Mandate graduate doctors do 5 years in Ireland post qualification?

Nonoperational

ScumLord wrote: »

I've had the pleasure of going public and private for the same condition. There seemed to be as many of the blue shirts as patients, I assume the ones in blue clothing are all doctors of some sort. 4 of them were in and out to me in A&E, in the ward there were 3 nurses. They had me on 3 different antibiotics. then of course there's the roving gang of doctors that come in and talk over you as if you were some sort of a plant in the corner.

Privately I had one doctor throughout, one nurse managed the ward and I was on one antibiotic. The upshot of it all was that a week in a fancy private hospital was substantially cheaper than a week in a public hospital. I think public hospitals have become over concerned with bringing in more money to the point they do pointless extra work so they can increase the bill to private health insurers. Public hospitals have way more staff than they need because they're taking money off the foreign doctors. They have terrible efficiency and giving them more money and staff will only make this worse.

Public hospitals seem to treat health insurers like a cash cow, private hospitals treat them like customers.

I was going to write a reasoned detailed reply, but this post is so full of nonsense and lack of insight I don't know where to begin.

Lucas Castroman

pocketkings wrote: »

Scumlord, I'd like to tell you a bit about antibiotic prescribing:

You think that because you got three antibiotics in one place, and just one in the other, the latter is better care for some reason. But there are many situations where people need three antibiotics.

The obvious situation is that you show up with X wrong with you, where X can be caused by any number of organisms. What the doctors would do is take a sample (bloods, throat swab, etc) and send it to the lab to see what the actual bacteria causing the problem is. Since this can take several days to get a result, in the meantime they put you on an "empirical antibiotic regime" where they basically give you antibiotics to cover ALL the likely pathogens. Once the lab results come back, then they know exactly what you have, and can give you the correct antibiotic for that.

For example, you come in with suspected bacterial meningitis. This can be caused by a wide range of bacteria, strep pneumonia and nesseria meningitidis the most common. So to cover these, they give cefotaxime to cover n.meningitidis, vancomycin to cover strep pneumonia, and sometimes ampicillin as well, which covers listeria (common cause in children but less common in adults). The lab results come back, you have n.meningitidis that is penicillin susceptible, so they stop the drugs you are on and put you on benzylpenicillin.

Another example: you come in with bad pneumonia. This can be caused by all sorts of bacteria, hundreds probably. For this the guidelines say to treat with co-amoxiclav & clairithromycin. Co-amoxiclav is composed of two antibiotics, amoxicillin and clavulanic acid. These three will cover the vast majority of the possible causes. So this is another, common, situation where three antibiotics are given. Lab results come back, you have staph aureus, so they stop the drugs you are on and put you on flucloxacillin.

Note in both cases the drug you end up being given is not one of the initial three: this is because the initial three are broad-spectrum (ie kill loads of bugs) and the latter ones are narrow-spectrum (ie targeted to kill as few as possible, as long as that includes the bug that is the problem). They can't put you on narrow-spectrum drugs at the start though, as they don't know what bug they have to target. If your pneumonia was caused by strep pneumonia, strep pyogenes, H influenza, aerobic gram negative bacteria, legionella, mycoplasma pneumonia, etc then flucloxacillin wouldn't work.


My guess is that you went to the public hospital with something, they put you on three antibiotics empirically. By the time you were in the private hospital, the bug had been isolated and identified, (probably by the public hospital) and they knew what antibiotic was needed.

Also, there is no incentive that I am aware of to ever prescribe extra unnecessary antibiotics from either the doctor's POV or the hospital's. That's nonsense.

Don't bother, It's like trying to reason with a sheep.

quadrifoglio verde

My ex is studying medicine. She didn't want to leave Ireland for better pay or better working conditions, she wanted to leave Ireland so that she could get better training in a specialist hospital in the states. Her long tent plan was to cine back to Ireland but she knew that she'd never get the clinical exposure here if she stayed.
I'd guess that there is a significant number of junior doctors in this situation.

ProfessorPlum

quadrifoglio verde wrote: »

My ex is studying medicine. She didn't want to leave Ireland for better pay or better working conditions, she wanted to leave Ireland so that she could get better training in a specialist hospital in the states. Her long tent plan was to cine back to Ireland but she knew that she'd never get the clinical exposure here if she stayed.
I'd guess that there is a significant number of junior doctors in this situation.

Don't worry. Once your ex is actually practicing medicine, she'll want to leave for better working conditions too!

quadrifoglio verde

ProfessorPlum wrote: »

Don't worry. Once your ex is actually practicing medicine, she'll want to leave for better working conditions too!

Worry? I don't give a **** about her

pow wow

pocketkings wrote: »

Scumlord, I'd like to tell you a bit about antibiotic prescribing:

+1. This is exactly how the Microbiologist explained things to us (albeit in more layman's terms!) when my dad was in ICU with sepsis - he was on 3 antibiotics because they didn't have the luxury of waiting to find out exactly what infection he had, so (in his words) they threw everything they had at it hoping one or other of them would work.

