Before considering medicine as a career READ THIS!

jumpguy

Y'know, after medicine, if you find being a doctor ain't for you, can't you can always to to get into research? Might be worse paid, but at least you'd be happy (if you liked research).

Also, I'm convinced there's a good story for every bad story here. There's a lot of concentrated negativity in this thread, at this point, I'd be almost half-fearful of saying something positive before I'd get my head hacked off by some naysayer...

2Scoops

jumpguy wrote: »

Y'know, after medicine, if you find being a doctor ain't for you, can't you can always to to get into research?

Not exactly. It's true that some doctors do research, but for most it's a side project they do to get promoted. If you actually want to make a career out of it, you probably wouldn't succeed. A medical degree is not designed to give the holder any research skills. Why would anyone hire a medical graduate for a science position ahead of an actual scientist?

Biologic

2Scoops wrote: »

Not exactly. It's true that some doctors do research, but for most it's a side project they do to get promoted. If you actually want to make a career out of it, you probably wouldn't succeed. A medical degree is not designed to give the holder any research skills. Why would anyone hire a medical graduate for a science position ahead of an actual scientist?

I think you're placing too much value on the skills learned in a science degree. From a practical point of view, the BSc will only know some proteomics/genomics/imaging techniques that the medicine graduate doesn't. I've only been studying medicine a few months and have already covered the vast majority of the relevant science which took 4 years to cover during my BSc. In some areas we've gone into detail I only touched on in my MSc. The amount of irrelevant detail in a science degree makes the 4 years a waste of time. I mean, how often would I need to call on knowledge from my applied ecology module if I chose to do an Immunology PhD? And my degree wasn't even non-denominated. A medical degree is also alot more academically demanding and intense than a science one (at least it has been in my case to date).
If I was an employer or PI and was presented with one scientist and one medic, equal in everything bar their undergrad, I'd pick the medic every time. If, on the other hand, you meant that a medical doctor (no PhD) was going for a research position against a science doctor (PhD), then it'd be one unemployed medic. Quite an interresting topic.

2Scoops

Biologic wrote: »

If I was an employer or PI and was presented with one scientist and one medic, equal in everything bar their undergrad, I'd pick the medic every time. If, on the other hand, you meant that a medical doctor (no PhD) was going for a research position against a science doctor (PhD), then it'd be one unemployed medic. Quite an interresting topic.

I was thinking more research science as a career. A medical graduate vs. PhD-level. Although, a medical graduate would also lose if the job was entry-level lab jockey at Big Pharma tbh! :pac:

Now, many doctors do perform research but, by and large, it is part-time and not very worthwhile. Occasionally at the consultant level, you get a good PI, but again, they remain practicing medics throughout.

In terms of what the just-qualified doctor can do that isn't medicine... I imagine the best bet is either medical sales rep, politics, or retrain.

lonestargirl

2Scoops wrote: »

I was thinking more research science as a career. A medical graduate vs. PhD-level. Although, a medical graduate would also lose if the job was entry-level lab jockey at Big Pharma tbh! :pac:

Any research scientist is going to need a PhD at a minimum.

2Scoops wrote: »

Now, many doctors do perform research but, by and large, it is part-time and not very worthwhile. Occasionally at the consultant level, you get a good PI, but again, they remain practicing medics throughout.

I work in a very large, internationally known research hospital. We have a lot of physician scientists on staff. These are MD/PhD graduates who have split commitments, usually 40% clinical, 40% research and 20% teaching. It works well, but again it's not an option for someone who wants to get out of clinical medicine.

2Scoops

lonestargirl wrote: »

I work in a very large, internationally known research hospital. We have a lot of physician scientists on staff. These are MD/PhD graduates who have split commitments, usually 40% clinical, 40% research and 20% teaching. It works well, but again it's not an option for someone who wants to get out of clinical medicine.

I agree, but no such program is in place in Ireland and the quality of the research environment is much poorer than in the US.

lonestargirl

2Scoops wrote: »

I agree, but no such program is in place in Ireland and the quality of the research environment is much poorer than in the US.

Agreed, it's a pity as it's the kind of setup that I would love to work in.

