMS style, its not easy and please dont be fooled by it. However it is pretty cool to study the stuff we cover, the skills we develop and then hit hospitals (at UL in third year) and join surgeries, clinics or assist in A&E. Its possible, but weigh up the capacity to afford it, as Ive had significant help from my family and wouldnt be here without that. Its all fine studying hard and achieving grades but financing it is also a reality.
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31-03-2018, 09:40   #20
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Brendan what career stage are you at, and what type of doctor are you, if you don't mind me asking please?

I think you're entitled to your own opinion and appreciate your experiences - but it doesn't put me off this path. All going well, I'll be starting GEM this September. Even if working for the HSE turns out to be a nightmare, I think you regret the things you didn't do more than the things you did. I'm hoping it will be a good decision for me, and a fulfilling career.
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31-03-2018, 09:46   #21
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I'm looking out of healthcare never mind trying to get in.
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31-03-2018, 10:03   #22
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Is not the training in gem is the issue.

It's the gruelling long long hours that follow it. Its the 36 hours + without breaks for food and i remember not even having the time to go to the toilet. Nobody minds doing cannulation etc but when your tasks are piling up +++++ and you can't get around to seein g sick patients because you have so many cannula to insert. So your actually not using th e skills that you trained in because you spend all your time puttijng in cannulas. I remember having like 20 patients waiting for cannulas and each having to wait hours for fluids or antibiotics. Its having 50 sick patients on your list and all their worried families and dealing th e chaos that follows that. Its dealing with totally inadequate work spaces and facilities and your patients not getting the tests they need and having to constantly go down to the radiology dept to beg for scans for your patients . Starting work at 7am on a Monday and finishing at 9pm on a Tuesday. Getting lambasted by the media.
Dealing with angry patient who have no understanding of the above and start shouting at you for things that you can't control.

The universuty bit is the fun bit!!!!
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31-03-2018, 14:51   #23
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Brendan, if you think it's all about the money, prestige and avoiding 'scut work', you really should have researched medicine yourself before rushing into it because it clearly doesn't suit you.
I can only imagine your not qualified yet. It's easy to have opinions like that in college. I'm non-GEM at Reg level. When your on call covering an ED and wards in some peripheral hospital on a 24 hour shift you'll have a different opinion. You'll get bleeped to put a cannula in or do a repeat trop or first dose antibiotics when you're drowning in ED and the nurses have more than enough staff and time but aren't trained or aren't engaging with handover of tasks. And it's an absolute misuse of skills to have a doctor porter a patient.

I think anyone signing up for GEM needs to understand the reality of working in the HSE. You'll have a loan that I imagine will take 10-12 years to pay back. If you want kids you'll have to hope that you get rotations in the same place and don't get shipped around the place. If you're hoping to jump straight to GP scheme from Intern you probably won't. GP applications doubled last year with loads of people having completed BST as competitive applicants.
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31-03-2018, 16:34   #24
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Thanks for other doctors posting here to give a better reflection of working in this country.

Lot of idealistic pre medicine or medicine students posting, trying to drown me out. I too had ideals as a medical student. You will be quick abandoning your ideal to save the world when you're working a 48 hour weekend shift in a peripheral hospital.

Working conditions in this country are truly appalling;training just as bad.

The amount of doctors who are planning to emigrate or leave medicine entirely is rising.

I know multiple grad med students who regret their chosen path. I know others who are leaving medicine altogether. I also know of people who are pinned so tight to the collar that they cannot afford to take appalling hse contracts and have to do long term locum just to keep their head above water.

100k debt is a lifetime of servitude. Easy to think you'll clear the debt and save every penny. Try paying off a loan of over a 1000 quid a month while taking home 2000 a month and living in dublin. It's hand to mouth for a lot of doctors and that's a harsh reality. Wait till your pals start saying "you must be loaded sure, you're a doctor".

There are finance and comp science grads coming out of college and getting bigger starting contracts that hse interns and will make more money faster too.