I'm all for encouraging med students to stay after graduation, perhaps by giving them tax breaks on their income for five years or something similar to sweeten the deal significantly (if money is a motivating factor for them). Making it compulsory doesn't sit right with me though.

steddyeddy

Taco Chips wrote: »

The proposal is unworkable for a variety of reasons that have already been mentioned. Doctors are highly skilled, highly educated professional graduates not sheep to be heralded into a pen. If proper restructuring of the training and working conditions was implemented to say, follow the Oz/UK/US models then there would be less reasons for them to leave in the first place. Doctors get better training, better qualifications at home and can practice better medicine. Win win for everyone.

At the same time however there is a strong tradition for Irish doctors to spend some portion of their training abroad, to gain important highly specialised skills and knowledge that is only available in places like the US, Canada etc... This is actually extremely important because Ireland just isn't big enough to see some of the rarer diseases in clinical settings.

I think this is a bit arrogant to be honest. I've completed eight years to get a biochemistry doctorate and have friends who worked longer. I have friends arrive from other countries such as Malaysia and Russia trained in medicine, biochem or engineering and the conditions of their scholarship was for them to work in their own country for a certain amount of years. Plenty of people are highly educated. I would disagree with the skilled professionals thing as this varies from clinician to clinician.

Some people secured PhD funding from companies with the promise they work there for a few years. A lot of people are highly educated in this country but would kill for the job security clinicians have and no my PhD isn't in a niche area. I will have no problem getting good jobs but I think that people who get a doctorate of medicine in are extremely privileged and cost the taxpayer a lot of money and it would be no bad thing to work here for a few years in return.

Saying that there is something extremely wrong with the working hours of clinicians and that needs to be sorted ASAP before mandatory working in Ireland begins.

steddyeddy

seamus wrote: »

Just on this point, incompetent doesn't mean stupid.
Everyone knows at least one person who went to college, did really well, got a first class degree, and then discovered that when it came to working in the real world they were actually really crap at it.

Doctors go through training and assessment in college, but all that really does is cull the intellectually feeble and the complete weirdos. Until someone has actually been placed out into the hospital system and all that entails, you don't really know if they're going to be able to make it as a competent NCHD.

My wife does the exams for RCSI, she's an actress and so is given a scenario where she plays a patient and the student has to attempt to diagnose. It's a pretty robust test - it examines their manner, their ability to troubleshoot/diagnose with a live patient and their overall level of general medical knowledge.
Many people that in her words she wouldn't allow near her, still pass this test because it's only one facet of the whole thing. But if someone freezes up when attempting to diagnose a live patient or completely panics when that patient is screaming in pain and/or anger, they're likely to completely crumble when the hit the A&E in Tallaght.

And then we tell them that they're stuck there for five years unless they cough up €100k to buy their way out.

Eh, no thanks, I'd rather we let him go than let him near any patients.

Bingo. Highly educated does not mean highly skilled. There are people who came through our lab with first class honours degrees who were hopeless in the lab.

medicine12345

[/QUOTE]I think this is a bit arrogant to be honest. I've completed eight years to get a biochemistry doctorate and have friends who worked longer.

How did it take you 8 years to do a biochemistry doctorate, thought the average was 3 or 4 and how is this relevant to the thread

Some people secured PhD funding from companies with the promise they work there for a few years. A lot of people are highly educated in this country but would kill for the job security clinicians have and no my PhD isn't in a niche area. I will have no problem getting good jobs but I think that people who get a doctorate of medicine in are extremely privileged and cost the taxpayer a lot of money and it would be no bad thing to work here for a few years in return.

ok if they are highly educated and want the job of a clinician why didn't they do it then or why don't they go back and do it now?
how are they privileged? We are all taxpaying citizens of this country and we all do the same leaving cert ete, if people want to do medicine then do it. It is a 5 or maybe 6 year degree, I don't believe it costs much more than an engineering, dentistry, science degree etc. Why don't we force these graduates to stay in Ireland too? Also doctors do have to do a year internship here after they qualify.

steddyeddy

I think this is a bit arrogant to be honest. I've completed eight years to get a biochemistry doctorate and have friends who worked longer.

How did it take you 8 years to do a biochemistry doctorate, thought the average was 3 or 4 and how is this relevant to the thread



ok if they are highly educated and want the job of a clinician why didn't they do it then or why don't they go back and do it now?
how are they privileged? We are all taxpaying citizens of this country and we all do the same leaving cert ete, if people want to do medicine then do it. It is a 5 or maybe 6 year degree, I don't believe it costs much more than an engineering, dentistry, science degree etc. Why don't we force these graduates to stay in Ireland too? Also doctors do have to do a year internship here after they qualify.

