Sir, – I was delighted to read Prof Shaun McCann’s thoughtful article “Why train doctors just to see them go” (HEALTHplus, January 31st, 2012).
He has analysed the reasons for this crazy state of affairs whereby we train them at our expense and then lose them to Australia or wherever, while leaving ourselves short of junior doctors here at home.
He has not, however, suggested how to remedy the defects – how to treat the “disease”. In medical terms, it is never sufficient to make the correct diagnosis, however satisfying, without also putting forward the therapy.
So, consider the broad picture – six years of medical study requires financing. Who pays? At present, funding is provided (inadequately) by the State, with a very minor contribution from the student, who then can decide at any point to emigrate free of responsibility, and free of debt. (Medical students in the US would love that!)
The remedy? Charge the incoming medical student a realistic annual fee. He or she can decide to pay it straight up, or in most cases take on a debt.
The six-year debt would be paid off either in full or in large part by working in our health service at the intern, senior house officer or registrar grade for a specified mandatory period of, say, three or four years
The result would be a fully staffed junior house doctor component throughout our health service; better funded and organised teaching in our medical schools, at both student and junior doctor level; and the normal facility if desired, for junior doctors to go abroad subsequently for further training, free of debt. – Yours, etc,