Medicine is no longer a career for the privileged. It's a career for the dumb. It's an intellectual death, financial ruin and an insurmountable cost to your personal life.

Back at the ranch, I've just finished a 24 hour shift this morning, and have another 24 hour shift to look forward to this easter sunday. And they say the crucifixion only happened once.
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31-03-2018, 16:58   #25
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2,000 a month take home as a reg? Is the HSE that bad?

My experience is in the private sector and an RMO (never mind a reg) would be on low 6 figures with little OT. And they'd have a relatively cushy number.

The consultants are in a different league and in some specialties can work significantly beyond 65 without much effort.

So, it's not that working as a doctor is a bad career choice, you just need to make the most of it and progress.

Last edited by Avatar MIA; 31-03-2018 at 19:21. Reason: on the phone
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31-03-2018, 18:20   #26
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2,000 a moth take home as a reg? Is the HSE that bad?

My experience is in the private sector and an RMO (never mind a reg) would be on low 6 figures with little OT. And they'd have a relatively cushy number.

The consultants are in a different league and in some specialties can work significantly beyond 65 without much effort.

So, it's not that working as a doctor is a bad career choice, you just need to make the most of it and progress.

Take home for a Spr should be 3.3k plus a month anyway I think A fair bit less for a Reg.

RMO isnt a job you'd want to be doing for a long time. It's not a job title they have in public hospitals. It's a bit of a dead end, doesn't look great to be doing it for a long time in my opinion. I'm surprised the pay is so good, you can get an RMO job after intern year sometimes.
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31-03-2018, 19:29   #27
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Take home for a Spr should be 3.3k plus a month anyway I think A fair bit less for a Reg.
That's surprising, approx. €60k before tax. But I suppose it's still a "training" role with a good pay off at the end.

Does anyone know what the approx. breakdown is for someone qualifying with their degree? How many go on to become GPs, Reg's or Consultants as their destination level? How many Reg's remain at that level and how many go on to be consultants. Some peak at Reg level, which is no mean feat.
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01-04-2018, 12:10   #28
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That's surprising, approx. €60k before tax. But I suppose it's still a "training" role with a good pay off at the end.

Does anyone know what the approx. breakdown is for someone qualifying with their degree? How many go on to become GPs, Reg's or Consultants as their destination level? How many Reg's remain at that level and how many go on to be consultants. Some peak at Reg level, which is no mean feat.
I was old once 2 percent of every graduating less will go on to be a consultant here. That could be completely wrong though.
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01-04-2018, 12:44   #29
PhoneMain
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Thanks for other doctors posting here to give a better reflection of working in this country.

Lot of idealistic pre medicine or medicine students posting, trying to drown me out. I too had ideals as a medical student. You will be quick abandoning your ideal to save the world when you're working a 48 hour weekend shift in a peripheral hospital.

Working conditions in this country are truly appalling;training just as bad.

The amount of doctors who are planning to emigrate or leave medicine entirely is rising.

I know multiple grad med students who regret their chosen path. I know others who are leaving medicine altogether. I also know of people who are pinned so tight to the collar that they cannot afford to take appalling hse contracts and have to do long term locum just to keep their head above water.

100k debt is a lifetime of servitude. Easy to think you'll clear the debt and save every penny. Try paying off a loan of over a 1000 quid a month while taking home 2000 a month and living in dublin. It's hand to mouth for a lot of doctors and that's a harsh reality. Wait till your pals start saying "you must be loaded sure, you're a doctor".

There are finance and comp science grads coming out of college and getting bigger starting contracts that hse interns and will make more money faster too.

Medicine is no longer a career for the privileged. It's a career for the dumb. It's an intellectual death, financial ruin and an insurmountable cost to your personal life.

Back at the ranch, I've just finished a 24 hour shift this morning, and have another 24 hour shift to look forward to this easter sunday. And they say the crucifixion only happened once.


Just going to address some of the points made here for some perspective.