I did a four years undergraduate in biochem and four years PhD. I'm bringing it in because I'm sick of the clinicians saying highly educated therefore we shouldn't bring in mandatory working in their home country. Physicists, engineers, biochemists ect are all educated as much if not more in some cases than clinicians but they would kill for a the job security clinicians have.

Some graduates are forced to work in their home countries for instance. We have free fees here for everyone. Whether you're rich or poor. International students who get scholarships to come here and as a condition of that they work in their home countries.

Clinicians graduate from a free medicine course (free relative to other countries) with a reasonably good education and enter a job with fantastic job security. As I said the priority is too sort out the working hours but once that's done there's no reason clinicians shouldn't stay here for around four years like a lot of other graduates.

I don't go back and do it because I want to be a scientist. If there was guaranteed jobs for doctorate level candidates then there is nothing wrong with asking engineers and scientists too stay here.

ProfessorPlum

steddyeddy wrote: »

I think this is a bit arrogant to be honest. I've completed eight years to get a biochemistry doctorate and have friends who worked longer. I have friends arrive from other countries such as Malaysia and Russia trained in medicine, biochem or engineering and the conditions of their scholarship was for them to work in their own country for a certain amount of years. Plenty of people are highly educated. I would disagree with the skilled professionals thing as this varies from clinician to clinician.

Some people secured PhD funding from companies with the promise they work there for a few years. A lot of people are highly educated in this country but would kill for the job security clinicians have and no my PhD isn't in a niche area. I will have no problem getting good jobs but I think that people who get a doctorate of medicine in are extremely privileged and cost the taxpayer a lot of money and it would be no bad thing to work here for a few years in return.

Saying that there is something extremely wrong with the working hours of clinicians and that needs to be sorted ASAP before mandatory working in Ireland begins.

Firstly, very few people have a doctorate in medicine, and if they do, they have funded it themselves, not the taxpayer. Medical graduates cost the taxpayer about €35,000, according to NUIG. Hardly hugely more expensive than other graduates. If any of them secure a scholarship from a private company or individual, of course the source can stipulate what they want in return. Nobody's arguing with that. The issue is that some people see no problem singling out medical graduates, above all other graduates in the country, and insisting they work here for 5 years. This would in most cases be detrimental to their training, their career progression, and ultimately bad for medicine in this country. Or would you prefer that only the rich graduates get to buy themselves out and get a head start in their career??

medicine12345

steddyeddy wrote: »

I think this is a bit arrogant to be honest. I've completed eight years to get a biochemistry doctorate and have friends who worked longer.

I did a four years undergraduate in biochem and four years PhD. I'm bringing it in because I'm sick of the clinicians saying highly educated therefore we shouldn't bring in mandatory working in their home country. Physicists, engineers, biochemists ect are all educated as much if not more in some cases than clinicians but they would kill for a the job security clinicians have.

Some graduates are forced to work in their home countries for instance. We have free fees here for everyone. Whether you're rich or poor. International students who get scholarships to come here and as a condition of that they work in their home countries.

Clinicians graduate from a free medicine course (free relative to other countries) with a reasonably good education and enter a job with fantastic job security. As I said the priority is too sort out the working hours but once that's done there's no reason clinicians shouldn't stay here for around four years like a lot of other graduates.

I don't go back and do it because I want to be a scientist. If there was guaranteed jobs for doctorate level candidates then there is nothing wrong with asking engineers and scientists too stay here.

Do you realise that nearly half of medical graduates now are post-grads who did an undergrad in something else and then funded their own 4 year medical course by paying 60,000 euro in fees? Should they have to stay aswell?
Do you realise that it is impossible to qualify in certain specialities in this country without training in america or another country for a few years? why force them to stay here for 4 years working dead end jobs moving around the country every few months with poor pay working up to 100 hours a week?

steddyeddy

ProfessorPlum wrote: »

Firstly, very few people have a doctorate in medicine, and if they do, they have funded it themselves, not the taxpayer. Medical graduates cost the taxpayer about €35,000, according to NUIG. Hardly hugely more expensive than other graduates. If any of them secure a scholarship from a private company or individual, of course the source can stipulate what they want in return. Nobody's arguing with that. The issue is that some people see no problem singling out medical graduates, above all other graduates in the country, and insisting they work here for 5 years. This would in most cases be detrimental to their training, their career progression, and ultimately bad for medicine in this country. Or would you prefer that only the rich graduates get to buy themselves out and get a head start in their career??

No I wouldn't prefer one socio-economic group to prosper. This would result in a dumbing down of graduates.

I totally accept that moving around is key to training. I would get nowhere If I did a undergraduate studies, PhD and post doc in the same country. Clinicians get singled out by the media because they are entering a stable well paid job as opposed to other graduates coming from equally hard degrees with no such guarantee.

