Leaving the Emerald ills behind

Why a junior doctor decided she had to leave

Tue, Apr 2, 2013, 01:00

I am not Irish. I am not even one of those Americans who claims their great-grand whoever for Irish heritage. But I love Ireland. No, it is not the Guinness or the weather, but very simply, the people that make me love Ireland. You are welcoming, good-humoured, and sincere. And perhaps your best quality is that, even now, you still don’t take yourselves too seriously.

Unfortunately, these are serious times. I feel compelled to share my perspective, as someone from the United States, who fell in love with Ireland and an Irishman, and who leaves with a great sense of disappointment. The reason I write is not to rant, but because I hope to improve one sector of Irish society: the healthcare system.

Did I mention I am a junior doctor? Many people have unfavourable assumptions about who we are, how we act, and what we do. Are we improperly trained staff running around hospitals, working too many hours? Are we worth listening to? Well, allow me to state the obvious:

Good health is priceless. And we are the future of Irish healthcare.

We should be the consultants for the next generation of Irish people, but many of us are leaving, perhaps never to return.

The fact is, junior doctors do run around hospitals. And we should be better trained. And we work too many hours. We are not overpaid, especially considering we take on the greatest responsibility of all – looking after your life. And if you disagree, let me point out that none of my overtime is paid now anyway, which is the same for most Irish doctors.

Even the title “junior doctor” is patronising – I am a doctor, full stop, and worked hard to get here. In the United States, no one is called a junior doctor. And everyone enters a speciality training programme and expects to finish as a consultant.

In Ireland, you enter a labyrinthine scheme, moving from hospital to hospital, without any guarantee of a consultant post at the end. Why go to medical school, face gruelling training and hours, dream of being a paediatrician, or a surgeon, with no assurance of ever being a consultant?

I have a few ideas on how to improve the health system and guess what? They are shared by most, if not all, of my colleagues.

And lots of these ideas, such as organising supplies the same way on every ward, are sensible, time-saving and inexpensive. Yet for these ideas to materialise, people must start caring about trainee doctors’ perspectives. There is little acknowledgement or encouragement for us, and there is generally poor morale in hospitals.

Few are asking why we are leaving, in greater numbers than ever. And, more importantly, no one is asking what would make us stay. Fundamentally, I am leaving because I do not feel like I am a doctor.

My days are spent doing administrative jobs that do not require medical expertise. This contrasts sharply with night shifts, where I treat the sickest patients in hospital with minimal support.

I did not go to medical school to spend my days faxing forms and my nights learning medicine through trial-by-fire.

In the US, there is daily clinical teaching. In Australia, you receive consultant training with every patient admitted to hospital. While some consultants in Ireland are caring teachers and make a great effort, there is no comparable standard.

Twice this week, I have worked more than 30 hours without sleep, in addition to my normal hours. I don’t even feel like a human being, let alone a doctor.

As I sit here, packing my suitcase for my flight abroad, I realise how much I will miss Ireland. But then I think how amazing it will be to work normal hours, in an organised environment, with structured teaching on a daily basis.

And I look forward to feeling like a real doctor, and not just a “junior doctor”. Farewell lovely Ireland, and may the luck of the Irish be with you.


Dr Natalie Ghosh is an American citizen who trained at Royal College of Surgeons in Ireland and is married to an Irishman. She and her husband are moving to Perth, Australia.