Medical Training in UK or Ireland - future prospects?

docbroc

Maybe your right. We should focus on the positives.

The HSE Benefits scheme

Weight loss - Constant stress plus no lunch breaks: The HSE diet
Savings - Working all day everyday with no time off : save a fortune
Divorce - Not a problem when your significant other dumps you as your sent to work in ballybog for a year
Easy access to prescription anti-depressants : Boy will you need them !
Stress- free holidays : plowing through stacks of paperwork for free
Increase your skills - do nurses jobs for them so they can work 35 hours a week
Travel the world as your forced to emigrate

The list goes on .............

sam34

Susie-O- wrote: »

and please, PLEASE don't be so patronising as to call me 'love'

likewise, please dont be so rude as to call those who are telling the (unpalatable) truth "miserable gits"

Susie-O- wrote: »

So stop being such miserable gits!

Jane5

well Susie, won't be calling you love anymore!

Since you seem to feel that us trying to warn you about what you've gotten into makes us "miserable gits", well ,allow me to warn you, you are about to get your ass handed to you in your intern year!

You actually have no idea what's waiting for you do you? Have you actually even ever been awake for 37 hours straight? Let alone worked in a stressful environment with sick and dying people for that long-with NO sleep or meal breaks? Or worked with the winter vomiting bug-yes, despite being infectious, you are required to attend work, many collapsed and were hooked up to an IV-and people brought them scripts to sign while on a trolley!

Have you ever gotten a needlestick from a cardiac arrest while in the middle of a 56 hour weekend with no sleep allowed? And waited 30 hours to hear their HIV status? I have. It's scary. You have to keep working though, as though nothing had happened. No-one gives a crap.

Now you may not want to believe these things that we are telling you, but they're true. Don't trot out that vocation crap, people who tell you your job is a vocation usually mean that they want you to do a lot of it for free, under crappy circumstances, because it's "a calling", and not, you know, a job, which is subject to employment legislation and therefore has limitations on how crap you can treat your employees. Bull****. No angel Gabriel came to me in the night telling me it was my sweet sacred path to become a doctor. I did it because I thought it might be interesting, and secure employment-one of those assumptions was wrong, and the interest has not been worth what I had to give up for it.

Honey, do yourself a favour, come back here after your intern year. Stop making a fool of yourself pontificating about things you have not experienced and know nothing about.

Jane5

Oh, and as for being paid so "damn well", I am making much less than if I had just become a teacher, I would have been way further up that payscale by now. And as I have no job security, my low pay is FA comfort. Not even a good mortgage risk.

ergo

interesting thread, and some very helpful replies posted by many different people with lots of varied experience of both the Irish system and abroad in different specialties - so to OP and Susie and anyone reading - ye are very lucky to have this insight

re the original question - I think it depends what you want to do and would you be happy to live in the UK forever? I don't think going to the UK will mean you won't be able to get back into the Irish system at junior doctor level - selection processes are becoming more transparent and all EU (?and more) are treated equally as far as I know

then again, what specialty you decide you want to do will probably determine whether or not you'll ever be able to live in Ireland ie. get a permanent job or have to look elsewhere - if it's something like Psychiatry or possibly Anasethetics there might be jobs but on the other extreme for something like Urology I suspect there are very few jobs. And then for GP apparently there's a big shortage of GP's, we have the among the lowest ratio of GP's to patients in the EU but there is no work right now for GP's because practices can't afford to take on new young GP's and all the uncertainty with cuts in funding and private patients attendences greatly reduced

last night I was out and I bumped into an old classmate of mine, she's about to complete her medical Spr scheme next year - really worried about the lack of consultant jobs coming up. Four years ago I rotated through the same specialty and worked for a fantastic spr who was just in her final year of training - I asked my friend if that Spr had gotten a (consultant) job yet - no she hadn't - 4 years later. I've heard of fully qualified spr's working shifts as locum intern to pay the bills. These are the realities at the end of a long career training pathway, the path you're about to start on. We're not being miserable for pointing this out

RobFowl

Susie-O- wrote: »

You're still a doctor, being paid pretty damn well (admittedly not as well as in times past), doing something you should enjoy and find rewarding. Please stop the attacking, I'm as entitled to my opinion as everyone else.

