Another day in casualty...

An ambulance pulls up, the doors swing open and another victim of a serious traffic accident is wheeled in. Nurses and doctors move in to assess the man's condition.

It's another busy day at the casualty department of Blanchardstown Hospital in north Dublin. Dr Peadar Gilligan is on duty - he can spend anything between 40 and 50 hours a week on duty.

Doctors in casualty must have "an ability to deal with stress and sometimes," he points out, "you work even better under stress. You have to decide what needs to be done quickly."

The most important quality for a doctor? "You have to like people. You have to be compassionate, sympathetic and empathetic as well. You shouldn't like sleeping too much - nor regular meals, if any at all.

"I enjoy the whole job. I enjoy its variety, the patient interaction and seeing people getting better."

Gilligan's specialisation is in paediatrics. "I really like kids," he says. "They get well very, very quickly which is nice to see."

Staff at Blanchardstown see lots of road accidents. Gilligan has seen many such patients.

"There's a significant burnout rate for people who work in casualty," he says, "because of the exposure to emotional and psychological trauma of dealing with people. But you make a big difference to their lives."

From Templeogue, Dublin, Gilligan did the Leaving Cert at St Mary's College, Rathmines, in 1985. "I was always interested in matters medical," he explains. "In the scouts my first merit badge was in first aid. I was always interested in biology and in health. "When I sat the Leaving Cert, I was thinking or either teaching or medicine. Then, when it came to the crunch, I just decided against teaching." He repeated his Leaving Cert to get enough points for medicine in UCD.

He got his place. There were about 120 in pre-med. "I hadn't done physics," he says, "and that was a major terror for me in first year. I got a lot of help from those who had done it before and we had good tutors. It was easy enough once we got into it and got started."

Overall, he says, "the final year would have been the toughest of all."

His fourth year, when medical students work in a hospital, was one most enjoyable. Gilligan was attached to St Vincent's General Hospital, Dublin.

"The clinical aspect was always my major interest," he says. "I was interested in being involved with the patients. It was a very good year from an academic perspective, less fraught. You don't have as many exams.

"It's about getting acclimatised to general medicine and surgery. The year helps to focus you, you're being exposed to the various specialities and some of them appeal to you and some don't"

Gilligan lived in the hospital during this year. "This meant that I was able to spend more time in casualty and on the wards. It's pretty much an all-consuming passion - when you hit final year outside interests tend to stop or go by the wayside." After graduating with an honours degree, he completed his internship at St Vincent's, a year which is broken into four three-month stints in different departments. At the end of this year he applied to work as a senior house officer in Beaumont Hospital. At this stage, he says, he was leaning towards general medicine rather than surgery. It's tough enough "leaving the academic fold" and working full-time as a senior house officer. "It's a big transition," he says.

Ultimately his "eventual ambition" was to do general accident and emergency for adults and paediatrics. "My whole career has been coming towards this."

While at Beaumont, he spent six-month periods working in respiratory medicine, cardiology and haematology. He also did six months in Letterkenny General Hospital - "a very busy, excellent unit."

At this stage, he felt that he had a good grounding in general medicine. "I found paediatrics very, very interesting so I decided to do paediatrics" - which took him to Crumlin Hospital, Dublin.

A year later, he went to the Rotunda Hospital, working in the neo-natal department with "babies weighing from 500 grams up to the full-grown 10 pounds," he says. Then he spent a further year in Crumlin Hospital, in paediatrics, including general and neuro-developmental.