I'm currently an intern in a large teaching hospital working in surgery having worked in medicine in a peripheral hospital up to January.

I previously worked in finance and have lots of friends who work in finance. While some of them may be making great money, they have to do big hours. A couple of my friends now work as managers and often have to work in excess of 12 hour days and occasionally at the weekend, for which they do not receive time in lieu or overtime. I also worked in finance for 3.5 years and I got more money starting as an intern than I did at the end of my 3.5 years in finance. I keep a good eye on my pay slips and if there's any issues with missed overtime, its always remidied in the next payslip.

I loved my time working in the peripheral hospital. While I did have to do a lot of cannulation, phlebotomy and urinary catherisation, my whole day wasn't taken up with this sort of work. I never had to do any portering work. I've been in the larger hospital now and only once had to porter a patient and that was to make it easier for the reg. The SHO's and Reg's on the team get great training and I have NEVER ONCE seen them doing cannulation, phlebotomy or portering while I've been working at them. 1 Reg admitted that I'm far more experienced at cannulation than her. They spend their days seeing patients in clinic or upskilling in this particular surgical field. We have journal clubs where they get good teaching from consultants and the consultants are very keen for them to learn.

I've worked 1 set of nights this rotation, 3 saturdays and no sundays and finish nearly every evening at 6 latest (which I don't mind as I'm paid this in overtime!).

Most of my intern year are probably going emigrating to Australia but that's because they're mostly 24/25 and it's a rite of passage at this stage, definitely not because they hate their work. I must reitterate this, I have not been talking to 1 intern who hates their work, they might hate particular rotations their on because some are definitely worse than others but I know noone who has hated all 3 rotations!!

I know noone who regrets their chosen career route. I have got onto the GP training scheme for next year and any interns I know who applied for it got it also. The ICGP are more open to those who pursue GP as their first career path over those who pursued some other hospital career first.

As I said, I love my job, I've absolutely no regrets about pursuing this career and if you have the supports to go through GEM, I'd highly recommend it! A helpful family and a very understanding partner are key!
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01-04-2018, 21:40   #30
supraspinaswim
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Originally Posted by brendanwalsh View Post
Thanks for other doctors posting here to give a better reflection of working in this country.

Lot of idealistic pre medicine or medicine students posting, trying to drown me out. I too had ideals as a medical student. You will be quick abandoning your ideal to save the world when you're working a 48 hour weekend shift in a peripheral hospital.

Working conditions in this country are truly appalling;training just as bad.

The amount of doctors who are planning to emigrate or leave medicine entirely is rising.

I know multiple grad med students who regret their chosen path. I know others who are leaving medicine altogether. I also know of people who are pinned so tight to the collar that they cannot afford to take appalling hse contracts and have to do long term locum just to keep their head above water.

100k debt is a lifetime of servitude. Easy to think you'll clear the debt and save every penny. Try paying off a loan of over a 1000 quid a month while taking home 2000 a month and living in dublin. It's hand to mouth for a lot of doctors and that's a harsh reality. Wait till your pals start saying "you must be loaded sure, you're a doctor".

There are finance and comp science grads coming out of college and getting bigger starting contracts that hse interns and will make more money faster too.

Medicine is no longer a career for the privileged. It's a career for the dumb. It's an intellectual death, financial ruin and an insurmountable cost to your personal life.

Back at the ranch, I've just finished a 24 hour shift this morning, and have another 24 hour shift to look forward to this easter sunday. And they say the crucifixion only happened once.
Hey Im not trying to drown out someones opinion far from it, and yes its easy to state things as a med student (its easier to toe the line of " I is only a med student, I know nothing" a line a consultant I had used often ). The only point I was making is that having the skills is crucial, espec when theres no else bothered or able to do it. ive seen it in ED with nurses not trained in doing ECGs (wtf, we do them in first year and theres no training course on it). One particular midlands hosp is known, from my experiences of first doses etc, Im aware that July is going to be an eye opener, Im just trying to see both sides.
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