Excessive hours and poor working conditions key reasons doctors leave Ireland, study finds

Medical Council’s workforce data for 2023 suggests over a quarter (26.6%) of clinically active doctors in Ireland reported working more than 48 hours a week on average, while a further third (32.6%) said they worked between 40-48 hours a week.

A “substantial portion” of doctors in Ireland are close to retirement age, while excessive work hours and poor working conditions are among the key drivers for doctors leaving this country, a new report has found.

The Medical Council’s workforce data for 2023 suggests over a quarter (26.6%) of clinically active doctors in Ireland reported working more than 48 hours a week on average, while a further third (32.6%) said they worked between 40-48 hours a week.

Furthermore, just over a quarter (25.7%) of clinically active doctors here hold a basic medical qualification from outside of Ireland, the EU and the UK, while almost one third of GPs (32%) are now close to retirement age.

“It’s important that Ireland remains an attractive place for doctors and their families to stay and work here long term,” Medical Council president Dr Suzanne Crowe said. 

“Our report cites research which states that lack of progression opportunities, fear of de-skilling, quality of training, excessive work hours and poor working conditions are among reasons why doctors seek to leave Ireland.

Medical workforce shortages in Ireland highlight the need for greater supports to ensure we retain doctors and incentivise them to practise medicine in Ireland.

The report said of the 24,794 doctors who were registered with the Medical Council in 2023, more than 19,000 of them (78%) said they were clinically active in Ireland some or all of the time.

Of these, 8,234 worked as non-consultant hospital doctors (NCHDs), or junior doctors, with about half of them in training.

The report also highlighted increasing pressure on GPs as a result of a growing and ageing population, increase patient multi-morbidity, GP retirement, poor morale and burnout.

The report said NCHDs work under the supervision of a consultant doctor but there was a significant shortage in the number of approved training posts and precarious career training pathways for those in training who are filling “growing gaps” in the healthcare system.

“The majority of NCHDs not in training are doctors who have trained overseas, and many have not been able to access specialist training in Ireland, a pattern that has remained unchanged in recent years,” the report said, adding junior doctors were more likely to be working over 48 hours a week than other cohorts.

It also said Ireland was highly dependent on international medical graduates, with just under 40% of the clinically active workforce here obtaining their basic medical qualifications abroad.

While research suggests internationally trained doctors report entering posts in Irish hospitals with the expectation of career progression or specialist training, this is often not the reality.

The report also highlighted increasing pressure on GPs as a result of a growing and ageing population, increase patient multi-morbidity, GP retirement, poor morale and burnout.

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“There is an urgent need for effective action to tackle Ireland's shortage of GPs, which can potentially impact the core elements of general practice, namely, continuity of care, the doctor-patient relationship and person-centred care,” it said.

On consultants, it said posts were not being adequately filled, which is having a knock-on effect for trainees and junior doctors, and could give rise to patient and professional safety issues in the future.

The Medical Council added it would publish a second report later this year focusing on doctors who left and also those who joined the register in 2023.