THERE are about 300 medical graduates produced each year and Conal Devine, the Irish Medical Organisation's head of industrial relations, estimates that 150 of them emigrate. Yet it required a minimum of 535 points to get a place in medicine last year - realistically the chances of getting into medicine are pretty slim unless you have six higher As in the Leaving.
So, what's happening? How do we arrive at a situation whereby 50 per cent of the brightest and the best the cream of each year's Leaving Cert cohort, end up emigrating?
Basically, it comes down to a lack of properly structured further training places. After graduating from university the medical graduate does a one year compulsory hospital placement.
After that, it's a choice of junior hospital doctor jobs, which are very often provided on a temporary basis as a six month contract; or a mad scramble for one of the traineeship positions necessary to advance to most properly structured careers in medicine - including becoming a GP.
The idea is that you work in a hospital and pursue further studies at the same time; so graduating from university really only gets you half way along the road; most medical graduates still face several years of further study while working in hospitals.
There are 55 GP traineeships and 80 to 100 other specialist traineeships available each year. Many graduates who don't manage to get one of those simply go to the UK to find traineeships there. The IMO is very concerned about the situation and Mr Devine says that training abroad seems almost essential as very few consultant posts in Ireland are ever filled by people who have not done some training abroad.
However, the majority probably, do not return and the IMO estimates only 20 to 30 consultant hospital posts and 55 GP opportunities coming on stream each year.
The other side of the coin is that roughly one in three junior hospital doctor jobs in the State are held by foreigners, mostly Asians. These jobs are so unattractive in terms of long term prospects that Irish medical graduates would prefer to emigrate.
Places and Points: The bad news is that there is no great likelihood of points falling significantly for medicine. There is a formal agreement between the Higher Education Authority and the medical body that only 300 places are available. In fact, the IMO would believe that even 300 is too many. There is certainly no prospect of an increase in the number of places, so anyone contemplating medicine has to reckon with high points.
What this means for the sensible CAO applicant is that it is vital that she or he cultivate an interest in a number of other careers in order to have other options.
It's important, too, to stop and think before applying for medicine: have you nice, cosy notions of a benevolent, highly respected GP dispensing wisdom all around and earning plenty of money or are you really aware of the hard graft, the long years of further study, the six month contracts, the 80 hour weeks of night shifts on hospital wards?
It can be a wonderful career - but make sure you know exactly what you are letting yourself in for.
Choosing a Course: Realistically, if you are going for medicine, you will need to put all the courses down on the CAO form. The last few places on each round are often decided by random selection, so even if the points are the same for, say UCC and UCG, it is useful to be in the running for both as you could be lucky in one and not the other.
Most CAO medical applicants will be applying separately to the Royal College of Surgeons as well; it is usually possible to get in with somewhat lower points here as there is also an interview. Sitting the college's own entrance exam can also be an advantage, as a quota of places is allocated from it.
Pharmacy: The job situation is positively splendid for pharmacy graduates. "The word on the ground is that it is very difficult to find a pharmacist," says a spokeswoman at the Pharmaceutical Society of Ireland. New pharmacies are opening, older pharmacists are retiring, every shopping centre wants its own pharmacy (often employing several pharmacists on a rostered basis), and there is a net shortage of newly trained pharmacists.
The problem is that there is only the one course - in Trinity - and there are only 50 places on it. Surely, with a net shortage of trained pharmacists, the number of places should be increased? Trinity is building a new school of pharmacy which will allow it to provide another 20 places - but not before 1997 at the earliest.
So, for this year, we are stuck with only 50 places and little prospect of the points dropping from 560. Anybody interested in pharmacy should seriously consider alternative options. A good alternative would be to take a science degree, opting for subjects such as bio chemistry, microbiology, chemistry, or pharmacology, with a view to going into the pharmaceutical or health care industries; quite a number of pharmacy graduates go into industry in any case rather than working in pharmacies.
Often, Leaving Cert students are not aware of the opportunities in industry and think only in terms of a chemist shop or hospital pharmacy if they have an interest in this area. But it is possible to be in much more at the cutting edge of new research and development by working in industry, for example.
Large numbers of Irish school leavers go to Britain to study pharmacy because of the shortage of places here. UCAS the UK colleges admissions service has provided hitherto unpublished figures to Countdown which show that 110 students from the Republic were taken into pharmacy degrees in UK universities last year; that is more than twice as many as are studying pharmacy at home. And they seem to have no difficulty finding jobs. Though whether the market eventually becomes swamped with UK graduates is another matter.
Physiotherapy: There are just two courses available at home, in Trinity and UCD. Between them, they have only about 70 places. The points, as a result, are astronomical, 550 at UCD (remember there are bonus points for higher maths results counted in this) and 520 for Trinity. There are no plans for an increase in places and no great prospects of a sizeable fall in points.
The jobs' situation for those qualifying in physiotherapy remains very good; apart from hospital work many go into private practice and there is quite a growth in sports physiotherapy.
Considerable numbers of Irish students opt to do physiotherapy in the UK where, again, the points are often much lower - but a number of science subjects and specific grades in particular science subjects are often the requirement there.
Carlow RTC has an interesting diploma course in Applied Physiology which seems to lead to reasonable jobs in itself, but it also provides a transfer route to some UK physiotherapy degrees for a number of students.
Radiography: The number of places is tiny 20 in UCD and 10 in the therapeutic radiography course in Trinity. The numbers are limited in line with the jobs' situation. Three years ago there" was a net shortage of radiographers and new graduates had a choice of jobs. The output of Irish radiographers from British universities has had an impact in the meantime and while UCD reports that all of its radiography graduates got jobs, it is often the case that they start in locum or temporary positions rather than the guaranteed permanent positions of three years ago.
So the job situation is still pretty reasonable, though changing, and the impact of further Irish graduates from UK colleges could depress the market.
One large Dublin hospital had nearly 60 applications for one permanent radiography job recently - but then the big Dublin hospitals are always more popular than smaller, regional hospitals.