ProfessorPlum

Medics are not moving I to a stable job! Most contracts are for 6 months maybe a year. I'm sure almost anyone in the country can find an employer willing to take them on when the worker will commit to working up to 100 hours per week and not expect their overtime to be paid.

Medics get singled out because the health service has been run into the ground over years of bad planning and bad management, and rather than fix it they think they can force doctors to work in it.

chumbawumba369

steddyeddy wrote: »

No I wouldn't prefer one socio-economic group to prosper. This would result in a dumbing down of graduates.

I totally accept that moving around is key to training. I would get nowhere If I did a undergraduate studies, PhD and post doc in the same country. Clinicians get singled out by the media because they are entering a stable well paid job as opposed to other graduates coming from equally hard degrees with no such guarantee.

I think doctors get singled out by the media for lots of reasons, we're seen as elitist and minted and no-one likes paying a GP 50 quid. But there's certainly a lot of ridiculous comments and misconceptions about doctors too. I've always thought 'Junior doctor' for example is an insulting title for an SpR with 8 years experience and people with no clinical experience have no problem making absolutely ridiculous comments which has happened in this thread. Christ, you yourself criticised using three antibiotics and what was that based on? Embarrassing.

I think veterinary is a harder degree than medicine but I can't see many other degrees being equally hard. 7am surgery starts on placement, getting regularly grilled and embarrassed by consultants, written exams and OSCEs with a huge knowledge requirement; if you get a 1st or an A in a medicine degree you deserve it, in my class 2% of people did. That's 2% of people with 580 plus points in their leaving so they're mostly going to be very hard workers. There's a reason it's a 5-6 year degree, you can't fit it all into 3 or 4 years like some business or science degrees. The final few years are a complete slog

And I've noticed you have a problem referring to doctors as 'doctor', I've never used the title outside of work but don't you feel that we earn the title? Or should it be for those with pHds who remain in the education field.

towelly

It would be possible to legally tie doctors to work a minimum term in Ireland after qualification, and impose a financial penalty should they decide to leave early, if there was an appetite to do so.

chumbawumba369 wrote: »

I think doctors get singled out by the media for lots of reasons, we're seen as elitist and minted and no-one likes paying a GP 50 quid. But there's certainly a lot of ridiculous comments and misconceptions about doctors too. I've always thought 'Junior doctor' for example is an insulting title for an SpR with 8 years experience and people with no clinical experience have no problem making absolutely ridiculous comments which has happened in this thread. Christ, you yourself criticised using three antibiotics and what was that based on? Embarrassing.

I think veterinary is a harder degree than medicine but I can't see many other degrees being equally hard. 7am surgery starts on placement, getting regularly grilled and embarrassed by consultants, written exams and OSCEs with a huge knowledge requirement; if you get a 1st or an A in a medicine degree you deserve it, in my class 2% of people did. That's 2% of people with 580 plus points in their leaving so they're mostly going to be very hard workers. There's a reason it's a 5-6 year degree, you can't fit it all into 3 or 4 years like some business or science degrees. The final few years are a complete slog

And I've noticed you have a problem referring to doctors as 'doctor', I've never used the title outside of work but don't you feel that we earn the title? Or should it be for those with pHds who remain in the education field.

7am starts? Getting grilled by superiors? That's shocking stuff altogether.

chumbawumba369

towelly wrote: »

It would be possible to legally tie doctors to work a minimum term in Ireland after qualification, and impose a financial penalty should they decide to leave early, if there was an appetite to do so.



7am starts? Getting grilled by superiors? That's shocking stuff altogether.

I didn't say it was shocking, it's completely necessary as it's preparing you to start as an intern. What I did say was its part of what makes medicine a tough course.

towelly

chumbawumba369 wrote: »

I didn't say it was shocking, it's completely necessary as it's preparing you to start as an intern. What I did say was its part of what makes medicine a tough course.

Sounds incredibly tough alright

medicine12345

towelly wrote: »

Sounds incredibly tough alright

Its all relative. It is tougher than the majority of other college courses.. In terms of contact hours, exams etc........

chumbawumba369

towelly wrote: »

Sounds incredibly tough alright

A good point well made.

Onto your other similarly well thought out post, of course you can't legally tie anyone to work in Ireland and good luck pursuing anyone who emigrates before their service is complete. You could charge fees upfront for medicine courses alright but everyone in Ireland gets a chance at a free degree if you take it away from one course that's not particularly fair.

towelly

chumbawumba369 wrote: »

A good point well made.

Onto your other similarly well thought out post, of course you can't legally tie anyone to work in Ireland and good luck pursuing anyone who emigrates before their service is complete. You could charge fees upfront for medicine courses alright but everyone in Ireland gets a chance at a free degree if you take it away from one course that's not particularly fair.

You need to look at the art of the possible.

