Increased HST intake and more consultants needed in several specialties

Six separate specialties require an increase in consultant recruitment in the coming years, according to a new HSE report.

The HSE National Doctors Training and Planning (NDTP) document provides an assessment of the future demand for six specialties (clinical neurophysiology, dermatology, medical oncology, neurology, palliative medicine, and rehabilitation medicine) until the year 2038.

NDTP chose to co-report on these specialties as the specialty training programmes have a common baseline entry of general internal medicine and all are accredited within the RCPI Institute of Medicine. However, the report recognised they are standalone clinical specialties with distinct specialty training programmes.

In his foreword, NDTP Medical Director Prof Anto O’Regan noted that the analysis identified “substantial existing unmet need as well as projected future growth in demand” across all six specialties.

Higher specialist training (HST) intake in clinical neurophysiology should be sustained at the current level of two per annum, according to the report. To facilitate this, training posts must be identified to support expansion. Concurrently, approximately 24 consultants outside Ireland will need to be recruited in the short- to medium-term.

In dermatology, the agreed annual HST intake is eight per annum, with seven doctors enrolling in July 2025. This number will need to be maintained, with two further consultants recruited from outside of the domestic training pipeline.

The current HST intake for medical oncology is eight per year. The report recommends increasing this to 14 by 2028. An additional 18 consultants will need to be recruited “to bridge the supply gap while the training programme builds in capacity”.

In neurology, the HST intake needs to build from eight to 14 per annum by 2028. Some 34 additional consultants are required from outside of the domestic training pipeline in the short-term.

In palliative medicine, the current HST intake of eight needs to increase to 16 per annum by 2030. In addition, 40–45 consultants from outside the training pipeline need to be recruited by 2038 to meet patient demand.

Finally, the agreed HST intake in rehabilitation medicine is four per annum. “However, rehabilitation medicine has historically had a lower intake of typically 0–2 trainees each year,” stated the report.

“Sustaining average intake at four per annum and recruiting a further four consultants from outside of this pipeline will see the consultant workforce grow to the required level nationally by 2038.”