Evidence of medical brain drain no longer merely anecdotal

Talk to people in the various branches of medicine these days and most will describe a profession in chaos. Resource cuts, salary reductions, onerous working conditions and continuing disorganisation in the health service are combining to drive doctors to the end of their tether. The result is rising emigration at all career stages, it is said.

Up to now, the evidence for this has been incomplete and somewhat anecdotal. More than 250 consultant posts – one in eight – remain unfilled.

For the first time in years, not all GP-training places have been filled. Stories of young doctors taking up plum postings in Australia or Canada abound within the profession.

The Medical Council's study of the 18,000 doctors on its books sheds some light on the issue, which is of critical importance since the collapse of consultant pay talks between the HSE and the Irish Medical Organisation (IMO) earlier this week.

This is only the second year the council has surveyed its members in this way, but the data appears to show a substantial increase in the number of younger doctors going off the medical register.

This would appear to back up claims that many newly qualified doctors are opting to leave Ireland after their internship is completed.

The council is cautious about the dangers of over-interpreting the data, saying five years of figures are needed before an established trend could be identified. Minister for Health Leo Varadkar and his planners in the Department of Health may not have the luxury of waiting that long if a staffing crisis is to be averted.

Of course, seen from the viewpoint of the rest of society, six years into the bust, the medical profession doesn’t seem quite so benighted.

Unemployment is unheard of. Senior consultants can still combine lucrative private work with handsome public salaries. Newer specialists have fewer options, but the deal rejected this week by the IMO still provided for starting salaries of up to €155,000.

None of this is much comfort to younger doctors who have spent long years in training on no or low pay and have accumulated large bank debts they would like to pay off as quickly as possible. With their skills in huge demand internationally, they have the option to walk away from the Irish health service, either temporarily or for good.

Supply and demand

Multiple reports on medical training and jobs seem to have made little impact on the challenge of matching supply of doctors with demand.

The Irish health service is ruinously dependent on international doctors, who account for one-third of those registered but are expensive to recruit and difficult to retain. The council is carrying out research into whether overseas doctors figure disproportionately in patient complaints.

The increasing feminisation of the profession – 40 per cent of doctors are women – also poses a challenge.

At all ages and career stages, women are more likely than men to work part-time. This points to a need to introduce more flexible training pathways to accommodate different family structures or to increase the number of medical school places.