Could fees be introduced for medicine? What is fair? Is it fair on taxpayers that people who receive a subsidised education in a field where there is currently a shortage of qualified personnel, which affects our compliance with EU law, leave as soon as they're qualified?

Training bonds may be an option that would make a few doctors think twice about jumping ship immediately. They are used in other professions, why not medicine?

Of course, if someone decides to buy a one way ticket out of Ireland after qualifying, there is little that can be done unless they return.

ProfessorPlum

towelly wrote: »

You need to look at the art of the possible.

Could fees be introduced for medicine? What is fair? Is it fair on taxpayers that people who receive a subsidised education in a field where there is currently a shortage of qualified personnel, which affects our compliance with EU law, leave as soon as they're qualified?

Training bonds may be an option that would make a few doctors think twice about jumping ship immediately. They are used in other professions, why not medicine?

Of course, if someone decides to buy a one way ticket out of Ireland after qualifying, there is little that can be done unless they return.

Sorry, but I had to have a good laugh at that! We have been non compliant with EU law since the EWTD was introduced (and even then the government asked for an exemption because they knew they couldn't be compliant) those were back in the god old days when most doctors were staying in Ireland. Some of the greatest abuses were happening in big teaching hospitals were jobs were coveted by doctors. It had NOTHING to do with the availability of doctors and EVERYTHING to do with the government not employing enough doctors because it was cheeper to get fewer doctors to work more hours, for free.

If med students should pay for their undergraduate degree (and there's an argument to be made for that), well then so should everyone.

humbert

If someone is critically ill they'll pay anything to be given the chance to recover. In countries that fully exploit this, like America, doctors can get very good salaries. It's hard to compete with this.

However, unless the Irish government are subsidising the course then they have no right to impose conditions. Malaysia, for example, will sponsor a student to come here if they work a certain number of years back there later.

Iwasfrozen

humbert wrote: »

If someone is critically ill they'll pay anything to be given the chance to recover. In countries that fully exploit this, like America, doctors can get very good salaries. It's hard to compete with this.

However, unless the Irish government are subsidising the course then they have no right to impose conditions. Malaysia, for example, will sponsor a student to come here if they work a certain number of years back there later.

The Irish government has no right to impose restrictions on emigrating anyway. This is the line of thought that lead to the Berlin wall and is against the EU rules to restrict the travel of any citizen the issue is a non starter.

chumbawumba369

towelly wrote: »

You need to look at the art of the possible.

Could fees be introduced for medicine? What is fair? Is it fair on taxpayers that people who receive a subsidised education in a field where there is currently a shortage of qualified personnel, which affects our compliance with EU law, leave as soon as they're qualified?

Training bonds may be an option that would make a few doctors think twice about jumping ship immediately. They are used in other professions, why not medicine?

Of course, if someone decides to buy a one way ticket out of Ireland after qualifying, there is little that can be done unless they return.

It's doctors who are hurting over non compliance withe the EWTD. No-one in the Uk or Oz is doing an 80 hour week normally. The article on the first page is talking about 100 hour weeks and 36 hour shifts and people are wondering why doctors don't want to work in Ireland. Ireland has had 10 years plus to comply with EWTD, improve conditions and to create more training posts but they can just blame doctors for emigrating instead and people will believe them.

Doctors sometimes emigrate for better training and then return to consultant posts in Ireland. Sometimes they leave because they're sick of crap conditions that are illegal in any other job. How long should someone have to work to pay back the state? Is an intern year with 70 hours a week enough? Or the years after that when things get worse. How many 36 or 48 hour shifts does someone have to have worked before people stop thinking you owe them.

I think sometimes people find it hard to sympathise with doctors. If other healthcare professionals had similar conditions I think there'd be more of an outcry. Junior doctors in Ireland have gone on strike for one day in 30 years to try and reduce working hours to healthy levels and even then it was organised so it would affect patients as little as possible

99% of Irish doctors graduating will stay working in Ireland for at least a year. If you want to retain them after that make working here reasonable.

And what other undergraduate degree uses training bonds? I've heard of it in finance masters but thats about it.

humbert

Iwasfrozen wrote: »

The Irish government has no right to impose restrictions on emigrating anyway. This is the line of thought that lead to the Berlin wall and is against the EU rules to restrict the travel of any citizen the issue is a non starter.

I assume they can impose conditions on the subsidy (apologies if this as been addressed earlier in the thread. It's not philanthropy, it's what's best for the country.

chumbawumba369

humbert wrote: »

I assume they can impose conditions on the subsidy (apologies if this as been addressed earlier in the thread. It's not philanthropy, it's what's best for the country.

I don't think there's much of a problem filling intern or SHO jobs at all. It's more regs and consultants who are needed, particularly in peripheral hospitals. Unless you want to tie doctors to Ireland for 10 years after they graduate this won't work. And you want your consultants to have spent time working in the specialist centres in Canada and US and Australia before they come back here anyway.

