Message from the Editor

From the Editor

Action needed on non-training posts

In the last issue (Medical Independent, 20 August) we published a letter by Dr Naveed Abbas honouring the memory of Dr Syed Waqqar Ali Shah, who sadly passed away due to Covid-19. The reaction to this piece has been overwhelming.

Dr Abbas powerfully describes an unjust system in which non-EU doctors languish for many years in non-training posts and are unable to progress in their careers. The letter’s message has clearly resonated with many readers, as seen in the comments on this page.

It has also inspired another letter, which we now publish, that offers further evidence of how frustrated many non-EU doctors are about the lack of training posts in the Irish healthcare service.

The health service is still facing an unprecedented challenge with Covid-19, but these concerns should not be ignored even at this time of crisis.

Letter to the Editor

The Covid-19 pandemic has proven to the world the importance of healthcare workers to the running of an effective health system. Like other health systems around the world, the Irish health system been dealt a major blow during this crisis. Frontline healthcare workers continued working through this health crisis despite the sacrifices of their own health, life and family. Non-scheme medical trainees, who make up the bulk of the doctors in the Irish health system, can continue to add career progression to sacrifices made as they stay to work in Ireland throughout this crisis.

These non-scheme medical trainees (NSTs) in Ireland mainly comprised of non-Irish/non-EU doctors, who are hired to support the Irish healthcare system that could not be sustained with just its own doctors.

Career progression is the goal of every medical doctor as the training of medicine is lifelong. It is the reason doctors move themselves and their families across the globe. Unfortunately, in Ireland, career progression is an opportunity that many NSTs find themselves denied despite the enticement from the HSE in their recruitment efforts. As years go by, this growing frustration amongst experienced NSTs lead them on the hunt for better career opportunities elsewhere despite already making Ireland their new home.

Their experiences have also discouraged non-Irish/non-EU doctors from relocating to Ireland. This is clearly a situation that would not benefit the Irish healthcare system; a healthcare system that has high dependency on non-scheme trainees to keep its healthcare system running.

The current pandemic has only added more fuel to this burning disappointment. Non-Irish/ non-EU doctors find themselves at a crossroad where they either remain in their posts to serve the population of Ireland during this crisis without any improvement in opportunities for career progression or to leave to return to their native country to support its healthcare system and their loved ones who needed it. Many stayed on; feeling tremendous guilt if they were to leave the Irish health system, they felt responsible to it. This is a snippet of issues faced by these NSTs.

To assess further, a survey was devised to provide insight into the issues faced by these NSTs. We received close to 400 responses from NSTs across a variety of specialities in the span of less than a week. The results so far are summarised as follows:

• 86 per cent of the responders are on the General Division, ie, not on a training scheme.
• 86 per cent of the responders were non-Irish/naturalised Irish/EU.
• 96.8 per cent of non-scheme trainees came to Ireland with the expectation of career progression – this was only fulfilled for 9 per cent of them.
• 97.7 per cent of them, after having worked here, believe there aren’t sufficient opportunities for career progression in Ireland and only half of these are aware of a parallel pathway to get their posts recognised towards specialisation.
• 87.3 per cent have considered leaving the HSE sooner or later.
• 53.5 per cent of them would not recommend other colleagues to work for the HSE.
• 97.7 per cent believe it is easier to obtain training in the UK and 81-86 per cent are aware of the alternative pathway in the UK and its clarity for non-scheme trainees.
• 98.6 per cent recommend equal training opportunities for all doctors (there were also questions on how this can be attained).
• 87.6 per cent believe a recognised, clear, alternate pathway would help ensure their career needs are met in Ireland.
• 96 per cent would like the RCPI/RCSI/ College of Anaesthesiologists of Ireland/HSE/Irish Medical Council to establish such a pathway.

These are results to only a few of the questions but it paints a clear picture of the issues plaguing NSTs in Ireland. Evidently, NSTs need fairer conditions for career progression opportunities along with a need for a well-structured, clear and recognised parallel training pathway to continue contributing to the Irish health system. This is an ongoing survey – responses are still accepted in order to strengthen our results and its resultant impact.

The purpose of writing this at this point in time is to present the resounding evidence from NSTs as we clearly set out our evidence-backed aims and interest in engagement with relevant stakeholders to achieve them.
Our aims are to:

1. Highlight the disparity and lack of training opportunities for non-scheme trainees in Ireland.
2. Ensure equal career opportunities/pathways for all doctors in Ireland.
3. End discrimination against non-Irish/non-EU medical doctors when applying for training posts.
4. Encourage training bodies to clearly state the requirements for recognition of parallel training pathway with official logbook on its website for the acknowledgement of non-scheme trainees’ experience whilst working in Ireland.

We hope that the relevant stakeholders will take our issues and aims on board and rectify them in order to benefit the Irish healthcare system in the long run.

Please get in touch if further information on the data collected is needed or any other matters.

Respectfully,
Train Us for Ireland
A collective voice of doctors not on training schemes in Ireland