Doctor Retention in Ireland - Where Are the Failings That Prolong the Problem?; Comment on “Doctor Retention: A Cross-sectional Study of How Ireland Has Been Losing the Battle”

Document Type : Commentary

Authors

1 Royal College of Surgeons in Ireland, Dublin 2, Ireland

2 National Doctors Training and Planning, Health Service Executive, Dublin 8, Ireland

Abstract

The issue of doctor retention has been a challenge in Ireland for many years. Poor working conditions including poor supervision, cost of training, bullying, worsening mentoring experiences and speciality specific issues are a substantial challenge faced by doctors in Ireland, thus leading to a higher degree of emigration. While some changes have been introduced to the system and have some positive effects, the root causes of doctor emigration have not been addressed. This commentary reviews the publication by Brugha et al published in the IJHPM in April 2020 on “Doctor Retention: A Cross-sectional Study of How Ireland Has Been Losing the Battle” and explains why the current system needs to change for the benefit of patient safety, doctor well-being and better patient care. Ireland’s Health Service Executive intends to take steps towards developing a new model of medical workforce to address the issue of recruitment and retention challenges within the healthcare system.

Keywords

References

  1. Department of Health. Strategic Review of Medical Training and Career Structure: Report on Medical Career Structures and Pathways Following Completion of Specialist Training. Dublin: Department of Health; 2014.
  2. Brugha R, Clarke N, Hendrick L, Sweeney J. Doctor retention: a cross-sectional study of how Ireland has been losing the battle. Int J Health Policy Manag. 2020; In Press. doi:10.34172/ijhpm.2020.54
  3. Department of Health and Children, Hanly D. Report of the National Task Force on Medical Staffing [Hanly Report]. https://www.lenus.ie/handle/10147/46569.  Accessed June 23, 2020. Published 2003.
  4. Department of Health, Health Service Executive (HSE). Securing the Future of Smaller Hospitals: A Framework for Development. http://hdl.handle.net/10147/623977.  Accessed June 23, 2020. Published 2013.
  5. Department of Health. Working Together for Health: A National Strategic Framework for Health Workforce Planning. Dublin: Department of Health; 2017. https://assets.gov.ie/10183/bb9d696ba47945e6b065512356fcb6c3.pdf. 
  6. Burke S, Barry S, Siersbaek R, Johnston B, Ní Fhallúin M, Thomas S. Sláintecare - a ten-year plan to achieve universal healthcare in Ireland. Health Policy. 2018;122(12):1278-1282. doi:10.1016/j.healthpol.2018.05.006
  7. World Health Organization (WHO). WHO Global Code of Practice on the International Recruitment of Health Personnel. Sixthly-third World Health Assembly – WHA63.16, https://apps.who.int/iris/bitstream/handle/10665/3090/A63_R16-en.pdf.  Published 2010.
  8. National Doctor Training and Planning, Health Service Executive. Report of the NDTP Working Group on Doctors Not in Training: Optimising the Irish Medical Workforce. Dublin: HSE; 2019.
  9. Brugha RF, Cronin F, Clarke N, et al. Retaining our Doctors Medical Workforce Evidence, 2013-18. Challenges and Responses. Royal College of Surgeons in Ireland; January 2018. doi:10.25419/rcsi.10776611.v1.
  10. Nolan E. Foreign Doctors No Longer Want to Work in Irish Hospitals. The Irish Times. October 18, 2018. https://www.irishtimes.com/opinion/foreign-doctors-no-longer-want-to-work-in-irish-hospitals-1.3666637.  Accessed June 23, 2020.
  11. Humphries N, Connell J, Negin J, Buchan J. Tracking the leavers: towards a better understanding of doctor migration from Ireland to Australia 2008-2018. Hum Resour Health. 2019;17(1):36. doi:10.1186/s12960-019-0365-5
  12. Brugha R, McAleese S, Humphries N. Ireland: A Destination and Source Country for Health Professional Migration. RCSI Publishing; 2015. http://www.healthworkforceireland.com/uploads/1/0/6/5/10659222/year_1_project_case_study_ireland_1.pdf. 
  13. McGowan Y, Humphries N, Burke H, Conry M, Morgan K. Through doctors' eyes: a qualitative study of hospital doctor perspectives on their working conditions. Br J Health Psychol. 2013;18(4):874-891. doi:10.1111/bjhp.12037
  14. Medical Council of Ireland. Your Training Counts Results of the National Trainee Survey: Report on trainee career and retention intentions. Dublin: Medical Council of Ireland; 2016. https://www.medicalcouncil.ie/news-and-publications/reports/your-training-counts-report-on-trainee-career-and-retention-intentions-2016.pdf. 
  15. Training. New Zealand Resident Doctors Association website. https://nzrda.org.nz/rmos/training/.  Accessed June 30, 2020.
  16. British Medical Association. Working as a Doctor in Canada. https://www.bma.org.uk/advice-and-support/career-progression/working-abroad/working-as-a-doctor-in-canada.  Accessed June 23, 2020. Published 2019.
  17. Shah SM, Zaidi S, Ahmed J, Rehman SU. Motivation and retention of physicians in primary healthcare facilities: a qualitative study from Abbottabad, Pakistan. Int J Health Policy Manag. 2016;5(8):467-475. doi:10.15171/ijhpm.2016.38
  18. Robyn PJ, Shroff Z, Zang OR, et al. Addressing health workforce distribution concerns: a discrete choice experiment to develop rural retention strategies in Cameroon. Int J Health Policy Manag. 2015;4(3):169-180. doi:10.15171/ijhpm.2015.27
  19. Boonluksiri P, Tumviriyakul H, Arora R, Techakehakij W, Chamnan P, Umthong N. Community-based learning enhances doctor retention. Educ Health (Abingdon). 2018;31(2):114-118. doi:10.4103/efh.EfH_153_17
  20. Training COFS. Strategic Review of Medical Training and Career Structure, https://health.gov.ie/wp-content/uploads/2014/04/SRMTCS_CareerStructures_Report_FINAL.pdf.  Published 2014.
  21. Hirayama M, Fernando S. Organisational barriers to and facilitators for female surgeons' career progression: a systematic review. J R Soc Med. 2018;111(9):324-334. doi:10.1177/0141076818790661
  22. Keane M, Long J. Mentoring in Post-Graduate Medical Education and Specialist Training. https://www.hrb.ie/fileadmin/publications_files/Mentoring_in_post-graduate_medical_education_and_specialist_training.pdf.  Published 2015.
International Journal of Health Policy and Management

Articles in Press, Accepted Manuscript
Available Online from 01 September 2020

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