Nonoperational

towelly wrote: »

Sounds incredibly tough alright

Not sure why the attitude is necessary. Medicine is a relatively secure career and it's not always hard, but there is a mountain of **** you have to put up with.

You have no set hours, you work until the work is done and you may or may not get paid when you stay late or start early.

You can rarely take more than 1 week off until you are well well into your training or a consultant, and you rarely have a choice over when you can take your week off. You rarely get more than 2-3 weeks notice of the week you can take off, and some jobs just assign you weeks off with no input from yourself. I've missed countless family events and occasions and there's feck all I can do about it.

You have to work the overtime necessary for the hospital. No choice. I've had jobs where I've had to work 60 hours a week every week. No choice in the matter at all.

I've no idea where I'll be placed for the next 7 years. Anywhere they want to put me, anywhere in the country, I'm off and there's no discussion about it. It's incredibly ****ty trying to plan your life around it tbh.

You have no set lunch or breaks at all. You work if there are jobs to do and you try and take a break if you can. You are contactable by your bleep every minute of the day while you're in the hospital.

The money is no better than many other professions and worse than lots.

I'm far from looking for sympathy, it's a good job and I appreciate having it, but the **** you put up with wouldn't be tolerated in many (or any) other job in the county. On top of that you have a responsibility to patients to look after them to the very best of your ability and the trust to intervene and treat them as you see fit. Expecting and striving for decent conditions isn't being arrogant or pompous. Instead of forcing people to stay, maybe conditions and training should be improved and they'd be no need.

humbert

chumbawumba369 wrote: »

I don't think there's much of a problem filling intern or SHO jobs at all. It's more regs and consultants who are needed, particularly in peripheral hospitals. Unless you want to tie doctors to Ireland for 10 years after they graduate this won't work. And you want your consultants to have spent time working in the specialist centres in Canada and US and Australia before they come back here anyway.

That essentially comes back to my first point. What will a person pay not to die - anything they have. The most lucrative place to work will be the place that exploits this to the fullest.

chumbawumba369

humbert wrote: »

That essentially comes back to my first point. What will a person pay not to die - anything they have. The most lucrative place to work will be the place that exploits this to the fullest.

For most doctors the problem with Ireland isn't money, it's training and conditions.

Caledonia

So true about the regs and consultants being needed imo. It's so sad to see case after case in the courts where there was a delay in calling a consultant/poor clinical decision made and the awful outcomes. It's not the same as a mistake anyone could make, it's the preventable errors that someone with better training could have caught.

People give out about specialists, but these cases only highlight how much we need them. And how much it matters that they are excellent clinically, which Irish consultants generally have been.
No offence to you PhD guy but what most Irish people -me included -are worried about is real doctors.

humbert

chumbawumba369 wrote: »

For most doctors the problem with Ireland isn't money, it's training and conditions.

I'll admit that I only know three doctors, but for them the incentive to leave is money.

Iwasfrozen

humbert wrote: »

I assume they can impose conditions on the subsidy (apologies if this as been addressed earlier in the thread. It's not philanthropy, it's what's best for the country.

Once again this is the kind of thinking that lead to the Berlin wall and it is against European rules to place restrictions on travel.

You plan won't prevent doctors from leaving it will just encourage those who do leave to stay away forever under fear of prosecution should they return.

towelly

Nonoperational wrote: »

Not sure why the attitude is necessary. Medicine is a relatively secure career and it's not always hard, but there is a mountain of **** you have to put up with.

You have no set hours, you work until the work is done and you may or may not get paid when you stay late or start early.

You can rarely take more than 1 week off until you are well well into your training or a consultant, and you rarely have a choice over when you can take your week off. You rarely get more than 2-3 weeks notice of the week you can take off, and some jobs just assign you weeks off with no input from yourself. I've missed countless family events and occasions and there's feck all I can do about it.

You have to work the overtime necessary for the hospital. No choice. I've had jobs where I've had to work 60 hours a week every week. No choice in the matter at all.

I've no idea where I'll be placed for the next 7 years. Anywhere they want to put me, anywhere in the country, I'm off and there's no discussion about it. It's incredibly ****ty trying to plan your life around it tbh.

You have no set lunch or breaks at all. You work if there are jobs to do and you try and take a break if you can. You are contactable by your bleep every minute of the day while you're in the hospital.

The money is no better than many other professions and worse than lots.

I'm far from looking for sympathy, it's a good job and I appreciate having it, but the **** you put up with wouldn't be tolerated in many (or any) other job in the county. On top of that you have a responsibility to patients to look after them to the very best of your ability and the trust to intervene and treat them as you see fit. Expecting and striving for decent conditions isn't being arrogant or pompous. Instead of forcing people to stay, maybe conditions and training should be improved and they'd be no need.