Dr.NickRiviera

Dear DocDaneka,

I read your initial post and most of the posts by other users afterwards. I am totally sympathetic to your ordeal. Just to give you a bit of background. I graduated from an arguably top school in Dublin 2009 (TCD) and spent a year of my life on a waiting list to get an internship in Ireland. As an international graduate who paid close to 30k/year for 6 years we are put on the backburner when it comes to the limited jobs available. I left no stone unturned in Ireland. The reigns were held by a 'intern coordinator' who offered jobs to others with lower marks and qualifications in a shrouded and non-transparent allocation system.

I fell into the most dismal period of my life where I was broke, in debt and had seemingly no options. Yeah sure there were times when I exhibited clinical signs of morbid depression. God knows there were times when I wished I wouldn't wake up. If it were not for the support of my loved ones and surprisingly boards.ie members I would not have got through that ordeal.

Now I have emigrated to New Zealand. There I not only found an absolutely breathtaking country, but I found the opportunity to live my dream. I listen to my old classmates and the quality of lives they lead back home in dublin and I really sympathize with them. Only a few years ago that insane work schedule was well compensated for by the HSE with money. Tonnes of it. I had mates that were pulling 10k/month AFTER taxes. Yeah sure they had no lives but they had the incentive of paying off all their debts and the knowledge that it was only temporary.

Things have changed now. Junior doctors are overworked and no longer just underpaid. They are not paid at all! Already I have spread the word among my old fellow classmates and 15 of us have made the move over to New Zealand. I can't promise you that you won't have delusional nursing staff that try to bully you or consultants that feel the need to unload their issues on you on any given day. It is far rarer over here though I have to say. Unfortunately that is part and parcel of being a junior doctor. It's world wide. Deal with it. What I can promise you though is a certain level of quality of life that cannot be dreamed of in the Irish health system. Work hours are fine. I do about 45-65 hours a week generally and if I do any overtime I am paid diligently for it no questions asked. I actually get trained. My registrar is happy to teach me a procedure or if the consultant is around happier to explain a clinical scenario to me. They have the time to do that here unlike Ireland. I'm less than 6 months in and already I've put in chest drains, central lines, wrist reductions and assisted in appendicectomies, Hemicolectomies and even an Ivor Lewis Esophagectomy! I love my job and I love my career. That's a given over here. The special thing is that I actually have a life. I work and still have time to socialize, play team sports, explore the wonderful nature of New Zealand and would you believe it..surf! I never surfed a day in my life until one weekend decided to try it out. The sun shines most days. The food is to die for. Everything is roughly 50% cheaper than Ireland. I actually can't find ways to spend my wages here. I wake up in the morning with the sun and smile on my face. Need I go on?

As for prospective medical students of the future. Although the HSE is currently in total melt down. I urge you to not let that sway you from your vocation. If you want to become a doctor no hell or high water should sway you. In fact I am certain you will face a magnitude of adversities on your journey to becoming a doctor. It only makes you stronger. As I am sure all you doctors out there recognize. We endure for that one moment when we are able to use our skills and judgement to affect a patients life, to console a family member or to make a child smile or just listen to the ramblings of a 80 year old lady in her last days. A career in medicine is without a shadow of a doubt not for everyone. You will question and wonder your choice often, thats only normal. It is however a lifelong journey full of excitement, sacrifice, hardship but immeasurable satisfaction. You need to think ahead and set a plan. Decide what lifestyle you want to lead and what makes you happy. For some the thought of leaving Ireland is not even on the table. That's fine. If you can though I urge you to take a moment and research what is out there. Word on the street is people are moving to Australia and New Zealand. Find those people and talk to them. Their feedback I am sure will prove inspiring. If you are not happy then you need to rectify the issue. Negativity only breeds more negativity and the day when you find yourself inadvertently unloading on a patient is the day you know its too late. Do not let it get that far. Empower yourself and live your life and career the way YOU want to.

If I'm not mistaken you will be soon applying for a training scheme in Ireland. If you're already there then I wish you the best of luck and strength in enduring. If you still haven't I urge you to contact me for further details about moving and working in New Zealand. I swear to you it will be the best move of your career and life.

