Ireland is "losing the battle" to retain its junior doctors with a new study showing that more than half intend leaving Ireland to work, with one in six saying they have no plans to ever return here.
And worsening levels of bullying are given as one factor in the decision to practice elsewhere.
A national sample of 1,148 junior hospital doctors completed an online survey about their intentions as part of new research now published in the International Journal of Health Policy and Management.
The survey was conducted in 2018 and found that 45% of respondents plan to remain in Ireland; 35% said they would leave but return later; 17% plan to leave and not return, while 3% said they would quit medicine. It also referred to issues such as bullying in the workplace, which it said is more likely to be a push factor in people deciding the work overseas.
Poor training experiences and stressful working conditions
Women, older respondents and those planning on entering General Practice are more likely to stay in Ireland. Younger medics are more likely to leave.
According to the research paper: "A negative finding was that trainees were more likely than non-trainees to leave (55% versus 45%); and most (70%) planned to leave after they completed their specialist training, at a point when they are highly sought after for permanent posts by employers abroad, and when most of the costs of their training has been borne by Irish taxpayers."
The main drivers for those planning to leave Ireland are levels of stress, staffing and training costs, while 44% of that cohort said that "bullying had become worse".
The authors said a 2014 national doctor retention strategy "achieved some successes in education and training but did not tackle the root causes of outward migration, related to low staffing levels, poor training experiences and stressful working conditions".
It also referred to poor supervision experiences and training costs, which are factors in distinguishing the leavers from those who stay.
Bullying in the workplace, and above all a strong association with worsening mentoring experiences, distinguish doctors who will remain abroad from returners.
"A more diversified retention strategy is needed, facilitating career paths towards toward permanent posts in Ireland for younger trainees who choose to undertake specialty training abroad.
"Specialty-specific migration-drivers need to be identified and addressed; measures to combat bullying reinforced; and mentoring links between trainees and senior specialists need to be strengthened to counteract the negative experiences of training in Ireland."
As for implications for the public of Ireland’s failure to retain the doctors it trains, it said the country then has to recruit large numbers of doctors internationally, while losing a "high value resource".
The four-person team behind the research includes a member of the Royal College of Surgeons in Ireland Division of Population Health Sciences, the School of Psychology at Dublin City University, the National Doctors Training and Planning in the HSE and the Department of Mathematics & Statistics at the University of Limerick.