Young doctors are continuing to leave Ireland because of poor training and career opportunities, and poor working conditions, a new report has found.

According to the report, some measures that were introduced in early 2015, to help retain non-consultant hospital doctor (NCHD) trainees in Ireland, are now having a positive effect. However, problems still remain.

The report by the Royal College of Surgeons in Ireland (RCSI) summarises six years of medical workforce research and includes the preliminary findings of a survey of over 1,500 NCHDs.

It reveals that while 30% of trainees have experienced improvements in the supervision of their training and better mentoring, around 20% feel that their supervision and mentoring is worse.

The research also reveals that poor working conditions remain, with trainees still being required to complete ‘non-core tasks', which divert them away from training and patient care. The RCSI notes that this is a poor use of a ‘precious and expensive resource'.

Meanwhile, over 50% of trainees say that work-related stress and staffing levels have become worse or much worse. These trainees are more likely to say they are planning to leave Ireland for good.

The report noted that just 14% of trainees said that they planned to go abroad and not come back to Ireland. Some 42% said they planned to go abroad, but return later, 41% planned to stay here, and the remainder planned to leave medicine.

However, according to lead researcher, Prof Ruairi Brugha, of the RCSI, while it is positive that 83% of trainees have signaled their intention to ultimately practice medicine in Ireland, the reality is that this may not happen.

"Once doctors leave to work abroad, they often establish roots and the window of opportunity for getting them back closes over time. In two of our earlier studies, Irish doctors working abroad reported that training, working and career opportunities are usually better in the countries to which our doctors go, and that Irish trained doctors are highly sought after in these countries," explained Prof Brugha.

He pointed out that the implementation of recommendations in the 2014 Strategic Review of Medical Training and Career Structure had led to some positive outcomes. Some achievements include flexible and predictable training schemes, reduced paperwork when NCHDs rotate to a new hospital and better career planning information.

However, he warned that these latest findings show that progress in addressing some of the factors relating to training and working conditions, is at a standstill, or is getting worse. Underlying this is the lack of consultants to deliver training and to take a greater share of routine service work in hospitals, which would allow NCHDs to do the training they need to in order to become specialists.

"Other research has shown that stress and burnout are a reality for consultants as well as NCHDs, and some of the NCHDs in our research reported that the life of a consultant in Ireland was a disincentive to them considering making a permanent career here," Prof Brugha pointed out.

In terms of the number of consultants per head of population, Ireland compares poorly to the countries which many of our doctors emigrate to, namely the UK and Australia.

"Over the years, our work has shown that many of our doctors are leaving because of the lack of acceptable working conditions and training opportunities, but also, as recent specialty workforce reviews produced by the HSE help to confirm, because the permanent posts for which we train them are not there.

"Addressing the root causes, including establishing more consultant posts to implement the policy of a consultant-delivered health service, will ultimately come down to political commitment," Prof Brugha added.

The report was produced by the RCSI's Health Workforce Research Group.