Hi Susie-O
I'm a bit long in the tooth so bear with me. I qualified in the early 90's from a class of 120. 7 of these are now consultants in Ireland. A similar number have left medicine.
I was one of the last who got paid full rates for the first 40 hours, 1/2 time for the next 32 and nothing after that. My worst experience was an 84 hour shift with 3-4 hours sleep in total.
Things improved after this largely due to a boards poster DrZ.
Unfortunately things are going backwards. The mater have announced they will not pay "unrostered overtime" except for transplants or "national emergencies". Believe me if you work there you will do alot of unrostered overtime. Training has been cut back with no funded training outside that provided by the HSE directly.
Every new consultant position will be provided at the expense of an existing NCHD one so for every new Consultant there will be one less job for students graduating to apply for (and they are increasing the number of graduates).
Don't get me wrong I'm a GP and I love my job. But the HSE is a nightmare to to work for. They view Doctors as "vested interests" and see us as a threat rather than a resource.
I would probably do medicine again but I would not be working in the Irish system if I knew then what I know now.
I'm sorry to be negative but the present system literally stinks at almost every level. Patients are great but the hierarchy is rotten. The HSE is a mess. Leadership from Doctors professional bodies is patchy. Training is poor compared to other countries in most specialities (thats being kind BTW). GP training is quite good but hard to access and once trained the job prospects are limited.
By all means go forward and hopefully prove all us naysayers wrong but do listen to all opinions and look at all the evidence (good and bad).

studentdoc

Susie-O- wrote: »

Best of luck with the GAMSAT, i hope it goes well! I'm currently a 5th (of 6) year medical student here in Ireland, and I was recently at a 'So you want to be a Surgeon' talk in RCSI. Almost all of the SpRs from a wide variety of specialties said that doing your training here gives you a huge advantage when it comes to getting jobs/promotions - and also, which might be of help in you making your choice, there are a lot of consultants, both surgeons and physicians, who will be retiring in the next 10-15 years, thus opening up a lot of places for trainees...and several higher training schemes will be offering more places over the next few years to fill these gaps. There will also be more new consultancy posts! The short answer is, as far as I can gather, if you train here, you'll probably get work here, and can also go back to the UK, but if you train in the UK, you'll need to be damn impressive to get back here before SpR level! Hope that helps!

Susie-O- Im a final med who was also at this RCSI-Surgeon talk. The overwhelming theme that I got from all SpRs who spoke that night was of the "bottle-neck" at the end of training trying to get onto SpR schemes and trying to make consultant.
We were repeatedly told that night that though training in Ireland is excellent job prospects are not! We were told to expect to go abroad and stay abroad for quite a long time at the end of your training and especially while awaiting consultant posts which are few and far between. The reality as we were told that night is that many go abroad and do not get the opportunity to return ever!
It is not enough to be optimistic because you enjoy what you do! I love what I do, Im a graduate who came back to do medicine with a massive loan on my head because of it! But that does not take away from the fact that the truth of the matter for irish doctors is dismal working conditions, poor career prospects, and overall a really awful place to try and practice medicine!!
I would not advise anyone to do medicine without having all the facts at their disposal! And it is unfair to anyone to tell them that the other posters here are painting a negative picture! they are painting the truth.Your rosy spectacles are not accurate!

bluewall

The reason for starting this thread, aside from looking for people's opinions on the differences between medical training in Ireland and the UK based on their experiences, was to ultimately see if those opinions given could help me make a more informed decision about my future in medicine beyond medical school. My only real goals from such a career (beyond the obvious altruistic reasons why most people get into medicine) like everyone else I'm sure; is to have a good quality of life and to earn a good living. Based on what people are saying in this thread maybe you could call me naive for wanting such things, but again this is why I started this thread in the first place - to find out about these things!

With the plethora of unsatisfied, disgruntled and clearly disillusioned doctors out there how has there not been some sort of a more recent uprising against the HSE? It quite honestly sounds like a better idea to be a bin man rather than work in the current Irish hospital system (going by this thread).

Jane5, with such a depressing outlook where is the light at the end of the tunnel for you and how do you intend on getting to it? If all of your colleagues are in similar positions, is the only real alternative to leave the country and if that is the case is the quality of life really that much better elsewhere?

dissed doc

bluewall wrote: »

The reason for starting this thread, aside from looking for people's opinions on the differences between medical training in Ireland and the UK based on their experiences, was to ultimately see if those opinions given could help me make a more informed decision about my future in medicine beyond medical school.