As a final note. I have to say I miss Ireland and Dublin every single day. The healthcare system is a joke. We all know that. But the Craic there is unique and Ireland will always be my second home. If things were better I'd head back in a flash even though I may not see the sun for 6 months or pay unrealistic prices for everyday commodities. Ah sure I'd even give up my 3 bedroom villa overlooking the beach to be back in my warm 1 bedroom viewless apartment in Smithfield market taking the Luas to James' every morning...hmmm...or maybe not...:)

Take care people and feel free to message me with any queries.

Dr.NickRiviera
Coninuetur Remedia

bluewall

Thanks for that very interesting post Dr. Nick.

Did you have to sit any qualifying exams to be able to work NZ?

Out of interest - if anyone else happens to know, apart from the USMLE's for the US are there many other countries that require entrance exams to work there if you have Irish/EU medical degree??

Dr.NickRiviera

The New Zealand medical council requires that you complete a year of internship in Ireland in order to be able to practice there. As my particular case was unique I was granted a provisional licence to practice without any need to sit any exams. This loop hole is rare and only granted due to my qualification from TCD (apparently its regarded internationally as a top medical school) and firm backing from the hospital that offered me a post. In reality it meant I pretty much was thrown in the deep end as I started a house officer job as an intern. I won't lie the first 6 weeks was crazy. I laugh about it now but it truly was one hell of a ride. The beauty of medicine is experience trumps everything. The learning curve is phenominal! With dedication and commitment and above all else solid safe practice you'll be surprised the things you will get proficient at and also how fast you learn with the right approach and teaching. Doctors over here LOVE to teach if you are keen. Something I know for a fact is very rare in Ireland.

There is a shortage of junior doctors in New Zealand as the majority of graduates move to Australia. You may move to Australia and do your internship equivalent there but you will probably have to sit entrance exams. NZ has its own entrance exams but they are usually reserved for graduates outside the UK & Ireland. All in all NZ is far easier to get into and work in that Australia. Most start in NZ work for a year or two then move to Oz to work a few more. Fingers crossed if you follow that plan not only would you have lived a first class junior doctor lifestyle but you got to work & travel at the same time!

I applied and got accepted in other countries such as the UK however regardless of your qualification they require you to sit PLAB exams as it goes by passport rather than qualification. I remember my conversation with the PLAB administrator. I asked him politely after 30 minutes of conversation on the phone if he thought I really needed to sit an English proficiency exam. The last thing any graduate wants to do is sit more exams. You need to get working and start learning and earning. Of all the countries that you can do this in, New Zealand is arguably the best.

Hope that helps!

docbroc

As someone moving to NZ in the New Year you have made my day Dr Nick ! Thanks a lot for the post. I also graduated from TCD - unfortunately I got an internship. Wasted 3 years of my life being shafted around Irish Hospitals. Cant wait for a new start. Dreaming away already......................

jumpguy

2Scoops wrote: »

Not exactly. It's true that some doctors do research, but for most it's a side project they do to get promoted. If you actually want to make a career out of it, you probably wouldn't succeed. A medical degree is not designed to give the holder any research skills. Why would anyone hire a medical graduate for a science position ahead of an actual scientist?

Is a doctor not a scientist but with a different purpose and working environment? Diagnosing illnesses, treating illness, injuries, psychological illness, etc surely doctors one of the most capable practitioners of science (ie. a scientist)?

And also, you said you assumed it was med student graduate vs PhD. What are the opportunities for medicine graduates to undertake research solely? Surely medicine would be one of the best courses to do if you wished to undertake medical research? Research (in the beginning anyway) is obviously not as highly paid as working in a hospital, I realise that.

lonestargirl

jumpguy wrote: »

What are the opportunities for medicine graduates to undertake research solely?

Pretty much the same as a science graduate and a PhD would be necessary. People do leave medicine for basic science research, the current registrar of UCD has a medical degree but never practiced and was a lecturer in the physiology department before moving into his current role.

jumpguy wrote: »

Surely medicine would be one of the best courses to do if you wished to undertake medical research? Research (in the beginning anyway) is obviously not as highly paid as working in a hospital, I realise that.

Clinical research is, by and large, carried out by those who also have a clinical practice.

2Scoops

jumpguy wrote: »

Is a doctor not a scientist but with a different purpose and working environment? Diagnosing illnesses, treating illness, injuries, psychological illness, etc surely doctors one of the most capable practitioners of science (ie. a scientist)?

