Health

The country that I love doesn’t seem to want me here

Ireland sucked me in, in that sad subtle way like a few too many pints, and I wanted to make a life here

Incredible doctors who want to stay in Ireland are forced to leave because of their citizenship. Illustration: iStock

Juan Lopez Tiboni
Tue Aug 3 2021 - 06:01

I always knew it would be hard to leave Ireland. From the moment I got here four years ago, I've felt at home. I can't yet fully understand what it was about Ireland that charmed me so furiously. Like any other place it has its flaws – and quite a few.

The weather sticks out as one: so mild yet miserable. Like a toxic relationship, you can convince yourself it’s not bad enough to warrant leaving; that is until you set foot somewhere else and remember what it’s like to be dry and warm, with the sun making regular enough appearances that its arrival doesn’t warrant jubilant celebration.

I moved here as a 23-year-old medical student. Born in Argentina, my parents moved us to Canada when I was six, and I grew up there, went to school there for my first degree until I got into medical school as a graduate-entry student here in Ireland. From the get-go, I got stuck in. I took the Luas every day. Three times a week I went on the piss. I started playing GAA. I discovered Irish trad, between classes humming the Wolfe Tones or Christy Moore; I even formed a duo and we played some shows in Dublin.

The Irish understood my sense of humour, that soft-spoken sarcasm and easy-going temperament, nobody seemed to take any of my barbs personally. Quickly enough, I found myself asking what’s the craic, calling French fries chips, and taking on a subtle lilt in my speech prompting a slagging when I returned home to Canada every Christmas.

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Ireland sucked me in, in that sad subtle way like a few too many pints, and before I knew it I wanted to make a life here. My sister came to visit at the end of my first year. We went to the Teeling distillery just outside my gaffe in the Liberties, and after she came home I showed her a bit of Christy. I remember she sat on my bed as I faced the computer. I spoke with my head turned away, feeling too vulnerable to look her in the eye.

“I really like Ireland,” I said. “It’s going to be hard for me to leave.” The conversation stopped there because I started choking up. I don’t think she noticed.

Before things could go any further I buried the subject and moved on – another habit borrowed from the locals. The only thing I could have done more Irish was pour myself a drink. This dependence on alcohol to dull the pains of life is something I never understood until I moved here.

Alcohol is not just for the pint men either, its role in Irish courtship I find equally baffling. “Meeting” people behind the smokescreen of liquor in compensation for fear was new to me as well. I told a story once to an Irish female friend about how I met a girl in the cue to renew my Leap card at Trinity. We just started talking about nothing in particular and got on well. She seemed really cool. I asked her if she’d fancy maybe getting a coffee.

“Oh no,” my friend said, interrupting the story. “That’s weird. Irish guys would never do that. We’re all much too uncomfortable. You’re meant to get them drunk and shift, then ignore each other in public for a while.” I guess I didn’t get the memo, although I accept no place is perfect. I still love it here.

As a newly graduated doctor, I had to leave

Why don’t I hate you more, Ireland? This is what I ask myself. I still don’t have an answer. I don’t think I ever will, because, as a newly graduated doctor, I had to leave. The country that I love doesn’t seem to want me here.

For medical school graduates in Ireland, finding employment as a doctor involves applying to enter a training pathway. The first phase of this training pathway is the so-called intern year, where intern doctors rotate through several teams getting exposure to the job and finding their feet. Every year hundreds of graduates apply for a finite number of intern posts that are given based on graduation rank – higher ranks getting first pick at available posts.

Juan Lopez Tiboni.

But there’s a caveat: preference is given based on nationality. Irish doctors get their first pick above all others, followed by non-Irish EU doctors, followed by everyone else. That is to say, the lowest-scoring Irish national will get a post before the highest-scoring non-Irish EU applicant, and that, theoretically, if there are enough applicants from the first two categories to fill all the positions, then no non-EU doctors may get a post at all.

As a Canadian citizen, I found myself at the bottom of the barrel. Despite having lived here for the past four years, I’m still considered non-EU, because years spent here as a student don’t count towards resident status.

While I was here, I did my best to leave my mark. I founded a conference, I won a national public speaking award, I finished as a national finalist in a case competition and won an academic medal at the college, I even represented RCSI in the GAA Division III All-Ireland championship (I sat on the bench, still find it quite difficult to scoop the ball up off the ground, but I was there in uniform nonetheless). None of it really mattered to the HSE, and this was made clear to me from day one; the rhetoric always blunt if not discouraging.