What you describe is par for the course for a lot of other professions too.

towelly

Iwasfrozen wrote: »

Once again this is the kind of thinking that lead to the Berlin wall and it is against European rules to place restrictions on travel.

You plan won't prevent doctors from leaving it will just encourage those who do leave to stay away forever under fear of prosecution should they return.

Once again, nobody is saying you can't prevent people from emigrating or place such restrictions on travel.

chumbawumba369

towelly wrote: »

What you describe is par for the course for a lot of other professions too.

It's not though is it. There's no other job that're expected to do the hours we do. Christ there's EU laws against it. I have never heard of another profession who are rostered for 36 hour shifts.

Its remarkable the amount of animus, apropos of a largely false impression of the benefits of a career in medicine, that doctors face. I don't know how anyone can consider the conditions, pay, and stress involved in the average docs life to be comparable to 'a lot' of other professions.

Celticfire

towelly wrote: »

What you describe is par for the course for a lot of other professions too.

Any chance you could provide a list of this "lot of other professions" that have the same or similar conditions?

towelly

chumbawumba369 wrote: »

It's not though is it. There's no other job that're expected to do the hours we do. Christ there's EU laws against it. I have never heard of another profession who are rostered for 36 hour shifts.

Every professional job I've ever had, I've had to opt out of working time directives. Imagine that!

Celticfire wrote: »

Any chance you could provide a list of this "lot of other professions" that have the same or similar conditions?

Lots of project managers put in 100 hour weeks, you work until the work is done, you don't get paid any extra for working beyond the "standard" hours because you're salaried. You can be sent anywhere in the country, or half way around the world. You miss family occasions. You don't whinge and moan about it, unlike some of the doctors in this thread.

towelly

chumbawumba369 wrote: »

It's not though is it. There's no other job that're expected to do the hours we do. Christ there's EU laws against it. I have never heard of another profession who are rostered for 36 hour shifts.

Every professional job I've ever had, I've had to opt out of working time directives. Imagine that!

Celticfire wrote: »

Any chance you could provide a list of this "lot of other professions" that have the same or similar conditions?

Lots of project managers put in 100 hour weeks, you work until the work is done, you don't get paid any extra for working beyond the "standard" hours because you're salaried. You can be sent anywhere in the country, or half way around the world. You miss family occasions. You don't whinge and moan about it, unlike some of the doctors in this thread. I know senior managers, investment bankers, and tradespeople who have similar situations - although the tradespeople did get paid more because they were on hourly rates, but they were still flat rates, which isn't great when the rates are low and they're working away 6 days a week.

Iwasfrozen

towelly wrote: »

Once again, nobody is saying you can't prevent people from emigrating or place such restrictions on travel.

They obviously are since we're having this discussion.

towelly

Iwasfrozen wrote: »

They obviously are since we're having this discussion.

That's not a possibility, the only people that are worse than the fools that suggest it are the fools that take them seriously!

towelly

towelly wrote: »

Every professional job I've ever had, I've had to opt out of working time directives. Imagine that!




Lots of project managers put in 100 hour weeks, you work until the work is done, you don't get paid any extra for working beyond the "standard" hours because you're salaried. You can be sent anywhere in the country, or half way around the world. You miss family occasions. You don't whinge and moan about it, unlike some of the doctors in this thread. I know senior managers, investment bankers, and tradespeople who have similar situations - although the tradespeople did get paid more because they were on hourly rates, but they were still flat rates, which isn't great when the rates are low and they're working away 6 days a week.

It's a rare tradesperson or banker who has responsibility for someones life and health as a matter of course. A project manager might lose money for their firm if she or he gets something wrong. A doctor deals in much higher stakes. There is no comparison in terms of stress, especially if the doc has been working 6 days a week with minimal sleep.

Whinging and moaning eh?

towelly

Candie wrote: »

It's a rare tradesperson or banker who has responsibility for someones life and health as a matter of course. A project manager might lose money for their firm if she or he gets something wrong. A doctor deals in much higher stakes. There is no comparison in terms of stress, especially if the doc has been working 6 days a week with minimal sleep.

Whinging and moaning eh?

If a project manager gets something wrong, buildings can collapse, fires can destroy everything in their path, people can lose their life or become seriously ill. If a project manager makes a mistake, he and his colleagues may not get paid at the end of the month.

chumbawumba369

towelly wrote: »

Every professional job I've ever had, I've had to opt out of working time directives. Imagine that!



Lots of project managers put in 100 hour weeks, you work until the work is done, you don't get paid any extra for working beyond the "standard" hours because you're salaried. You can be sent anywhere in the country, or half way around the world. You miss family occasions. You don't whinge and moan about it, unlike some of the doctors in this thread. I know senior managers, investment bankers, and tradespeople who have similar situations - although the tradespeople did get paid more because they were on hourly rates, but they were still flat rates, which isn't great when the rates are low and they're working away 6 days a week.

