Sir, – The report of research from NUI Galway, to the effect that a very large proportion of our medical graduates will emigrate, must call into question the funding model for courses that have a high propensity for emigration after graduation ("Nine in 10 medical students may leave Ireland on qualifying", March 12th).
As a taxpayer, I have no objection to a significant proportion of my taxes going to education, providing that Ireland can secure some level of benefit from this investment.
However, it is a different matter altogether when our taxes go to fund education in medicine, engineering and other high-value areas only to find that the graduates then leave Ireland to provide this benefit to another country that has in no way contributed to their education.
I think a cost should be set against certain high-value courses, with this liability cleared by a fifth each year for each year that the graduate works in Ireland after graduation. If he or she decides to emigrate with the newly acquired qualifications, then this liability should attach to the person. I’m sure that a system could be created that would allow for gap years, further education and short-term overseas work. However, the principle should be that if we have invested in your education, then we deserve some level of return on that investment.
No doubt some will see this is harsh – especially those who might be affected by such a model.
However, our education system urgently needs funding and if that is to be out of general taxation, then that taxation pool must benefit from the earnings of those we have educated. – Yours, etc,
T GERARD BENNETT,
Bunbrosna,
Co Westmeath.
Sir, – Cormac Ó Gráda (March 13th) has naively recommended that Irish medical trainees who leave Ireland after graduation be made pay the cost of their education, which he estimates to be €300,000, on the basis that the majority of that cost was borne by the taxpayer. The State has an active policy of underfunding Irish medical student education and allowing non-EU students to subsidise the shortfall. In NUI Galway, the total value of the government "EU fee" contribution is €32,793 over six years. Non-EU students pay €31,000 per annum.
The study he refers to also found that those surveyed largely did not have an understanding of what postgraduate training entailed. Irish medical graduates who go abroad do so for a defined period to acquire skills and experiences that will make them valuable assets to the Irish healthcare system. Consider anybody who has been treated for cancer or had a minimally invasive procedure here in the last decade – the expertise for their treatment was invariably acquired abroad. – Yours, etc,
DAVID COYLE,
Booterstown Avenue,
Co Dublin.
A chara, – In the spirit of equality and fairness for all, Cormac Ó Gráda’s suggestion of a return of service by Irish medical graduates should be extended to all graduates benefiting from the free education system.– Is mise,
CONCHOBAR Ó MÓRÁIN,
Glasnevin,
Dublin 11.
A chara, – I applaud Cormac Ó Gráda on his innovative thinking, suggesting indentured servitude for those of us who have been lucky enough to study medicine in Irish universities.
Given the current low morale in the health services as a result of chronic and systemic underfunding and poor management, I wholeheartedly believe that such a move is likely to entice many more to devote themselves to 36-hour shifts without rest, 10 to 15 years of unstable employment, limited “training”, frequent house-moves and familial instability, and the vanishing prospect of a permanent post at the end of training.
I further suggest that in addition to enticing more to the (wonderful and rewarding) profession of medicine, Mr Ó Gráda’s proposals are likely to lead to a highly motivated, contented workforce and I wish him every success in securing the necessary constitutional and EU legal changes to make such a proposal come true. – Is mise,
Dr DÁIBHÉAD
Ó DORÁIN ,
Dublin 13.
Sir, – The working conditions for doctors undergoing training in Ireland are terrible, and the progressive erosion in these conditions continues unabated. Morale is low, and a toxic relationship between employers (ie the HSE) and doctors exists based on years of mistrust, unilateral cutbacks and broken promises. Every other English-speaking country provides a more supportive environment for trainees, with the opportunity to work in more functional health services. Irish-educated doctors are highly sought after in North America, the United Kingdom and Australasia.
The result is that every year an increasing number of doctors trained in Ireland is leaving the country at earlier and earlier stages in their career. Many will never return. The Irish health service has an ever-increasing shortage of doctors in hospitals and primary care. Waiting lists and trolley counts rise.
Proposals to charge people more for medical training or stop them from leaving would be extremely counter-productive.
Instead may I suggest an attempt to deliver better working and training conditions, and an improvement in relationships with health service management? – Yours, etc,
EOIN FEENEY,
Consultant Physician
in Infectious Diseases,
St Vincent’s
University Hospital,
Elm Park,
Dublin 4.
Sir, – Anyone who has worked in this health service for any length of time has by far repaid any supposed debt owed to the State. – Yours, etc,
Dr JOHN LEGGE,
Dublin 4.