Medical students should be paid to stay in Ireland, says department

Medical graduates cost State up to €126,000 each, says Department of Public Expenditure

A ‘return-of-service’ scheme involving loan financing could be set up to encourage medical graduates to work in the Irish health system. Photograph: Jason Lee/Reuters

A ‘return-of-service’ scheme involving loan financing could be set up to encourage medical graduates to work in the Irish health system. Photograph: Jason Lee/Reuters


The Government should consider a scheme to provide several thousand euro annually to medical students to meet living expenses in return for a commitment to work in the Irish health service on graduation, officials in the Department of Public Expenditure have proposed.

It has suggested that a return-of-service scheme could involve loan financing to students that could either be repaid monetarily on graduation or by an agreement to work in the domestic health system for a period.



An analysis on the country’s medical workforce said that while Ireland produced the highest number of medical graduates per head on foot of a €200 million annual investment programme over recent years, there were concerns that many were choosing to emigrate in the face of poor career prospects.

The report said it cost between €105,000 and €126,000 for every graduate educated by medical schools across the country, depending on the length of studies.

“Clearly a situation where we produce the most medical graduates in the EU but are also the most reliant on internationally- trained doctors – and this despite having the lowest number of doctors – cannot represent good value.”

The report drawn up by the labour market and enterprise policy division of the Department of Public Expenditure and Reform said one means by which a greater number of domestic medical graduates could be retained in the Irish health service would be the introduction of some form of return-to-service agreement.

It said that in Australia, a bonded medical places scheme was in operation under which participants received government funding to cover some fees in return for working after graduation in areas identified as having a shortage of doctors.

It said in Canada, graduates of international medical schools were permitted to take part in its return-for-service agreement and compete for residencies.

However, it said one study had found that only one-third of doctors completed their service obligations.

It suggested that any Irish scheme would need to be targeted at EU students.


It said any agreement offering fee remission would be much more attractive to international students, but based on the Canadian experience these might be more likely to renege on their service agreements.

“A possible solution would be to offer loan financing to medical students which can either be paid down or written off through service.

“For example, students could access an annual amount of €5,000 to help with living costs during their studies and upon graduation either repay their borrowings as they would a normal loan or have the €5,000 written off for each year of service they complete in the domestic health system.

“The agreement could also specify that their service take place in hospitals or areas where there are shortages of staff.

“The European Committee of Social Rights has previously concluded that the Irish practice of requiring Army officers to repay some of their training costs if they do not complete a minimum period of service was a contravention of article 1 of the European social charter on the grounds that it interfered with an officer’s right to work.”