The number of places for Irish and other EU medical students in the State should be more than doubled and the number of non-EU students trained here reduced, a ministerial working group has recommended.
The group's report, seen by The Irish Times, also found major governance deficits in the training of doctors "reflecting a medical education system in serious difficulty".
The Fottrell working group, established jointly by the Minister for Health and the Minister for Education, recommends a multi-stream entry model to medicine, to include graduates as well as post-Leaving Certificate students.
With EU student entry capped at 305 places per annum since 1978, the group found the number of non-EU entrants to medicine increased by 96 per cent between 1998 and 2002. Acknowledging, that medical schools here have become overdependent on fees from non-EU students as a result of this increase, the group calls for increased State funding for all future entrants to medicine.
The Fottrell group, formally known as the Medical Education and Training Working Group, was asked by the former minister for education, Noel Dempsey, to examine the feasibility of introducing a system of graduate entry to medicine.
With a membership ranging from the deans of medical schools to senior representatives from the Health Education Authority and the departments of Finance, Health and Education, the group was also established in response to the Medical Council's "Review of Medical Schools in Ireland 2003".
This report was highly critical of the current education of student doctors in the State. The Fottrell group was also asked to consider medical manpower needs in the health service.
In setting out its plans for the reform of medical education here, the working group, chaired by Professor Patrick Fottrell, the former president of the National University of Ireland, Galway, recommends that the intake of EU students into Irish medical schools be increased from 305 to 725 per year.
It calls for a phased reduction in clinical training places for non-EU students, to a maximum of 25 per cent of total student numbers. "There should be a 60:40 ratio between intake to the undergraduate and graduate programmes," it says.
However, in what is a potential blow to Limerick University and the University of Ulster, both of whom have well advanced plans to introduce graduate-only medical schools, the working group states: "In order to maximise the educational experience for all students, undergraduate and graduate and non-EU students should be allocated across all [ medical schools]".
Addressing the issue of entry to medical education, the Fottrell group recommends that Leaving Certificate results should no longer be the sole selection mechanism for undergraduate students. "A national implementation committee should be formed to assess and devise appropriate entry mechanisms for both (undergraduate and graduate) streams," the report says.
In an observation that reflects widespread concern about "quality control" in the training of doctors in the State, the working group notes "the provision of medical education in Ireland is deeply undermined by the absence of a model which incorporates the key stakeholders in medical education". It calls for an inter-departmental steering group in medical education and a separate national medical education consultative body to remedy this.