Most non-EU doctors in Ireland are still prevented from progressing their careers

A new law that purports to end discrimination against non-EU doctors still unfairly excludes most such medics — and all amid a chronic shortage of doctors in Ireland

Dr Mohsin Kamal, who works at Crumlin Children's Hospital, points out that the new law only affects a minority of doctors in Ireland from non-EU countries.

I got many 'congratulations' messages from my Irish colleagues after the Regulated Professions (Health and Social Care) amendment Act 2020 was signed by the President on October 14.

I have realised that most people took it the wrong way and thought all the problems that non-EU doctors are facing have been sorted through the signing of this law.

It states that non-EU doctors who are already on the General Division of Irish Medical Council registration, and doctors who graduated before 2009, can now apply for training, and their internships from back home will be recognised for training programmes, which is good for very few doctors from Pakistan and Sudan.

It will also benefit those who graduated from countries such as Brazil, India, or Turkey because their internships were not recognised for training purposes before this.

But what’s the reality of this new law?

Most non-EU doctors working in Ireland graduated after 2009 — and, by most, I mean nearly 90% so they were already eligible for training.

One improvement is that, previously, some of these doctors who were already working in Ireland had to take three Pre-Registration Examination System (Pres) exams before applying for training: Now they don’t need to.

However, let’s suppose, if 3,000 doctors were waiting to get equal training rights before the new law was enacted, now there will be 3,300 waiting for the same.

In reality, this law hasn’t addressed the most prevalent issue faced by non-EU doctors, which is training opportunities.

This act has just increased the number of doctors waiting to get on to training schemes, nothing else.

We will be still at the bottom when it comes to getting on to the training schemes due to the EU community preference being applied, regardless of our portfolio or our achievements. 

Doctors from Ireland will be chosen first, then EU doctors, then us. So this act means nothing to us.

So how can Ireland keep recruiting more non-training doctors from outside the EU, given the lack of career progression?

It will be a big loss to the Irish health system and, indirectly, to the patients, if there is a reduction in these doctors coming to Ireland.

How can these doctors get registered? By doing the Pres exams.

The Pres exam has three parts, Pres 1, 2 and 3. You will be surprised to learn that the Pres 2 exam doesn’t even exist in Ireland any more.

We either have to take the UK's equivalent exam, the PLAB, or take the USA's equivalent exam, the USMLE, in order to get Irish Medical Council registration. This makes no sense at all.

Now I will come to my main point, which is the training issue in relation to basic specialist training and higher specialist training. 

Hundreds of doctors have fought very hard to access this in previous years.

We will face the same hurdles to access training as before, as we will not be exempt from basic specialist training on the basis of our experience in Ireland, even if we do equivalent rotations.

Without basic specialist training, we cannot access higher specialist training to become a consultant.

Even if we are exempt from the basic specialist training, when we apply for the training schemes, we will be chosen last based on our nationality.

Why has the Government passed this act now? 

They wanted to calm us down because we demanded training and career progression opportunities on an equal basis, irrespective of race and nationality.

I’m disappointed with the timing of this act because doctors who wanted this have already gone to the UK or they are too senior to start their career from the basic specialist training level.

The doctors who want to stay and have training opportunities will face the same old problems.

Ireland is already at the bottom of European countries when it comes to the number of doctors per capita, and patients’ waiting lists are increasing every day.

While Ireland needs more doctors to make it through this pandemic, the authorities are not giving us any hope of getting on to training schemes.

I request that the authorities please do something for the hard-working non-EU doctors, who make up 43% of the Irish health system. 

Their demand is very simple: Training opportunities on an equal basis.

• Dr Mohsin Kamal is in his third year as a registrar in Crumlin Children's Hospital and he wants to become a consultant in paediatrics.