The Irish medical system is becoming ever more reliant on doctors who qualified overseas but not doing enough to develop their skills or retain their services, according to the Irish Medical Council, which has published its annual report for 2023.
Almost 40 per cent of 19,328 doctors actively working in Ireland last year had obtained their qualifications outside of Ireland while more than a quarter (25.7 per cent) studied outside of Ireland, the UK or EU.
Overall, the Irish Medical Council (IMC) report points to previous findings that Ireland has “the fourth highest proportion of foreign-educated doctors within OECD member states”.
The research conducted for the this IMC report indicates “the proportion of doctors qualified in the EU or UK has remained stable at 13.7 per cent when comparing 2023 and 2022, while the proportion of doctors qualified outside of Ireland, the EU and UK has increased by 2.4 per cent (25.7 per cent vs 23.3 per cent).”
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The figures for non-consultant hospital doctors (NCHDs), a key cohort in the public health sector, suggest a particularly high level of dependence with just 935 of 4,233, barely more than 20 per cent, of those not in training having obtained their qualifications in Ireland.
By contrast, 1,128 were from Pakistan and 783 from Sudan, a combined 45 per cent of the total and far ahead of the numbers from the likes of Romania, South Africa and Egypt, although they are all among the many countries well represented too.
Despite their critical importance to the system, however, the experience of many of these doctors in Irish hospitals is an issue, the IMC says, with fewer training opportunities or supports and more work than might be expected.
“Many have not been able to access specialist training in Ireland, a pattern that has remained unchanged in recent years,” it says.
Instead, it is suggested, the doctors find themselves viewed as absolutely central to the maintenance of many hospital services, a reliance that often requires that they work excessive hours.
“Overall, NCHDs are more likely to work excessive hours compared to other doctor cohorts. Our data indicate that close to half of NCHDs in training and almost 30 per cent of NCHDs not in training were working more than 48 hours per week,” the report finds.
“What we see is that these doctors come here feeling that there will be opportunities for career progression but that doesn’t happen,” says Jantze Cotter, executive director for regulatory policy and standards at the medical council.
“There’s actually a sense from those doctors that we get from our reports and other reports that they feel like they are deskilling during their time here, that they are working excessive hours in poor conditions and there are even some who say ‘I don’t feel like I’m safe to practise’, and for them that’s a real professional dilemma. The result of that is that they might either migrate or return home.
She says the report has already been presented to the Department of Health where there was “a lot of recognition of how important this data is and how it can be used to inform workforce planning and build the supports needed in relation to this this critical element of our workforce, doctors who are feeling overworked and undervalued”.
The report, meanwhile, finds that while 53 per cent of doctors actively working in Ireland last year were men, the landscape is changing with women set to be a majority in the coming years.
There are already more women than men in general practice, the largest area of specialised work, while about 40 per cent of hospital consultants and NCHDs not in training are women with the numbers continuing to grow.
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