I'm sure you work very hard at whatever you do. There's no 36 or 48 hour shifts though is there? Yep we should stop moaning about having to work long hours because sometimes other people have to work hard too.
Are you a PM? You're definitely wrong if you're saying they regularly work 100 hour weeks. My partner has been one for nearly 4 years, has worked for two of the big CROs and she's never done 100 hours as far as I know. Yep she works long hours if there's deadlines coming up but that's at most four times a year.
I realise other people work hard too but you're not comparing like with like.

towelly

chumbawumba369 wrote: »

I'm sure you work very hard at whatever you do. There's no 36 or 48 hour shifts though is there? Yep we should stop moaning about having to work long hours because sometimes other people have to work hard too.
Are you a PM? You're definitely wrong if you're saying they regularly work 100 hour weeks. My partner has been one for nearly 4 years, has worked for two of the big CROs and she's never done 100 hours as far as I know. Yep she works long hours if there's deadlines coming up but that's at most four times a year.
I realise other people work hard too but you're not comparing like with like.

It depends on what role the PM is in and what projects they deal with. Some PMs can tick along working normal hours and join some doctors with similar hours out on the golf course. As I'm sure you know, most professions don't do shift work, but you're just expected to work the hours.

Just a thought, maybe things wouldn't be so bad if ye weren't so negative about having to work hard for your money?

OSI

OSI wrote: »

Apart from being illegal in the EU.

I know a number of courses that have a mandatory year or two years of work afterwards, nursing courses in particular.

chumbawumba369

towelly wrote: »

If a project manager gets something wrong, buildings can collapse, fires can destroy everything in their path, people can lose their life or become seriously ill. If a project manager makes a mistake, he and his colleagues may not get paid at the end of the month.

You've made some incredibly poor arguments over the last few pages. You started off with with a dig about medicine not being a tough course and now you're comparing the hours worked in unrelated fields while refusing to acknowledge the length of shifts that docs work and suggesting that PMs have a comparable influence on people dying or getting ill.

towelly wrote: »

It depends on what role the PM is in and what projects they deal with. Some PMs can tick along working normal hours and join some doctors with similar hours out on the golf course. As I'm sure you know, most professions don't do shift work, but you're just expected to work the hours.

Just a thought, maybe things wouldn't be so bad if ye weren't so negative about having to work hard for your money?

Sure why not throw in something about doctors on golf courses and try and blame things on negativity. I do genuinely enjoy what I do and feel privileged to do it but I don't enjoy working brutal shifts all the time while people like yourself try to justify it. That last line is pretty poorly thought out and insulting really. Earlier you blamed doctors emigrating on non-compliance with the EWTD (non-compliance which has been going on 15 years), now yo're saying maybe doctors would be grand with the hours if we were more positive. Laughable really.

ProfessorPlum

towelly wrote: »

Every professional job I've ever had, I've had to opt out of working time directives. Imagine that!




Lots of project managers put in 100 hour weeks, you work until the work is done, you don't get paid any extra for working beyond the "standard" hours because you're salaried. You can be sent anywhere in the country, or half way around the world. You miss family occasions. You don't whinge and moan about it, unlike some of the doctors in this thread. I know senior managers, investment bankers, and tradespeople who have similar situations - although the tradespeople did get paid more because they were on hourly rates, but they were still flat rates, which isn't great when the rates are low and they're working away 6 days a week.

Maybe. But each of those professionals can choose to work wherever they please. Nobody is suggesting they are tied to working a job they don't want to be in. Why should doctors?

What is your point re the issue of the thread???

towelly

chumbawumba369 wrote: »

You've made some incredibly poor arguments over the last few pages. You started off with with a dig about medicine not being a tough course and now you're comparing the hours worked in unrelated fields while refusing to acknowledge the length of shifts that docs work and suggesting that PMs have a comparable influence on people dying or getting ill.




Sure why not throw in something about doctors on golf courses and try and blame things on negativity. I do genuinely enjoy what I do and feel privileged to do it but I don't enjoy working brutal shifts all the time while people like yourself try to justify it. That last line is pretty poorly thought out and insulting really. Earlier you blamed doctors emigrating on non-compliance with the EWTD (non-compliance which has been going on 15 years), now yo're saying maybe doctors would be grand with the hours if we were more positive. Laughable really.

I didn't say medicine isn't a tough course, I accept that some doctors work long hours, I just don't buy into the bull**** on here that it's the most difficult course and job ever and nothing else compares! You really should read posts properly, instead of getting worked up over them when you don't.

The last point (re positivity) was a joke, but on a serious note, when somebody is that negative about their job it's time to move on. Some people crack easier than others, there are certain types of environments where some people just aren't suited.

I have to say, I have fortunately had very limited dealings with doctors and medical professionals in a professional capacity, mostly in a social capacity. None of them, fortunately for them and those around them, seem to have the attitude that some of ye on boards.ie have.