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Making training count

Trainees left unsupervised when a consultant was absent for a week.

Trainees taking consent when unqualified/untrained.

Alleged unprofessional treatment of interns by members of a radiology department.

Signs on another radiology department door saying ‘No NCHDs’.

Allegations of bullying being observed by interns, which went unchallenged by other members of a multidisciplinary team.

Male interns in one site reportedly receiving preferential treatment from nurses, compared to that of their female colleagues.

New Medical Council reports lay bare a litany of troubling findings from inspections of hospitals across two Hospital Groups: the South/South West Hospital Group and the Saolta University Health Care Group. 

Our old friend, protected training time, is once again revealed as a festering sore in the delivery of postgraduate clinical training, something that the Colleges, the Council, the HSE, and trainers and trainees are well aware of.

The Council says there are “evident difficulties” in ensuring the delivery of training to NCHDs through protected time for trainers. It says prioritising service delivery over education due to a lack of resources has been repeatedly presented as a barrier to compliance, “which apparently cannot be controlled by individual clinical sites, or Hospital Group management”.

According to the Council, it has raised concerns regarding access to protected training time for trainers with the HSE’s National Doctor Training and Planning unit, the Forum of Irish Postgraduate Medical Training Bodies and the Department of Health.

The Council also referred to “many positives” identified during its inspections, including the commitment of the Chief and Associate Academic Officers and Intern Co-ordinators.

Hospital Groups must now submit an action plan and the Council says implementation will be monitored on an annual basis until its next visit.

There is a refreshing candour to the documents published by the Council, but it will be judged by its actions.

Earlier this year, speaking in the context of below-par training experiences in some sites, RCPI CEO Mr Leo Kearns told the Medical Independent (MI) he was reaching the conclusion that unless there was “really strong action taken by the various players” to ensure training commitments were respected, there was no incentive on the system to change.

The Council will need to take such views on board to ensure the continued good standing of Irish clinical training and, indeed, better retention of our doctors.

Meanwhile, it has also been positive to note the emphasis placed on doctor health and wellbeing by new Council President Dr Rita Doyle. She has been vocal on this issue via social media, and in response to issues raised in the recent reports, the GP said “when doctors are overworked without appropriate rest periods and breaks, this can lead to an impact on their physical and mental wellbeing and, in turn, could become a patient safety issue”.

This looks to be a touchstone issue for Dr Doyle, who as a GP will be well-versed on the growing workload pressures on doctors.

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