I think your thread was essential, as many med students are at a young age (I know I was) and only see forward to the next exam, with little understanding of long term objectives. The older Americans in the class usually have much more forward thinking, but they are typically coming into college here from the age of 22-23 or even older.

There is no uprising because by and large doctors do not respect each other and instead are lead to competing with each other to prevent any large unionised presence. Doctors are generally above average IQ and earning power. If they all ganged together, most governments would be ****ed as you can't buy off people who actually work based on principals and morals and not looking for bailouts.

Sorry for going off in a tangent - there is a point. The antitrust issues in the US prevent most doctors for literally "ganging up" and dictaing health policy. Most of the US movements in health care (including the current changes proposed by Obama) are geared towards non-medical areas extractign as much money from out between doctor and patient. The result is competition, and separation of identity and ultimately control as incomes can rise and fall each year.

In Europe, countries with strong doctors union tend to have the "good" healthcare systems - Germany, netherlands, France, etc., . In ireland, we are a derivative of the US system, and becoming even more so.. The result will be no uprising, but simply open competition: GPs are now allowed advertise for services - this was illegal until the recent Medical Practitioners Act. Thhere will be no "godlike" consultant in 10 years, save for a few academic positions. It will be entirely private and kill or be killed. This does not make for a pleasant work environment, when your colleagues are lookign for you to make a mistake and vice versa.

So far, many non-Dublin hospitals have been struggling to staff their rotas. There is no uprising because it's not in Irish culture to do it: the people who would uprise, uprise themselves onto a Ryanair flight to the UK, or elsewhere.

straight_As

Guys, thank you so much for this thread.

I'm doing the Leaving Cert atm, and I want(ed?) to do med.

But after reading this, holy fuck. I mean, I love the idea of the job, and I think the career would be unbelievably interesting, but I'm really starting to wonder about whether or not it is actually worth it.

I know that sounds selfish. But I have to be. I don't think I'd have the stomach to work in this system. I wouldn't be able to help patients if I was without sleep for 3 days. I don't think I could do it. I'd make mistakes. Patients would suffer. How could I argue myself as working for the patient if I accepted abject conditions which endangered the patient. It terrifies me.

Aswell, I want to have a family, a life. The opportunity to travel(?) sounds ok for the first few years, but I mean, after that? How could I possibly ask a partner to just pack up their career and move abroad just because I need to train. Is it possible to have a family, and more importantly, be part of your family, i.e., see your kids grow up, have time to love people?

This thread has screwed me up. I could pretend and say, 'oh this makes me want it more', but that would be bull. I've never been so confused.

That puts my last five years' dreams into perspective.

ergo

straight_As wrote: »

I know that sounds selfish. But I have to be. I don't think I'd have the stomach to work in this system. I wouldn't be able to help patients if I was without sleep for 3 days. I don't think I could do it. I'd make mistakes. Patients would suffer. How could I argue myself as working for the patient if I accepted abject conditions which endangered the patient. It terrifies me.

.

don't let this one reason (long hours) be the main thing that puts you off. the EWTD should be fully enforced by time you come through so hopefully not working longer than 13 hours in a row......hopefully.... Or go to AUS for a 40 hour week. for info google EWTD or search boards - I have to run to work!

tallaght01

straight_As wrote: »

Guys, thank you so much for this thread.

I'm doing the Leaving Cert atm, and I want(ed?) to do med.

But after reading this, holy fuck. I mean, I love the idea of the job, and I think the career would be unbelievably interesting, but I'm really starting to wonder about whether or not it is actually worth it.

I know that sounds selfish. But I have to be. I don't think I'd have the stomach to work in this system. I wouldn't be able to help patients if I was without sleep for 3 days. I don't think I could do it. I'd make mistakes. Patients would suffer. How could I argue myself as working for the patient if I accepted abject conditions which endangered the patient. It terrifies me.

Aswell, I want to have a family, a life. The opportunity to travel(?) sounds ok for the first few years, but I mean, after that? How could I possibly ask a partner to just pack up their career and move abroad just because I need to train. Is it possible to have a family, and more importantly, be part of your family, i.e., see your kids grow up, have time to love people?

