Foreign doctors ‘don’t get essential training’

We rely heavily on overseas doctors to prop up our health service — but their training opportunities appear thin on the ground compared to our homegrown medical graduates, new figures indicate.

The Medical Council’s Medical Workforce Intelligence Report 2014, published yesterday, found that one-third of doctors practising in Ireland qualified elsewhere and that our reliance on international medical graduates was among the highest in the OECD — a fairly static state of affairs according to the council’s CEO, Caroline Spillane.

However, the roles undertaken by these overseas doctors differ to those of Irish graduates — for instance when it comes junior doctors, most of the training posts essential for career enhancement are not held by international medical graduates — in fact, three-quarters of doctors who work as junior doctors, and who were not in training, were overseas graduates.

Ms Spillane said: “It does point to a need to support doctors coming here from the outside, firstly through proper induction and orientation and secondly through access to training and development on a continuous basis,” Ms Spillane said

The five leading countries of qualification for doctors working in Ireland who did not qualify here were Pakistan, South Africa, the UK, Sudan and India.

The council’s report also shows that Ireland had a relatively young medical workforce, with just one in five doctors aged 55 or older, compared to an OECD average of one in three, however some specialties have a significantly higher proportion of older doctors, such as Occupational Medicine (48.6%), Public Health Medicine (41.7%), Psychiatry (35.2%), General Surgery (34.9%), and General Practice (33.3%).

Other comparisons with OECD trends show that while in the OECD, on average, there were two specialists for every generalist, in Ireland, the ratio was far lower of almost one-to-one.

However, this ratio changes across specialties: two in three doctors (64.1%) working in ophthalmology are specialists, while less than one in five (17.2%) doctors working in Emergency Medicine are specialists.

Asked if the low number of emergency medicine specialists pointed to a crisis, Ms Spillane said Ireland “has a reliance on generalists in hospital posts that other countries wouldn’t have” but that the purpose of the report was to set out information on the current skills mix “for the purpose of informing future policy and workforce planning so that the health service would be able to meet its requirements going forward”.

The figures also show there has been a 12% relative increase in the number of women on the medical register since 2008, and now four in 10 (41.3%) doctors on the register are women. Women are twice as likely as men (20.5% vs 9.9%) to work part time. Figures also show almost one in 10 doctors aged 25-29 years left the practice of medicine in Ireland, and there was an annual relative increase of 23% in the exit rate among graduates of Irish medical schools in that age bracket.