Ireland must address growing reliance on foreign doctors, RCSI

Ireland must urgently put in place effective retention measures for Irish trained doctors and comply with global responsibilities not to recruit doctors from poorer countries that can ill afford to lose their doctors.

A new report by the Royal College of Surgeons in Ireland (RCSI) has also warned that this can only be done by providing better working conditions, better terms and conditions and more attractive training and clearer career paths for the doctors which Ireland produces.

The recommendations are being made against the backdrop of new RCSI figures which show how Ireland’s growing need for doctors is being met in the main by employing foreign-trained doctors.

The report shows that despite the graduation of around 700 Irish doctors annually from six medical schools in Ireland the percentage of Irish doctors on the Medical Council register continues to fall.

The figures show that Africa contributes 28% of Ireland’s foreign-trained doctors doctors. 20% come from pakistan.

The RCSO survey also reveals a new pattern of growth in the numbers of doctors trained in other European Union (EU) countries, now representing 20% of all foreign trained doctors.

The RCSI suggest the new analysis, which summarises Medical Council registration trends, alongside data from the HSE’s National Doctor Training and Planning unit, also profiles the nationalities and countries of training of non-consultant hospital doctors (NCHDs) working in Irish hospitals.

It points out that while the numbers of NCHDs increased between 2011 and 2015, most of these were recruited to non-training posts. This, they suggest, means that efforts to put in place a specialist-delivered-health service are being undermined.

The report reveals that the systemic drivers of this growing medical workforce crisis include; high rates of emigration among graduates of Irish medical schools, attracted by better working conditions, training and career opportunities in other English speaking countries; the need to be compliant with the European Working Time Directive, which restricts hospital doctors’ working week; and increasing demand.

Reacting to the report findings and recommendations Prof Ruairi Brugha, RCSI Head of the Department of Epidemiology and Public Health Medicine said Ireland needs to give a high level recognition to the scale of the problem and the need for radical responses.

"Currently, Irish hospitals are employing increasing numbers of foreign-trained doctors into posts that don’t provide these doctors with an adequate level of supervised training. This is not good for patients, or for these doctors’ careers.”

“The high turnover of such doctors confirms earlier research which shows that international recruitment is not an effective strategy; and many of those recruited are leaving Ireland for the same reasons that Irish doctors leave, a process we describe as: brain gain, followed by brain waste, ending with brain drain.

"This involves firstly a brain gain through the recruitment of non-EU trained foreign doctors. Then ‘brain waste’ through slow or stagnant career progression for these individuals leading to deskilling, and finally ‘brain drain’ through the onward migration of these doctors, mainly to other wealthy countries.”


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