This thread has screwed me up. I could pretend and say, 'oh this makes me want it more', but that would be bull. I've never been so confused.

That puts my last five years' dreams into perspective.

By the time you qualify, the hours will be better, but the conditions probably won't. BUt if you go straight in from school, you'll be competing for top jobs against GAMSAT graduates, who generally aren't as good as those who do the straight undergrad.

So, I think the picture may be a BIT better by the time you would be working.

docbroc

ergo wrote: »

don't let this one reason (long hours) be the main thing that puts you off. the EWTD should be fully enforced by time you come through so hopefully not working longer than 13 hours in a row......hopefully.... Or go to AUS for a 40 hour week. for info google EWTD or search boards - I have to run to work!

Nonsense. My current intern started medical school in 2005 - the year the Working Time Directive came into force. 5 years later and she did over a hundred hours last week (under duress - not from me and was paid for 48 of them. The HSE has conspired with the IMO to re-brand working time "study time". Thus if you work 80 hours a week - only 48 hours of it is actually work - the rest of it is training. Any difference ? Nope but it means that once again employment legislation doesnt apply to us. Thanks IMO - I dont remember voting on that ? When you graduate in 5 years working conditions will almost certainly be worse. The Irish are far to incompetent to run any large organisation be it government or health service. The EWTD has been ignored for 5 years , it will be ignored in another 5 years. The average working hours have gone up significantly for some sectors too - particularly SHOs who are forced to cover to absent interns ( for no money). Its a short leap until the HSE re-brands study time as free time and then I doubt we will even get the 8 hours overtime we do now.

tallaght01

docbroc wrote: »

. My current intern started medical school in 2005 - the year the Working Time Directive came into force. 5 years later and she did over a hundred hours last week (under duress - not from me and was paid for 48 of them. The HSE has conspired with the IMO to re-brand working time "study time". Thus if you work 80 hours a week - only 48 hours of it is actually work - the rest of it is training. Any difference ?

That's ****in disgusting, but I figured they'd get around the EWTD somehow. HSE are just scumbags.

Svalbard

I'm starting to get worried that this thread is turning people off medicine, so here's the positive spin on what has been said so far - medicine is a great career, just not in Ireland. To the OP, it doesn't really matter if you do your undergrad in Ireland or UK, so go with personal choice. But if you do study medicine be prepared to emigrate as soon as you graduate, then you will be better off.

tallaght01

Svalbard wrote: »

I'm starting to get worried that this thread is turning people off medicine, so here's the positive spin on what has been said so far - medicine is a great career, just not in Ireland. To the OP, it doesn't really matter if you do your undergrad in Ireland or UK, so go with personal choice. But if you do study medicine be prepared to emigrate as soon as you graduate, then you will be better off.

I LOVE my job (I do public health) but wouldn't work in Ireland. When I come home it will be with a view to working outside the HSE with an aid agency or Irish aid.

I do have a great job though

sam34

Svalbard wrote: »

I'm starting to get worried that this thread is turning people off medicine...

i may be partly responsible for that, so let me qualify what i have said on this and other threads...

yes, the conditions here are crap, and are likely to get worse

yes, the HSE treats us as if we are scum of the earth and not worth their while bothering with

but........

notwithstanding all that, i love my job. when you cut out the crap, the bureaucracy, the sh*te conditions, you get to the core clinical work, which i adore.

given the chance, and knowing what i know now, i would still do it all over again in a heartbeat.

RobFowl

Svalbard wrote: »

I'm starting to get worried that this thread is turning people off medicine, so here's the positive spin on what has been said so far - medicine is a great career, just not in Ireland.

I agree completely. I'm a GP in Ireland but if I was free to move abroad now I would. The HSE and the DOH seem at war with doctors in particular and terms and conditions are getting worse and worse.
As a career though medicine is fabulous, satisfying and challanging BUT Ireland is not a good place to work at the moment and probably for the next 5 years at least.

DrIndy

I do like being a doctor. I like to joke with my patients, settle their fears and see that through all their worries and pain - I can still make them laugh.

I like interacting with families and also being my patients advocate is getting them treated quickly and effectively and stand up for them against other teams and staff if needed.

