Medical training and competence


Sir, – In a court report carried in The Irish Times in 2016, we read of Mr Justice Peter Kelly’s concern at how a doctor who mistook an ankle for an elbow in an X-ray could have been employed in three Irish hospitals (“Judge concerned at how struck-off doctor got work”, News, October 18th, 2016).

Two years later, the same judge heard how a registered medic who had worked as a junior doctor in an Irish hospital maternity unit had said he was never taught how to examine a pregnant woman.

The judge said such issues were not “isolated” and he had encountered other cases where registered medical practitioners “with little knowledge of the basics of medicine” were nonetheless recruited to work in Irish hospitals.

Does anyone in the HSE, the Department of Health or the Medical Council actually read the newspapers? – Yours, etc,



Co Wicklow.

Sir, – We note with concern the comments of the president of the High Court, Mr Justice Peter Kelly, regarding the poor training of some doctors who graduated and trained overseas, and were subsequently recruited to work in the HSE (“Defective doctor recruitment poses danger to patients, judge says”, November 7th).

Medical education in Ireland is internationally renowned and its alumni have a proud tradition of delivering excellence in healthcare both in Ireland and abroad. Furthermore, our students are trained within Irish hospitals and healthcare settings.

The Irish universities not only provide medical education to Irish students, but also have a long history of training students from all over the world. The public can be reassured that the Irish Medical Council has a rigorous accreditation process for the medical education provided in all our medical schools.

However, while some of these international students would like to remain in Ireland for their postgraduate training and work as junior doctors in the HSE, currently they cannot do so.

This is because there are almost no pre-registration (intern) positions available to them. As a result, we are losing these high-quality graduates, while the HSE is recruiting foreign-trained doctors whose competencies may be in question.

An increase in the number of pre-registration positions for our graduates could reduce the HSE’s reliance on foreign-trained junior doctors and locum agencies.

We are committed to working with the relevant bodies to ensure that doctors providing healthcare in Ireland are of the highest standard. – Yours, etc,


Professor of Psychiatry,

Head of School of Medicine,

Trinity College Dublin;


Consultant Surgeon,

Head of School of Medicine,

National University

of Ireland, Galway;


Consultant Physician,

Head of School

of Medicine,

University College Cork;


Adjunct Professor

of Medicine,

Head of School of Medicine,

University of Limerick;


Professor of Surgery,

Head of School of Medicine,

Royal College of Surgeons

in Ireland;


Professor of Medicine

and Therapeutics,

Head of School of Medicine,

University College Dublin.

Sir, – Implicit in Mr Justice Peter Kelly’s much-publicised recent judgment in relation to the competence of a foreign graduate appointed as a senior house officer in obstetrics is a view that those employing doctors for even the most junior of posts above intern (junior house officer) level should not rely on the fact that they are on the general register of the Medical Council as evidence of basic competence.

A fundamental question arises as to how the Medical Council can be properly fulfilling its statutory role to protect the public when it is licensing some foreign-qualified doctors, as in the case in question, without the evidence of competence that is required of Irish graduates in the form of certification of successful completion of an internship year in recognised hospitals, or something equivalent. – Yours, etc,



Dublin 15.