Cork University Hospital chief says doctor training 'promotes subservience'

The head of one of the country’s largest teaching hospitals has criticised the ‘master and apprentice’ training model and culture in which young graduate doctors are being trained.

Tony McNamara, the chief executive officer of the Cork University Hospital Group, said the hospital doctor training environment — where graduate doctors are dependent on consultants to impart their skills — promotes subservience.

And in a relatively small medical pool in Ireland, where obtaining references is vital, the culture often places graduate doctors in a difficult position.

He said: “Of course consultants in our multiple specialities in hospitals differ and to their credit, most promote values of respect, acknowledgement and unconditional support, which is as it should be. However, some do not and instead behave in a way that is counter to these values and, in the process, create a culture in which this is seen as normal and can be promoted in a way that it is acceptable — which it is not.”

He made his comments in his blog, published on the hospital’s website.

Speaking to the Irish Examiner, he called for a debate on how the training structures and culture can be refined and improved to better reflect the standards and values of respect, dignity, and equality espoused by society — values and standards often underpinned by workplace legislation.

He said he has seen many reports on the adequacy of training facilities in hospitals but has yet to see any meaningful reference to the culture within which graduate doctors are being trained. “It is a matter for leaders at all levels of hospitals, executive, clinical, and academic, coupled with those bodies charged with the responsibility of accrediting and training, to consistently emphasise what are and what are not acceptable behaviours. We must, at every level, increase awareness of these standards and embed them in the culture of our hospitals to improve the work and training environment for doctors.”

There are about 350 doctors in training in the CUH hospital group. “They are the best and brightest of our graduates and I feel we should support them.”


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