Lack of specialist doctors putting patient health at risk, review warns

The Irish Medical Council found although new doctors continue to join the profession, there were significant numbers of leavers at 982.

Patient safety is at risk due to specialist doctors' roles not being filled and a significant number of medics quitting last year because of burnout and bullying, a review of the medical workforce has found.

The Irish Medical Council’s annual review has for the first time linked recruitment challenges directly to patient safety.

They warned 34.9% of doctors are now registered on the "General Division" while at the same time specialist roles are not being filled, which has implications for patient safety.

Data shows over 25% of complaints about doctors related to the General Division compared to just over 1% about doctors in the Trainee Specialist or Supervised Division.

The IMC found although new doctors continue to join the profession, there were significant numbers of leavers at 982.

Some 76 doctors retired compared to 216 who left for personal or family reasons, and 146 because of limited career prospects. Another 21 said they left for more money.

'Burnout and bullying'

President of the Medical Council, Dr Suzanne Crowe said: “the risks are evident”.

She added: “We have unfilled consultant posts, there’s ongoing growth in the general division of the Medical Council register and our medical workforce continues to experience burnout, bullying and working excessive hours.

“There needs to be an urgency in looking at these and other related issues, as they lead to risking the care and safety of patients."

The Medical Council made a series of recommendations including the development of a workforce strategy.

Reliance on foreign doctors while at the same time limiting their ability to apply for specialist training was highlighted also as a safety risk.

New doctors

The report said last year 2,605 new doctors registered with the Council, an increase of 14% from the year before.

“Of those, 1,717 were international graduates and 888 were Irish graduates,” the report said.

Medical Council chief executive Leo Kearns said they welcomed recent changes to legislation to improve access to training for these doctors.

“More needs to be done as, without access to career development, these doctors too will leave,” he said.

Their working conditions pose serious implications for patient and professional safety, he added.

One doctor quoted in the report who has now left Ireland said they were grateful to supportive colleagues but in general found the environment intolerable.

“I found it difficult sometimes to be considered as the same level professional as my Irish colleagues,” they wrote.

I worked for less money, more than they and sometimes it felt like exploitation.

 "During the Covid period, I rarely saw Irish consultants intubating people, everything was left for the trainees and specialist registrars. I wanted to work in more fair conditions, and I do.” 

There were 21,680 doctors registered with the Medical Council last year with 85% actively working.

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The report states 62% self-reported working more than 40 hours a week and over one quarter more than 48 hours a week.

Resentment at these long hours is reflected in comments, such as: “Having a family it is impossible to maintain good work personal life balance working in the Irish health system especially being on the training scheme.” 

 The report also shows a small number of the retirements were “re-retirements” as recently-retired doctors had come back to work during the pandemic, and are now leaving again.