I think we differ on what science actually is. To me, science is the process of finding out new things through observation and experimentation. I don't agree that the practice of medicine itself fits that definition. Also, my comment was a follow up on whether a doctor could leave med to pursue science as a career, i.e. research.

jumpguy wrote: »

And also, you said you assumed it was med student graduate vs PhD. What are the opportunities for medicine graduates to undertake research solely?

Well, as I said before, many doctors perform science to some level. But, by and large, it is either a stepping stone to promotion or a side project to their clinical practice. Research as a career without medicine rarely happens in Ireland... or anywhere else.

jumpguy wrote: »

Surely medicine would be one of the best courses to do if you wished to undertake medical research?

I don't agree. Medicine teaches very little research skills, nor should it. I wouldn't hire a doctor to do a researcher's job.

A Neurotic

2Scoops wrote: »

I don't agree. Medicine teaches very little research skills, nor should it. I wouldn't hire a doctor to do a researcher's job.

As far as I know, most medical schools will offer an intercalated, research-based M.Sc during the med degree. I know in TCD we have the option of taking a year out after 3rd year to study for a M.Sc in Molecular Medicine, Neuroscience, Bioengineering, or Global Health.

Also, to a lesser degree, I've been told my med school has endeavoured to introduce more project- and research- based work in recent years. The main brunt of our last semester in Anatomy was to research, put together, present and teach each other projects on various parts of the head and neck, and next semester research projects will be a pretty large part of pharmacology, so much so that we get two weeks off in the middle of term solely to work on them.

We've also been informed about summer scholarships whereby we can apply to undertake our own research for an 8-week period under supervision.

All in all, obviously not as good as a proper science degree but the research opportunities are there for those of us who are interested!

lonestargirl

A Neurotic wrote: »

All in all, obviously not as good as a proper science degree but the research opportunities are there for those of us who are interested!

The original question posted was regarding going into research if you didn't like practicing medicine, that is very different from engaging in research (usually clinical, outcomes based) as part of your job as a doctor.

For a purely research career a medical degree is not worth any more than a science degree.

2Scoops

A Neurotic wrote: »

As far as I know, most medical schools will offer an intercalated, research-based M.Sc during the med degree. I know in TCD we have the option of taking a year out after 3rd year to study for a M.Sc in Molecular Medicine, Neuroscience, Bioengineering, or Global Health.

Also, to a lesser degree, I've been told my med school has endeavoured to introduce more project- and research- based work in recent years. The main brunt of our last semester in Anatomy was to research, put together, present and teach each other projects on various parts of the head and neck, and next semester research projects will be a pretty large part of pharmacology, so much so that we get two weeks off in the middle of term solely to work on them.

We've also been informed about summer scholarships whereby we can apply to undertake our own research for an 8-week period under supervision.

All in all, obviously not as good as a proper science degree but the research opportunities are there for those of us who are interested!

I'm not comparing a med degree with a basic science degree. I'm saying that full-time research gigs for qualified docs are few and far between. The things you have described are undergraduate projects, at best. If you think they give you any of the necessary research skills to secure full time employment in research, I disagree. The same can be said of basic sci degrees.

HQvhs

2Scoops wrote: »

I'm not comparing a med degree with a basic science degree. I'm saying that full-time research gigs for qualified docs are few and far between. The things you have described are undergraduate projects, at best. If you think they give you any of the necessary research skills to secure full time employment in research, I disagree. The same can be said of basic sci degrees.

I have to agree. While there is a much bigger focus on research in udnergraduate medicine, I think this is to prepare students for a world where doctors will also be carrying out more clinical research on the side (whether for an MD, promotional, or academic reasons). Medicine degrees also do not teach the same lab skills as any science degree, and are not particularly suited for preparing someone for a career in lab-based research. And rightfully so, too; a medicine degree prepares someone for being a clinician, a science degree prepares someone to be a scientist. There may be some overlap, but I think it would be very naive to assume one could simply jump ship to full-time research if medicine didn't work out without extensive retraining and considerable effort and expense. This is not to say it doesn't happen, just that it is very uncommon.

El_Dangeroso

Interesting (and horrifying) thread.

