Brain Drain to Brain Gain: Ireland's Two-Way Flow of Doctors

Medical workforce stressors continue to undermine Ireland’s ability to achieve medical workforce sustainability and compliance with the WHO Global Code on the International Recruitment of health personnel. These include: i) high rates of emigration among graduates of Irish medical schools, attracted by working conditions, training and career opportunities in other English speaking countries; ii) the need to be compliant with the European Working Time Directive, which restricts hospital doctors’ working week; and iii) increasing demand. The result is that the increased domestic supply of doctors is not sufficient to keep Irish hospitals staffed, which recruit or employ doctors from low-and-middle income countries, such as Pakistan and Sudan, to fill this gap. However, this is only a stop-gap measure. Ireland has implemented an innovative programme to provide structured postgraduate training to doctors from Pakistan – the International Medical Graduate Training Initiative (IMGTI). While popular, it is undermined by systemic medical workforce weaknesses, including the pressure on Irish specialists to provide training to its own graduates. Since 2013, Ireland’s Health Service Executive (HSE) and Medical Council (MCI) have made progress in collecting and analysing routine medical workforce data, thereby generating medical workforce intelligence to inform national decision-making. The Brain Drain to Brain Gain project, run in Ireland by the RCSI Health Workforce Research Group –see http://www.healthworkforceireland.com/braindrain- to-brain-gain-project.html, has supported this national policy goal and Ireland’s compliance with the WHO Global Code, by linking these two sources of data so as to profile Ireland’s medical workforce by nationality and country of training.