Madam, - I read with interest the findings of the labour market research unit of FÁS (The Irish Times, November 24th). Its report forecasts a shortage of over 1,000 general practitioners 2015. There are a number of points I wish to make.
1. There is no shortage of doctors in Ireland who wish to become GPs. General practice remains by far the most popular speciality among medical graduates. In fact, an average of 200 fully qualified doctors are rejected by the Irish GP training schemes annually because there are currently only 98 training places. Proposals to increase this number to 150 will not be enough to meet demand. Furthermore, this proposed increase was factored into the report commissioned by FÁS. At a time of critical shortages in the primary care sector this situation is unacceptable.
2. The Irish College of General Practitioners has contributed to this problem by insisting that its training schemes remain the only route by which a doctor can become a GP and remain in Ireland. By contrast, the UK allows a system of "self-structured" training. This system has allowed many Irish doctors to become GPs, but to do so they must emigrate. It is truly disappointing that the ICGP continues to ensure that a similar system does not operate in Ireland.
3. A further difficulty lies with the refusal of the ICGP to recognise a doctor's clinical experience before he or she enters the GP training scheme. This again contrasts with the UK system where previous training is fully recognised, often allowing a doctor to become a General Practitioner much more quickly. The rejection of this logical approach leads to unnecessary delays in doctors' qualification.
4. It should also be noted that since July 2005 the ICGP has increased the duration of most Irish GP training schemes from three to four years (in the UK almost all schemes last a maximum of three years). This additional time is to be spent by doctors working for a second consecutive year in a GP surgery. Here they will essentially do the same work as their GP colleagues but will be paid a lower income as "GP registrars". This form of extended cheaper labour was apparently deemed necessary by the ICGP for training purposes.
I believe that the current policies on GP training enforced by the ICGP are contributing to the future manpower crisis in primary care. This issue must be addressed urgently. - Yours, etc,
Dr RUAIRI HANLEY, (Trainee in General Practice), Mount Merrion, Co Dublin.