Trainee doctors opting to leave country due to lack of 'lifestyle-friendly' schemes
Doctors undertaking national training schemes in Ireland have called for urgent reform of the schemes to promote a healthier work/life balance. File picture
Doctors undertaking national training schemes in Ireland have called for urgent reform of the schemes to promote a healthier work/life balance.
The doctors say the schemes are a big factor in why so many Irish medics choose to emigrate.
In Ireland, doctors who have completed their undergraduate degree become a junior doctor and complete an intern year with various placements.
Junior doctors can then apply to different specialised training schemes of varying lengths, and upon completion, the doctor has become a specialist registrar.
This training is provided by independent medical postgraduate training bodies, who are accredited by the Medical Council of Ireland.
Anne Murray, a trainee paediatrician based in Dublin but originally from West Cork, says the system needs reform.
She will be separated from her partner, who is also training to become a doctor, as they only have two weekends off together in the next three months.
"We are actually split for the next 12 months, the three months is just what we know of our rotas," Anne .
"Obviously it is necessary to move for training because different hospitals have different resources and different levels of care."
However, Anne says for her there is no option to request getting certain hospitals at certain periods or to request to be closer to family. "That's one of the biggest issues, having to move away and live apart from partners, and sometimes children, for a year at a time.
"You do get a list of jobs when you apply for a training programme, and you are able to preference those. Whether you get your first preference is based on how well you do in your interview.
"The positions I am in, and a lot of other people, are that both myself and my partner are training to become doctors in Ireland, and there's no option for us to be paired to the same location."
Sourcing accommodation is another major problem for medics in training here. "Especially if you are moving every three months, you may have to move to Kerry, Clonmel or Waterford for three months."
Anne says people end up paying double rent, to keep their room in one location, while they go to the other hospital.
"In terms of your personal life, trying to buy a house or settle down and plan a family is extremely difficult.
"[The system] needs to become more lifestyle-friendly going forward. That is one of the big reasons why medical professionals are leaving Ireland. There are no lifestyle options in place as there are in the UK, Australia, and New Zealand."
A non-consultant hospital doctor wishes to remain anonymous because they fear that they will be placed far away from their home base, as a 'reprimand' for speaking out about the problems with the training schemes.
"In general, [after you intern year] you start off as a Senior House Officer, and you do that for approximately two years. You probably know where you are going to be for those two years. But some people could have been in Galway, then in Dublin, then in Kilkenny, then back to Dublin.
"Inherent in that is emergency tax every six months, which is difficult because you are constantly trying to have something saved in the bank to cover [that]."
The doctor says after those two years, you "might" find out where you will be placed. "There's a lot of pressure to do the extra curricular research, to stay where you want to be."
"The next step is the specialist registrar route, which is five to six years of training depending on the scheme. By the time those years rock around, most people will be in a relationship."
Some of their co-workers have had to give up accommodation, move to a new city, put their children into a new school and organise childcare, only to be moved again after a few months.
They recall one doctor in training who was moved from Waterford, to Dublin, to Limerick. The doctor had two young children and a partner, and they continued to pay rent in Dublin while living in Limerick because they were afraid the rent would rise and they would not be able to find accommodation upon their return.
The doctor says they have heard of cases where people have appealed [a far away placement] on the grounds that their children are in school and their partner is working in a certain area, but they are made to feel this is an 'exception to the rule' and that they should be prepared to move to a hospital further away later on.
The doctor says the UK's training schemes have had partner matching for 15 years. "With partner matching, you could ask to be placed in the same region as your spouse. You are kept within a reasonable distance of your partner and kids if you have them.
The doctor says these policies are also very anti-women, and it is affecting the number of women who finish their specialist training. "There are so many women doing medicine now, but there is a real reduction in the number of women who are finishing up as consultants. It [must be] so hard to have kids, with the fear of moving around, the upset."
They also say they are doing 24 hour calls in the peripheral hospitals, even on weekends, which means very little time at home. "It's so life-unfriendly. No one wants to do 24 shifts anymore, they are not safe. And then you have to drive home after it."
"It factors down to patients. If you are working for 23 hours in a place that really doesn't suit your life, you end up being short with staff and patients, or not being caring, because you become demoralised."
When contacted for comment, the Irish Medical Council said Part 10 of the Medical Practitioners Act 2007 makes the Medical Council responsible for quality assurance of medical education and training in Ireland at undergraduate and postgraduate levels.
"Of the programmes accredited to date, the majority offer trainees the national flexible training options such as the HSE National Doctors in Training Programme supernumerary flexible training scheme and job sharing.
"Individual schemes may also have an informal process with regards to flexible training. Requests are dealt with on a case by case basis in the event a trainee is unable to avail of the national flexible training options."
When contacted for comment, the HSE said: "A set of flexible training principles agreed by the postgraduate training bodies and the HSE National Doctors in Training Programme (NDTP) were launched in November 2017.
"These include principles governing flexible training, eligibility, post reassignment, job sharing and supernumerary flexible training.
"Also, trainees entering year 3 of a training scheme should receive a minimum of 2 years pre-defined rotations a minimum of 13 weeks prior to commencing year 3 of the scheme.
"The process of allocation of training placements is the responsibility of the individual postgraduate training body."