I had a brief flirtation with doing medicine but in my heart of hearts I know I'm not cut out for it. I work with doctors on a daily basis and I just couldn't do what they do. I did notice a trend though, people doing psychiatry and dermatology spr's tend to be a lot more chilled out and happy. Something to do with the specialty or co-incidence?

Also, if you want to get involved with clinical research as a doctor then you must continue clinical practice in order to get funding. Even the real big honcho's of research have to do this, it's seen as keeping your ear tuned to the needs of the patients, for whom research will ultimately benefit. Bench research I'm not so sure, but I don't think many doctors who'd accept the low wages, I know Phd's working for less than 30k!

docbroc

If you're looking for a job in Research a medical degree is definitely not the way to go. Each and every time you will lose out to someone with a Biochem degree and lab experience. To be honest the inter calculated years TCD does are a bit of a waste of time. 8 weeks indepedent research is a joke. These days you need a phd as a basic qualification for research / consultancy. Spending a year doing a msc is wasting a year you could be putting towards your phd. On the other hand it does postpone the time to the hell that is hospital medicine while you have some sort of a life left Medical research in Ireland is generally very low level stuff with job opportunities few and far between.

El_Dangeroso

docbroc wrote: »

Medical research in Ireland is generally very low level stuff with job opportunities few and far between.

I would argue that is changing, slowly. There has been a European-wide increase in clinical research, one of the largest clinical research organisations in the world is an Irish company. The reason that Ireland hasn't been seen as an attractive option for clinical research is that we were perceived as having overly strict regulations, when we were actually setting the benchmark that all European countries now adhere to. I'd say in 10-20 years time we'll have a much better research infrastructure than we do now, and medical graduates are always going to be needed for that.

2Scoops

El_Dangeroso wrote: »

The reason that Ireland hasn't been seen as an attractive option for clinical research is that we were perceived as having overly strict regulations, when we were actually setting the benchmark that all European countries now adhere to.

I would say that Ireland was one of the least strict countries in this regard until very, very recently. Does not explain why Ireland was not attractive for clinical research. I could point at far bigger problems tbh.

Things can only get better, though! :pac:

El_Dangeroso

2Scoops wrote: »

I would say that Ireland was one of the least strict countries in this regard until very, very recently. Does not explain why Ireland was not attractive for clinical research. I could point at far bigger problems tbh.

Things can only get better, though! :pac:

Ha! true

But believe it or not we put very strict regulations on clinical research in the late 80's (Control of Clinical Trials Act, 1987), which I think was response to a scandal that emerged from a pharma company performing vaccine trials on children without permission in the 60's and 70's.

Those regulations were perceived by the pharma industry as being overly draconian and Ireland was perceived as a 'difficult' place to conduct research but now they are the standard across Europe.

So I learnt in my GCP training anyway!

What other problems would you see btw? I'd be interested to know.

2Scoops

The regulations may have been strict compared with what was there before, but having obtained and renewed ethical approval for similar studies in Ireland and the US, Ireland is a walk in the park. As for other problems, I would point first and foremost at lack of infrastructure, expertise etc.

El_Dangeroso

2Scoops wrote: »

The regulations may have been strict compared with what was there before, but having obtained and renewed ethical approval for similar studies in Ireland and the US, Ireland is a walk in the park. As for other problems, I would point first and foremost at lack of infrastructure, expertise etc.

Ethical approval using a novel medicinal product? From the IMB or a local ethics group? The IMB are incredibly thorough having watched applications go through there numerous times, quite the opposite from a walk in the park! The regulations were much stricter than most of Europe when it came to testing novel drugs.

Re: infrastucture, completely agreed, my personal opinion would be the lack of joined up thinking when it comes to IT systems is a major barrier to conducting observational research in Ireland.

lonestargirl

2Scoops wrote: »

The regulations may have been strict compared with what was there before, but having obtained and renewed ethical approval for similar studies in Ireland and the US, Ireland is a walk in the park. As for other problems, I would point first and foremost at lack of infrastructure, expertise etc.

+1, the level of rigor applied to studies in the US is far higher, especially when we are talking about small in-house studies carried out by SHO, regs etc.

