Doctors from abroad need more support, says Medical Council chief

Overseas medics five times more likely to face fitness-to-practise if complained about

Medical Council chief executive officer Caroline Spillane said the HSE needs to put proper human resources procedures in place so that doctors who graduate outside Ireland “can perform to the best of their ability within the health system”. Photograph: Dara Mac Dónaill
Medical Council chief executive officer Caroline Spillane said the HSE needs to put proper human resources procedures in place so that doctors who graduate outside Ireland “can perform to the best of their ability within the health system”. Photograph: Dara Mac Dónaill


Doctors from abroad, who account for a disproportionate number of Medical Council fitness-to-practise hearings, need additional support from the Health Service Executive to help them work successfully in Ireland, according to the council's chief executive officer.

Caroline Spillane said the HSE needs to put proper human resources procedures in place so that doctors who graduate outside Ireland "can perform to the best of their ability within the health system". It needs to design and put in place "a more uniform and standardised approach" to the recruitment, induction and supervision of international medical graduates.

Ms Spillane was responding to figures that show doctors who graduated outside Ireland were five times more likely to face a fitness-to-practise inquiry if complaints were made against them compared with doctors who graduated in Ireland.


Complaints
Of the 322 complaints made about Irish-graduated doctors to be dealt with by the council's preliminary proceedings committee (PPC) last year, 23, or 7 per cent, were found to have enough evidence to be sent forward to a fitness-to-practise inquiry.

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But of the 91 complaints made about international medical graduates, 37 per cent or 34 complaints were found to have enough evidence to warrant a fitness-to-practise hearing.

International medical graduates make up more than a third of doctors registered to work here. Complaints made against them and considered by the PPC were roughly proportionate to their numbers, at 27 per cent. But they made up 60 per cent of the complaints referred forward for a fitness-to-practise inquiry.

The figures, in the Medical Council’s annual report for 2012, were broadly similar in 2011.

Ms Spillane said the phenomenon was not unique to Ireland. Each complaint made to the Medical Council was considered by the PPC on its merits and its procedures were “legally sound, fair, transparent, and accessible”. The “key thing to understand” was the nature of the complaints, she said, and “qualitative research” was required to establish why more complaints about international medical graduates were going forward to full inquiries. This would be completed next year, she said.

International doctors could “potentially have difficulty in integrating into the Irish system”, and needed a specific level of induction, orientation and supervision, Ms Spillane said.


Supervision
Only 400 of the approximately 3,400 international medical graduates who came into the country between January 1st, 2011, and September 30th, 2013, were registered on the Medical Council's supervised division.

To register a doctor in that division, the HSE had to identify the post, specify the doctor’s duties, name who would provide their supervision and have the chief executive of the hospital in question sign off on the post, Ms Spillane said.

Fiona Gartland

Fiona Gartland

Fiona Gartland is a crime writer and former Irish Times journalist