Irish health service most reliant on foreign-trained doctors

The number of doctors registered with the Medical Council has reached an all-time high of over 19,000, according to a new report.

Yet the Irish health service depends on foreign-trained doctors to a greater extent than in any other OECD country and has a relatively low number of doctors by international standards, according to the report published by the council.

Last year, 35.7 per cent of doctors on the register had qualified in a medical school outside Ireland, up from 34.3 per cent in 2014. This compares to 3.1 per cent of foreign-trained doctors in France and 25.9 per cent in the US.

Pakistan is the country where the greatest number of foreign-trained staff qualified, with 1,238 doctors working in Ireland, according to the Medical Workforce Intelligence Report. The other main source countries are South Africa, the UK, Sudan, India and Nigeria.

The skill mix and roles of foreign-trained doctors is different from Irish medical graduates. They are twice as likely to be working in non-specialist roles and account for three of every four non-training junior doctors in the State. Foreign-trained doctors also account for a majority of obstetricians and gynaecologists, surgeons and emergency medicine doctors.

Doctor emigration

There is some evidence of a decline in doctor emigration in the survey, notably a fall in the exit rate, from 8 per cent in 2012 to 5.6 per cent last year. Emigration is only one reason why doctors exit the medical register, but it’s one of the more significant ones.

In another indication that emigration may be easing off, at least among newly qualified doctors, the report shows a 44 per cent drop in the exit rate for graduates of Irish medical schools aged 25-29 years.

One in five medical trainees intends to practice outside Ireland in the foreseeable future, according to a separate report on their career intentions. Some 54 per cent see themselves practicing in Ireland in the foreseeable future.

Those training to be consultants were most likely to say they did not intend to practice in Ireland (30 per cent) and older trainees were more likely than younger trainees to express an intention to leave medical practice here.

The UK, Canada and Australia were the most frequently mentioned destinations for those going intending to go overseas.

Trainees who were bullied, or who had a limiting illness or disability, were more likely than other to say they were leaving medicine.

The total number of doctors registered in 2014 was a record 19,049, almost 1,000 up on the previous year. Although not all doctors registered are working, the 5 per cent rise is a strong indicator of a burgeoning medical workforce.

Professionally active

Ireland has 304 professionally active doctors per 100,000 of population, lower than any other European country apart from Poland. Norway, which tops the list, has 487 doctors, and Germany 434.

The density of GPs varies significantly between counties. Galway, Cork, Waterford and Westmeath have the highest densities, while Longford, Kilkenny and Monaghan have the lowest.

For the first time in recent years, the feminisation of the profession has been halted, with a marginal 0.1 per cent reduction in the proportion of women doctors, to 41.2 per cent. But as almost 60 per cent of younger doctors are female, this is likely to be only a temporary reverse in the trend towards majority female workforce.

One in seven doctors on the register say they are working part-time; women are twice as likely to be working part-time. Women account for just over one-quarter of hospital consultants, but three-quarters of consultants aged under 35 years.

Doctors are also getting older, with 23.3 per cent aged 55 years and older. Public health medicine, occupational medicine and psychiatry have the highest proportions of older doctors. One in six doctors is practising less than full time.

Overall, almost 2,000 doctors joined the medical register last year, while 1,000 left.

Two out of every three doctors on the register is a graduate of an Irish medical school; this would include overseas students who obtained qualifications in Ireland.