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Non-EU doctors still waiting for substantive response on training access

By Catherine Reilly - 30th Nov 2020

High Quality 3d art showing a caged metalic structure of the earth casting a shadow over white.

Doctors from non-EU countries have renewed their call for access to training programmes.

A number of doctors, originally from outside the EU and working in Ireland for several years, met with RCPI representatives in July to discuss the matter. However, the doctors have yet to receive any specific details on what may be proposed.

Recently, the Government announced a legislative amendment to remove the necessity for non-EU doctors to have an internship deemed technically equivalent to the Irish version in order to attain trainee registration with the Medical Council.

However, according to non-EU doctors, the key barrier to accessing training is the application of EU community preference in the selection process, without a recognised alternative training pathway. It means all or most places are taken by EU candidates throughout the selection process.

While doctors in medical specialties under the auspices of RCPI have raised this matter most prominently, EU community preference is a requirement on all the postgraduate training bodies.

Dr Mohsin Kamal, a registrar in paediatric infectious diseases, told the Medical Independent (MI) he had received “many congratulations” from Irish colleagues after news of the recent legal amendment, as it was assumed this would resolve the difficulties.

Dr Kamal said the legal change would make no difference to the majority of non-EU doctors seeking training access.

He requested Irish authorities to “please do something for the hard-working” doctors from non-EU countries who comprise over 40 per cent of doctors in the health service.

Dr Kamal commented: “We need some kind of answer now; it has been too long. Our careers are stuck at the same stage, just doing the service jobs without getting any progression.”

Dr Kamal drew attention to RCPI’s sudden withdrawal of a process allowing for exemptions to basic specialist training (BST), which it had granted to doctors in recent years.  This process entailed the doctor’s credentials and experience in service positions in Ireland being appraised by the relevant Faculty which would decide if a BST exemption was appropriate.

According to Dr Kamal, the re-instatement of this exemption is crucial, as doctors at registrar level are well beyond the stage of BST. Without a BST exemption, such doctors cannot apply for higher specialist training.

Doctors not in training programmes, but intent on working towards specialist status, are coordinating their own training with no mentors, established research opportunities, or study days.

Many have left for the UK where based on their experience in service jobs in the HSE, they have accessed training positions

Dr Kamal emphasised that Ireland was already “at the bottom” of European countries in numbers of doctors per capita “and patients’ waiting lists are increasing every day”.

“When Ireland needs more doctors to stay in this pandemic, authorities are not giving us any hopes of getting onto training schemes.”

A spokesperson for RCPI said that as the largest postgraduate medical training body in Ireland, it has “long been aware” of issues regarding access to specialist training for non-EEA qualified doctors.

The spokesperson said RCPI “continues to work with a wide range of stakeholders, including the HSE National Doctor Training and Planning (NDTP) and the Medical Council to expand educational and training opportunities for those doctors who are not currently in training schemes.

“The RCPI is currently working with the NDTP/HSE and the Forum of Postgraduate Training Bodies on a Framework of Structured Supports for Non-Training Scheme Doctors in Ireland. This is being led out by the NDTP and the training bodies are engaged in formulating this for the HSE (NDTP) and the wider healthcare system.”

RCPI specialist training programmes are “governed by guidance issued to RCPI by HSE NDTP”, they added.

The spokesperson did not respond directly to questions on the BST exemption issue.

Meanwhile, doctors not on training schemes –who are mostly from outside the EU – have highlighted difficulties accessing RCPI membership exams this year.

According to RCPI’s spokesperson, its clinical exams were postponed due to the pandemic. However, it recommenced these exams in November with the first groups of doctors on the final year of their training programmes.

“These examinations are essential for the completion of their training,” according to the College’s spokesperson.

“For candidates who are not on our training programmes and applied for a clinical examination in Ireland, which was postponed due to Covid-19, they will be offered a place to take our clinical examination in Ireland in spring 2021.

“We are fully committed to providing clinical examinations for all eligible candidates based in Ireland in 2021. This is of course subject to the relevant Covid-19 guidelines and our hospitals being able to facilitate this. We are reaffirming our commitment to international candidates to recommence delivery of examinations in the first half of 2021.”

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