Since leaving medical school and embarking on training to become a consultant, Dr Brian Doyle has worked in 14 different hospitals.
To build up his skills, he has rotated every six or 12 months between hospitals, like thousands of other junior doctors.
“You spend months in one location, and the next one could be 200km away. Most of us expect to rotate in training, but it’s the frequency with which it happens that is so draining.”
As a trainee in anaesthesia and intensive care medicine, Dr Doyle must gain experience in other specialties such as obstetrics and surgery, so he recognises the necessity of moving location.
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“It’s how you organise it, though. In the UK, the system is regionalised so you never have to go farther than 150km from home. Here you could end up in Letterkenny, then go to Cork, and on then to Dublin.”
In his time practising medicine, he has worked in Cork, Tipperary and Castlebar as well as Dublin, but considers himself lucky that, by swapping rotations with colleagues, he has not had to move around even more.
Doctors can spend up to 30 per cent of their career in training to become a specialist, so poor working conditions during this period are a big disincentive that helps to explain the worrying exodus of medical staff to Australia and other countries.
“During this time we’re training, junior doctors are trying to do all the normal things everyone else is doing, whether it’s maintaining friendships and relationships or buying a home,” Doyle says. “If you have a long-term partner in Cork, say, and you’re sent to Dublin, paying Dublin rents, it’s impossible to save for a mortgage.”
“Worse, you don’t know during these years where you are going to be, so planning ahead is very difficult. It is not unreasonable for someone on a surgical training scheme to know where they are going to be for those five years. Then they can get on with planning their lives.”
This is “basic stuff”, Doyle says, “but it has a huge impact on NCHDs (non-consultant hospital doctors)”.
When doctors finish their training, they are often expected to go abroad on a fellowship to gain experience of a different health service. “This is a positive opportunity but it can be hugely expensive.”
Doyle is also keen to see more flexibility in working conditions for NCHDs, pointing out that up to 10 per cent of doctors in the UK can work half-time or variations on flexible contracts.
“We shouldn’t look down on people who work less than full-time,” he says. “Our profession needs changing.”
Medicine has a tradition of long working hours, which is regarded as providing better continuity of care for patients. Doyle says better investment in IT could effect improved patient handovers.
Our lunchtime interview concluded, he headed to bed, having come off a 4pm to 8am shift in the Dublin hospital where he currently works.
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