Retaining our Doctors Medical Workforce Evidence, 2013-18. Summary

This report summarises original research findings on the scale and causes of outward migration of non-consultant hospital doctors (NCHDs1 ) from Ireland. It draws on findings from five mixed methods research studies undertaken by the Royal College of Surgeons in Ireland’s (RCSI’s) Health Workforce Research Group 2014-18, together with an analysis of routine data published since 2011 by Ireland Health Service Executive (HSE) National Doctor Training and Planning Unit (NDTP) and the Irish Medical Council (IMC). A consistent picture emerges of the factors that ‘push’ Irish and international medical graduates to leave Ireland, namely poor working conditions, and inadequate training and career opportunities. Research findings from 2018 show that, while trainees report improvements in mentoring and supervision of their training, they also report a worsening of work-related stress and staffing levels in Irish hospitals. Furthermore, there is evidence to suggest that shortages of consultants are contributing to NCHD emigration. This report starts with a summary of the Challenges and Responses that emerged from a policy dialogue of key national stakeholders conducted at the Royal College of Surgeons (RCSI) in November 2017. Each chapter summarises different dimensions of the evidence, ending with questions that were proposed and discussed at the policy dialogue, with a view to framing interventions to retain Ireland’s doctors, specifically NCHDs. Most of the focus of the report and much of the research has been on trainees, who are NCHDs in post-graduate training programmes. However, the report and some of the research and routine data also focus on non-trainees, on whom Ireland is increasingly reliant for the delivery of its health services. Most NCHDs in long-term non-training posts are international medical graduates (IMGs), who are recruited to non-training posts, to which Irish-trained doctors will not apply.