I love the pace, the excitement of getting to the bottom of things and making people better.

However, medicine is not about sunshine, lollipops and rose-scented-farts. Its a grind, its awful and stressful sometimes and its is not good to be a doctor in ireland right now. Lets face it - it was NEVER good to be a doctor in ireland - but the salary and overtime compensated this somewhat.

Irish doctors are internationally sought because we have a very high academic standard and a very strong work ethic which makes other countries favour us to work there.

I'm staying on in Oz and watching closely what is happening. I hope it improves or I won't be back.

Psychedelia

thank god for the last page of this thread!

at least there is something good to be found!!

I'm in leaving cert and possibly naively want to do medicine.
the prospect is however becoming scarier everyday as accounts of reality accumulate.
i'd love to go abroad to do medicine but i didn't get accepted for UK and going to the continent would involve gaining fluency in another language which would take how many years?!

so after completing your six years in college, is it possible to escape somehow???

tallaght01

Psychedelia wrote: »

thank god for the last page of this thread!

at least there is something good to be found!!

I'm in leaving cert and possibly naively want to do medicine.
the prospect is however becoming scarier everyday as accounts of reality accumulate.
i'd love to go abroad to do medicine but i didn't get accepted for UK and going to the continent would involve gaining fluency in another language which would take how many years?!

so after completing your six years in college, is it possible to escape somehow???

You'll need to do an internship in Ireland. But afterwards you'll easily get a job in Oz or NZ, or possibly the UK.

Psychedelia

and is that much of the medical process in ireland bearable?? college + internship?

studentdoc

Psychedelia wrote: »

and is that much of the medical process in ireland bearable?? college + internship?

as a final med...the four years (im a graduate student) went so quickly!! Our class was amazing, the study is hardcore, but ive made some fantastic friends andd in medicine from the start we studied in groups-i never did that in my previous degree.... once you are on the wards and begin clinical work its just fantastic....i love going in everyday learning something new... i love meeting patients and hearing their stories....its been a hard slog but i loved it...

as for intern year...obviously im not there yet..but from the interns i know its a tough tough year long hours hard work (and in some centres who are EWTD "compliant" not paid for OT)and in a lot of hospitals little to no teaching...most just seem to slog their guts out for a good reference to get on a training scheme/go abroad.
BUT its the one year where your working with a load of your classmates, (most) senior team members look out for you and your really not expected to know a whole lot (except maybe EXACTLY how yr consultant likes his coffee!!)
also the training here is really excellant so ig you can get the points go for medicine here.. but be prepared to leave after intern year!!! most of my classmates will

p_holmz

Svalbard wrote: »

I'm starting to get worried that this thread is turning people off medicine, so here's the positive spin on what has been said so far - medicine is a great career, just not in Ireland. To the OP, it doesn't really matter if you do your undergrad in Ireland or UK, so go with personal choice. But if you do study medicine be prepared to emigrate as soon as you graduate, then you will be better off.

Can I just say I sat the GAMSAT yesterday at rcsi and I make it about 850 people sat for it. This is definitely up from last year. Things appear to much worse out there for Law, Engineering, Social Sciences, Business etc.

At least with medicine you have the assurance your qualification is transferrable other countries subject to passing thier academic requirement. The same cannot be said for Law, Business or even engineering. People who moved to australia have since come back unable to secure jobs in the banks. Lawyers who sat US bar exams have since returned also unsuccessful. Doctors will always be needed GLOBALLY recession or no recession.

I think the HSE will finally come to thier senses but lets hope its not too late for them or thier "tight budget".:rolleyes:

RobFowl

p_holmz wrote: »

At least with medicine you have the assurance your qualification is transferrable other countries subject to passing thier academic requirement. The same cannot be said for Law, Business or even engineering. People who moved to australia have since come back unable to secure jobs in the banks. Lawyers who sat US bar exams have since returned also unsuccessful. Doctors will always be needed GLOBALLY recession or no recession.

You need the USMLE's for the USA as they do not fully recognise our qualifications. They are recognised fully in the EU but everywhere else it does vary.

Bear in mind the basic degee is a bit like the leaving cert. The most important exam in your life until you get it, after which it's meaningless

bluewall

I just want to bring this thread back to life very briefly. Many thanks to all of those who posted their thoughts and comments up to now.

