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GP trainee pay inequality ‘impacting’ on retention efforts

By Niamh Cahill - 27th Jan 2025

trainee pay

Pay inequality affecting doctors on the GP specialist training programme is impacting Ireland’s ability to retain GPs, a GP trainee has warned.

Dr Ali Raza Ansari, who is one of four lead NCHDs with HSE National Doctors for Training and Planning, said he had been unable to attain an explanation for the pay imbalance.

Dr Ali Raza Ansari

GP trainees in years three and four of training are paid as registrars rather than as specialist registrars (SpRs) despite the fact they are on a specialist
training scheme.

Doctors who complete their two years of basic specialist training in hospital medicine and enter higher specialist training are SpRs. The SpR salary scale is higher than that of registrars (€74,970-€93,339 vs €66,872-€78,748).

“The HSE and the Government are undermining GPs in this country and this difference is very discouraging for GP trainees,” Dr Raza told the Medical Independent.

“With increasing inflation, crisis of accommodation, travel costs, and the fact that most have young dependant families, the difference has badly impacted the mental health of this cohort of doctors.”

A spokesperson for the IMO said the matter will be raised as part of NCHD contract talks with HSE officials. These talks are ongoing.

The IMO spokesperson noted that GP trainees are paid two allowances during training, which are unique to GP trainees.

“These are an out-of-hours allowance of €12,967 and a travel allowance of €4,332. These are allowances which the IMO secured for GP trainees and also ensured were not removed as part of a previous review of allowances paid in the public service following IMO submissions on the matter,” the spokesperson stated.

“The IMO are seeking to deal with specific issues for GP trainees in the NCHD contract talks, including dealing with issues around these allowances and the general terms and conditions for GP trainees. This would include addressing the fact that GP trainees are not paid on the SpR salary scale.”

The HSE was contacted for comment, but had not responded by press time.

Dr Raza also made reference to research findings on emigration of Irish-trained GPs.

“This pay difference is undermining efforts to keep Irish-trained GPs in Ireland and is a huge loss at a time when the country is short of GPs,” Dr Raza argued.

According to a paper recently published in BMC Health Services Research, there is a substantial cohort of Irish-trained doctors working in general practice in key destination countries (Australia, New Zealand, the UK, and Canada).

“The flow data suggests a relatively small annual emigration flow of GPs from Ireland to individual countries. However, when compared with the total numbers of GPs trained in Ireland each year, the numbers are notable,” stated the authors.

For example, between 2021 and 2022, 42 Irish-trained/Irish citizen GPs emigrated to Australia, New Zealand, Canada, or the UK. In the same year, 144 GPs completed training in Ireland.

The authors highlighted the need for a central register of clinically active GPs in Ireland for effective workforce and training planning. They said further research was required to understand GP retention and emigration flows amid significant
GP shortages.

The research was funded by the Health Research Board and the Irish College
of GPs.

In 2023, surveys undertaken by the College showed 14 per cent of trainees and 18 per cent of graduates were considering emigration.

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