Scottish medical schools receive four times as much money per student from the State compared with universities in the Republic, according to a report published this week.
The report, compiled by the Medical Council, is based on visits to the State's medical schools in October and November last year. It says it wished to draw the public's attention "to the chronic underfunding of medical education which we now consider is interfering with attempts to reform and modernise the medical schools".
Commenting on the findings, Prof Tom O'Dowd, chairman of the Education and Training Committee of the Medical Council said: "They show the struggle medical schools are having to provide modern education for undergraduates".
He said the council was especially concerned at the huge disparity between funding in Northern Ireland and Scotland and that provided in the Republic.
Medical schools in the Republic received between €7,135 and €9,000 per EU student per year. According to the report, the University of Glasgow estimates the average grant for each of its medical students is €36,430. Queens University Belfast receives €34,976 per student per year.
As evidence that the lack of funding is blocking effective reform, the Medical Council says none of its 1996 recommendations to medical schools has been implemented in full.
While proposals on medical ethics teaching and clinical skills laboratories have been partially implemented, recommendations concerning the content balance of the curriculum and the need for special study modules still await implementation. The report is also critical of the lack of library space and the fact some schools continue to have accommodation problems.
The Irish Times understands there is some concern that modern practices are not being translated into the best standards of clinical care because of current shortcomings in the education system.
The 1978 Medical Practitioners Act requires the Medical Council to satisfy itself as to the content and delivery of medical education in the Republic.
The report is the first-ever publication of information gathered during visits to medical schools by the council.
According to the report, "the Department of Health and Children has no role in undergraduate medical education despite the fact that the graduates of the medical schools are eventually employed, in one way or other, by the Department of Health and Children.
This is an anomalous situation, and the Department needs to become engaged in the medical education process as a priority".
Prof O'Dowd confirmed that the council is to seek an urgent meeting with the Department of Heath and the Higher Education Authority to address the issues raised in the report.
"We are engaging external experts to assist medical schools in reform. We need to convince government that this reform is needed," he said.
The report also contains information on the gender balance of medical students in the Republic who started their studies in 2000.
With the exception of the Royal College of Surgeons in Ireland (RCSI), female EU students in all other medical schools outnumbered males by two or three to one. The genders are more evenly balanced among EU entrants to medical schools.
Both Cork and Galway have considerably more EU than non-EU students. In Trinity College Dublin and University College Dublin, the 2000 intake figures show a significant non-EU presence.
RCSI is primarily an international medical school, so EU students are in a significant minority there.
On a positive note, the Medical Council says it is pleased that considerable progress has been made on the intern year and that intern tutors and university co-ordinators are in place in all approved intern hospitals.
This follows initiatives in 2001 when the council produced a job description and log-book for newly qualified doctors. After qualifying in medicine, new doctors are provisionally registered with the Medical Council subject to the satisfactory completion of a 12-month internship. Concern had been expressed about the quality of teaching and the depth of supervision of newly qualified doctors in the State.
"The council is anxious that hospitals, medical schools, funding agencies and the council itself should establish structures to formalise intern education," the report says.
MAIN RECOMMENDATIONS
• The chronic underfunding of medical education in the State must be addressed urgently
• The teaching of medicine must become more balanced: more emphasis on medical ethics, the behavioural sciences and general practice
• The Department of Health must engage in shaping the context and delivery of medical education
• Some medical schools need to provide adequate lecture theatres, seminar rooms and library space
• The factual load in the curriculum must be reduced
• Intern training must be standardised