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The “fragmented” governance system for the intern year has compromised the Medical Council and HSE’s ability to undertake their statutory roles efficiently, according to a paper they produced.
The paper, dated September 2017 (amended in December 2019), outlined a new governance structure for the year.
The “current fragmented governance system” led to the lack of a national approach to issues “such as induction, assessment, leave (including maternity leave) policy, remediation, QA [quality assurance] of intern posts and MCI [Medical Council of Ireland] sign-off on completion of the year, amongst others”, according to the paper.
The Council has a number of legislative responsibilities regarding internship, such as approving posts and inspecting intern training sites, to ensure compliance with guidelines.
The HSE’s legal responsibilities include, among other aspects, annual assessment of the number of intern training posts required by the health service and advising the Minister for Health on development and co-ordination of specialist medical education and training.
According to the paper, medical schools are contractually obliged to develop and provide the intern training programme through service level agreements (SLAs) with the HSE.
The Council and HSE recognised that the intern year was “relatively under-funded” in comparison to postgraduate specialist medical training.
“A new governance structure will ensure that the benefits of this new investment will be reflected evenly across the intern system.”
This reformed structure, involving a medical intern board and unit, has since been taking shape.
Funding for intern training is covered in SLAs between the HSE and medical schools and is subject to a confidentiality clause.
Increased funding levels have not yet been determined, stated the HSE.