Sir, – I find myself once again disappointed to read Dr Chris Luke (August 29th) propose draconian restrictions on non-consultant hospital doctors (NCHDs), who opt to spend a year working abroad, early in their careers, before returning to Ireland to join formal training schemes. Dr Luke seems to think that the reason Irish emergency departments are currently understaffed is due to this “gap year” phenomenon.
Typically, up to 100 recently-qualified doctors per year choose to head to the Antipodes, with the overwhelming majority choosing to return after one year. With almost 5,000 NCHDs in Ireland, we therefore lack only about 2 per cent of our graduates at any given time, and since the emigrating cohort is always replaced by those returning, the net effect is minimal.
Dr Luke praises those NCHDs who undertook medical degrees having already obtained a high honour in a previous undergraduate degree. I too have had the pleasure of working with some of these doctors and I share Dr Luke’s opinion that they bring something different to the practice of medicine from those of us who qualified aged 23. Certainly, I have never had cause to question their academic ability (unlike Dr Niall Conroy, August 25th). It may also be true that the mature graduates are less likely to spend a year working Down Under, but I have bad news for Dr Luke if he thinks they are the answer to his manpower crisis: to train as a fully-qualified GP takes a mere five years after graduation, as opposed to hospital-based specialties which take about 10. Many of the graduate-entry doctors are over 30 years old. Some have already hit 40.
Understandably then, most of the mature graduates to whom I have spoken want to become GPs, not emergency physicians or surgeons like we all did.
For those who would remain in a hospital specialty, the training is much more expeditious in other countries. My last intern, a mature graduate who worked as an engineer in the Celtic Tiger days, told me he intends to train in the US in order to “claw a few years back”.
Thus, Dr Luke’s solution is to reward those doctors with life experience gained before they became doctors but persecute those who try to experience life after qualification. Unfortunately, he will still be left with at least “dozens of vacancies” as our new class of mature doctors head for foreign shores – not for a year, but for life. – Yours, etc,