Most non-consultant hospital doctors (NCHDs) change jobs every six months - moving on January 1st and July 1st. The July changeover is a more fundamental one as it involves all grades of non-consultant doctor, from intern to senior registrar.
For many years, the number of NCHD posts in the State was stable at about 2,500. Most of these have traditionally been filled by non-EU doctors who come to Ireland to fulfil postgraduate training needs.
Before 1996, non-EU graduates could get temporary registration to work here for five years. The Medical Council introduced an examination in 1996 which required non-EU graduates seeking temporary registration to demonstrate a medical competency equal to that of Irish final medical examination students.
This examination led to fewer non-EU doctors coming here, and the numbers with temporary registrations taken out before the exam was introduced are diminishing rapidly. In 1997, 609 non-EU graduates applied for temporary registration; this fell to 97 in 1998 and 44 in 1999.
However, the manpower crisis cannot be traced to the Medical Council decision alone. An extra 500 NCHD posts have been created in the last few years. But as against this, Irish graduates are leaving the system earlier in their careers, lured by what they perceive as better structured training abroad. And posts in anaesthetics and accident and emergency have been particularly hard to fill. With only two days to the fixed starting date of July 1st, many are likely to remain vacant, leaving significant gaps in patient services.