El_Dangeroso wrote: »

Ethical approval using a novel medicinal product? From the IMB or a local ethics group? The IMB are incredibly thorough having watched applications go through there numerous times, quite the opposite from a walk in the park! The regulations were much stricter than most of Europe when it came to testing novel drugs.

I would have thought that very few studies involve novel drugs, far more common would be:

• a new regime for an already established indication, e.g. 1 vs. 3 years hormonal therapy for prostate Ca
• an new indication for a medication whose use is already established in another setting.

El_Dangeroso wrote: »

Re: infrastucture, completely agreed, my personal opinion would be the lack of joined up thinking when it comes to IT systems is a major barrier to conducting observational research in Ireland.

The whole system does not favour research, treatment of patients is not standaridised and centralised enough to allow adequate numbers for many studies.

El_Dangeroso

lonestargirl wrote: »

+1, the level of rigor applied to studies in the US is far higher, especially when we are talking about small in-house studies carried out by SHO, regs etc.

I think in that case it is the local ethics committee in the hospital, which vary considerably, but believe me, it used to be worse!

lonestargirl wrote: »

I would have thought that very few studies involve novel drugs, far more common would be:

• a new regime for an already established indication, e.g. 1 vs. 3 years hormonal therapy for prostate Ca
• an new indication for a medication whose use is already established in another setting.

Both of those situations require at least consulting the IMB, but maybe some of those types of studies proceed without it. I know that most pharma-sponsored studies *should* have IMB approval, in order to get adequate insurance etc. The FDA are rigourous, but the GCP regulations hold their own in terms of strictness and are very rigourously implemented.

lonestargirl wrote: »

The whole system does not favour research, treatment of patients is not standaridised and centralised enough to allow adequate numbers for many studies.

It really is sad that such as small country doesn't have the same level of standardisation that larger countries do. We don't even have a national patient identifier, and according to the latest from the data protection commissioner, we won't be getting one anytime soon.

Chunky Monkey

Having just read this entire thread it seems that it consists of a group of doctors describing their real, and rather horrifying experiences, of working in Ireland and a group of medical students and various other members of the public calling them whinging b***ards with a few supporters in between...

take everything wrote: »

Maybe others here would disagree with this but surely a more gradual transition from student to work is better.

I wonder if the people who have to work their way through med school or who have any other kind of hardship whilst studying cope differently once they graduate than those who have had relatively privileged upbringings.

When working in Dublin I saw interns bullied, frazzled and frightened. This alone put me off ever coming back to work here. This thread has confirmed that.

IainSymptom

hello i would just like to take a moment to thank everyone for all the information given, it as made me re-think my future but only for a fraction of a minute.

Im in 5th year now and im dyslexic but saying that my J.C i recived 7 A1s in all houners and a B2 in pass english has im sure your all aware of now :P!

but my question is for everyone all imput is wanted,
since i can remember i wanted to be a docter and I love my country I love Ireland i love the people i love the land maybe not the prices but in genreal i love this place and deep in my heart i know i couldnt leave i just couldnt i would miss it to much and also i want a family here where i grew up im proud to be irish even with the way the country is at the moment i am proud to call myself one, but now i have to decide is it for me,
what are the hours the real hours on average(there is like 30 diff opinions i dont no which is which) and ill be going to TCD so what is the set up do i do 5years there and then become and intern? and for how many years do i do that and where do i go from there??
How do i get into GP?
what are the average earnings of medics i.e internship junior senior etc
for people in med and docters do you enjoy it would you do it again?
how does it effect your relationships with your partner or spouse??
do you see them often does it create conflict where you dont see them enough?

im really looking for a personal input on this i dont want to miss important thins with my family yano im the youngest of 7 brothers so you can imgaine what is the come weddings, children even ones outside of marrige ha and all the good things in life?? i love helping people but i also want to live a life where i meet someone i love and spend time with them while doing something i also love? is it a job where my career or my life come as one or can i have a family??

Iain

Kwekubo

A Neurotic wrote: »

As far as I know, most medical schools will offer an intercalated, research-based M.Sc during the med degree.

Trinity's the exception rather than the rule. Vast majority of places offer bachelor's degrees rather than master's degrees, the benefit being there is a broader range of fields you can choose to specialise in.