Medical Council to develop ‘regulatory position paper’ on general division

The Medical Council has commenced preliminary work to determine the future of the general division of the medical register.

Ms Fiona McVeigh, Head of Regulatory Policy, presented a “scoping paper” on the general division at a Council meeting in January.

“Council held a broad discussion in relation to the paper which presented an outline of the work required to support the development of a regulatory position statement on the management of the general division of the Medical Council’s register,” according to minutes of the meeting.

Following the discussion, it was recommended that the Council establish a group to support wider engagement and inform “solutions” for the future of the general division.

In 2023, some 33 per cent (6,369) of clinically active doctors were registered in the general division. This compared with 50.2 per cent (9,700) in the specialist division and 16.1 per cent (3,105) in the trainee specialist division. Over half of doctors on the general division obtained their basic medical qualification outside of Ireland, the EU, or the UK.

The general division was created as a transition point for doctors progressing from internship to specialist training. It does not provide a framework for appropriate supervision and specialist training. “This can potentially have implications for patient care and doctor wellbeing,” according to the Medical Workforce Intelligence Report 2023.

The Council’s 2022 workforce intelligence report also noted that an “over-reliance” on doctors in the general division to deliver specialist care “can have potential implications for patient safety”.

The training requirements of NCHDs with general registration needed to be “urgently addressed by investing in professional development opportunities”. The report also stated that many of these doctors had not been able to access specialist training in Ireland.

“Research indicates that foreign-trained doctors report entering posts in Irish hospitals with the expectation of career progression or accessing specialist training,” according to the report. “Lack of progression opportunities and fear of deskilling prompt many to actively seek to migrate or return to their home country within a few years of arriving in Ireland.”

A Medical Council spokesperson told the Medical Independent: “We do not have an update to report on this project yet, as it is currently being scoped.”