Find a grandparent who can get you a Spanish passport,
or marry an Irish girl

When I had my first interview at the RCSI, I remember mentioning that I would be happy to stay in Ireland after training. The interviewers cut me off, the mere suggestion was jarring to them. The one lady interviewing me even apologised after: “We just want you to know that’s not a realistic expectation,” she said.

When I was almost finished my second year, I met the director of graduate-entry medicine. She said the same thing, almost laughing. “Find a grandparent who can get you a Spanish passport, or marry an Irish girl.” She wasn’t being rude at all, just brutally honest.

When I met the head of anaesthesia as a final med student, immediately after he offered me a letter of reference for my month spent in Beaumont ICU during the back end of the first wave of the pandemic, he got very real with me. “Unfortunately, as much as we want to change it, the likelihood that there will be spots for you here doesn’t look good.”

Despite everything I was told, I tried to keep positive. For a time I convinced myself that one of the few posts for non-EUs may as well go to me. I'd take a post in Donegal, I'd go to the midlands, I'd go to Kerry. I'd take a post anywhere. Since I got here, I have wanted to stay and I was determined. All that optimism began to fade as time went on, and I have had to acknowledge the reality that working conditions here are far from where I want them to be. Even if I got an intern post, which there is little guarantee, I would face the same struggle for basic specialist training and higher specialist training in the following years. I would continue to fight an uphill battle due to my citizenship at every turn.

There are many others like me. Incredible doctors who want to stay in Ireland but are forced to leave. It's frustrating to me that as someone who has given so much of themselves and loves this country so deeply, that there is no feasible pathway for me to stay. It pains me more that someone can get off a plane from Estonia or Italy and get a post ahead of me despite how much I want to be here. Say what you want, this is the EU and I get it, but that's my bitterness.

Canada was meant to be my home, and yet there was nothing about it that pulled on me

So I did what any sensible man in my position would do. I applied elsewhere. I put my name in the hat overseas at just a few high-quality places in America nearly hoping they'd turn me down. It was a calculated risk. If I get one of these I thought, they'd be too good to pass up. If I don't, I'll bite the bullet and gun for a spot here despite my chances. It would take something incredible to rip me from this island willingly. In the end I got a residency position at an Ivy League school in America, and that was me done. I withdrew myself from the Irish intern application and set my sights on Philadelphia.

Leaving Ireland was hard. The night before my flight, I lay in an empty room and couldn’t sleep. Not because I was nervous, but because I was sad. I didn’t want to leave. I never felt this way when I left Canada. When I was 23, I couldn’t have been happier to go. Canada was meant to be my home, and yet there was nothing about it that pulled on me. My family and friends are there, and I love them. I am Canadian yes, but I don’t feel any pride or shame about it; I feel neutral. What does that say about me? I’m not sure.

My relationship with identity is complicated. I grew up speaking Spanish at home and eating Argentinean foods. All my friends ate dinner at 6pm and I at 8.30pm. I never played hockey. I hate the cold. I never felt love for the country I grew up in, and I don’t know why. When I left Canada I just felt like I was going from one place to the other.

It hurt me to go, Ireland my love. Things weren't meant to be, this time. I chose my career first and I'm sorry

Leaving Ireland felt so much different. It felt like I was leaving home. It felt like a loved one of mine was dying. I was leaving a part of me here, feeling like I’d move on with something missing. It was a connection so deep and mystic that I questioned whether some part of me had always been here, in Ireland, long before I set foot on the island.

Maybe somewhere in my lineage there is Celtic blood, from one of the many defectors who stormed the shores of the Rio Plata on English ships and turned on their captains. Admiral William Brown, one of Argentina's greatest heroes, was an Irish man after all.

There's a song by Ringo Starr (I know, who listens to Ringo's solo work – this guy does that's who), it's called Liverpool 8. It's a beautiful tune about how he left his home, his destiny pulling him elsewhere, although he carried Liverpool in his heart forever. I had listened to it hundreds of times, and I listen to his words now and they hit me so much harder. I think leaving Ireland has helped me to understand my parents' own struggle, leaving their home in Argentina despite how much it hurt them. I don't pretend to know their pain, but I think I recognise it.

This is life. It hurt me to go, Ireland my love. Things weren’t meant to be, this time. I chose my career first and I’m sorry. A new adventure awaits me across the pond. Someday I’ll be back with a gang of wee ones to show them where their daddy fell in love. Thanks for everything.

In the (slightly altered) words of Ringo Starr: Ireland I left you, but I’ll never let you down.

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