Sir, – The proposals for a new grade of surgical consultant, which are being championed as good for the patient, are in reality the opposite. Irish surgical training has long been recognised for producing excellent surgeons in all disciplines. This training process involves a mandatory fellowship, usually in an international centre of excellence, which is essential. Irish trainees are often chosen above counterparts from other countries because of the quality of their existing training.
While on their fellowship they almost universally out-perform their counterparts and many are invited to remain in these international centres for the remainder of their career.
The number of surgeons who have elected to remain abroad has increased in recent years, due in large part, to the consultant contract which was negotiated in 2008. Those specialists who remain abroad can expect better terms and working conditions than currently exist in Ireland.
The idea that quality surgeons would forego a fellowship in favour of a service level position in Ireland is ludicrous. Equally they would not return from their fellowship to take up such a position.
The trainees recognise the importance of the fellowship process and if this new position becomes reality so too, unfortunately, will the patients. It would make sense to consult with the trainees in a meaningful way. However, that did not happen in 2008 and will not happen now.
A further exodus of highly trained individuals is to be expected and in 10 years’ time the detrimental effect of this Alice in Wonderland scheme will be a reality. – Yours, etc,