In 2 weeks the Irish Grad Med offers will be out and I am sure there will be plenty of people alongside myself having to decide between taking up a place in either the UK or Ireland.

As mentioned before, my concern is more about the post-graduate training and career path opportunities in the HSE versus the NHS.

The general consensus seemed to be choosing the UK over Ireland (or maybe just anywhere other than the HSE), but I'm just wondering if people really feel that strongly about it. Am I, and other people, about to torture ourselves slowly if we set our short to medium term futures inside the HSE? Is it THAT bad?

RobFowl

bluewall wrote: »

I just want to bring this thread back to life very briefly. Many thanks to all of those who posted their thoughts and comments up to now.

In 2 weeks the Irish Grad Med offers will be out and I am sure there will be plenty of people alongside myself having to decide between taking up a place in either the UK or Ireland.

As mentioned before, my concern is more about the post-graduate training and career path opportunities in the HSE versus the NHS.

The general consensus seemed to be choosing the UK over Ireland (or maybe just anywhere other than the HSE), but I'm just wondering if people really feel that strongly about it. Am I, and other people, about to torture ourselves slowly if we set our short to medium term futures inside the HSE? Is it THAT bad?

I'm a GP and did my postgraduate in the UK. I'm back in Ireland and have a FT position now.
I strongly feel the postgraduate training is better in the UK simply because it is more structured and stable. The HSE is a system in flux and there will not be enough training position for the number of graduates coming through. This will get worse over the next few years as thr numbers of training post goes down but the number of graduates increases.

Chunky Monkey

bluewall wrote: »

I just want to bring this thread back to life very briefly. Many thanks to all of those who posted their thoughts and comments up to now.

In 2 weeks the Irish Grad Med offers will be out and I am sure there will be plenty of people alongside myself having to decide between taking up a place in either the UK or Ireland.

Good luck!

tallaght01 wrote: »

That's ****in disgusting, but I figured they'd get around the EWTD somehow. HSE are just scumbags.

I'd agree with your comment about the HSE, certainly after what everyone has said here. However this is also happening in England, where the EWTD is fully in effect- you get paid for 48 hours a week but work at least 60 hours or more which you can't be paid for as it is illegal! Otherwise your consultant will tell you you're not taking your job seriously enough.

RobFowl wrote: »

You need the USMLE's for the USA as they do not fully recognise our qualifications. They are recognised fully in the EU but everywhere else it does vary.

I believe everyone outside of the US needs the USMLE's? I could be wrong though.

RobFowl wrote: »

I'm a GP and did my postgraduate in the UK. I'm back in Ireland and have a FT position now.
I strongly feel the postgraduate training is better in the UK simply because it is more structured and stable. The HSE is a system in flux and there will not be enough training position for the number of graduates coming through. This will get worse over the next few years as thr numbers of training post goes down but the number of graduates increases.

Is it stable? I'd love to hear from doctors currently working in the UK if there are any here.

What confuses me about the HSE (actually tell a lie, I wasn't surprised) is that the UK made the same mistakes a few years back...and yet Ireland decided to do the same thing. :rolleyes:

I know things are bad in Ireland and I will never come back to work here but there's 'the grass is greener on the other side' notion that may be cropping up here.

That being said I live in the South West and to quote a blood transfusion nurse who works here 'things are a bit backwards compared to the rest of the country'.

lonestargirl

Chunky Monkey wrote: »

I believe everyone outside of the US needs the USMLE's? I could be wrong though.

Everybody who wants to work in the US needs USMLEs regardless of where they graduated from. If you graduated outside the US you also need ECFMG certification.

mardybumbum

I have a question which arose from reading this thread.

I would also like to travel after college and have considered working in Oz or the U.S.
I know what the deal is concerning the USMLE's but what about Australia?
Would I need to sit supplementary exams to work there or New Zealand?

Also, what benefits, if any, are there to having an honours medical degree as opposed to an ordinary degree.
I put the minimal effort in during first year and although I didn't fail any exams, my results were mediocre to say the least.
I put in a big effort this year and did quite well in my exams. I know I could do the same for the remaining three years.
So, is there any advantage with an honours degree if I did decide to go abroad?