IMT readers split down the middle on indenture issue

'The IMT poll results place in sharp relief how deeply divided the medical community is regarding the issue of compulsory ED service'

By Pat Kelly. Irish Medical Times readers are divided almost equally on the issue of whether or not NCHDs should be compelled to serve a period of compulsory service in an emergency department (ED).

In a poll on the IMT website, which went live on July 4, readers were asked the question: ‘Should NCHDs be compelled to serve at least six months in an emergency department as part of their medical experience, as a way of partly repaying the State for their medical training?’

The results revealed a deep division among readers as to whether this should be implemented as a compulsory measure. When the poll was closed on July 27, a total of 328 votes had been cast — the largest number of votes accumulated within a three-week period of any poll run by Irish Medical Times.

Voters who answered ‘No’ accounted for 171 votes, or 52 per cent of the total. However those who voted ‘Yes’ accounted for 48 per cent of the total, translated as 157 votes. This places in sharp relief how deeply divided the medical community is regarding the issue of compulsory ED service.

Dr Ruairi Hanley

Indenture was the subject of a number of columns and correspondence in Irish Medical Times, notably by Dr Ruairi Hanley, and provoked a strong response from doctors across the country. Dr Hanley was highly supportive of such a proposal in his column, ‘Blazing Row over EDs’: “A short period of six months or one year on the ultimate ‘front line’ is hardly an onerous burden to require of any medical practitioner. For those of my colleagues who disagree, I have a news flash — Ireland is bankrupt. You are not going to get paid any extra to stay. The State forked out for you to become a doctor. In return, I believe you owe our country six months of hard work in an ED.” Dr Hanley’s full column on the subject can be viewed at http://bit.ly/mSrggH.

Consultant in Emergency Medicine Dr Chris Luke had also promoted the concept in a letter to The Irish Times, when he wrote: “I plead with all our medical graduates not to repudiate this Republic, but — rather than highlighting the (undoubtedly erratic) ‘terms and conditions’ in this country that they say drive them to Bondi and beyond — to consider the terms and conditions that their own families, friends and fellow citizens endure in our emergency departments, as a consequence of the mass exodus of so many gifted graduates.”

Dr Garrett FitzGerald

However, as evidenced by the IMT poll results, support for the proposal was not universal. IMT columnist Dr Garrett FitzGerald commented in his column, ‘When All Else Fails, Talk to Them’: “If we want to keep our doctors, we’ll have to do better. Calls to patriotism and pleas about the quality of training which we offer do not address the major reality; the doctors are leaving in droves. Nor indeed can we expect anything but derision from them when we suggest coercion — like telling them that, in payment for their education at the nation’s expense, they are to become bound-boys and indentured servant-girls for five to seven years.” The full column can be accessed via http://bit.ly/nu1rlS.

Readers now have the opportunity to cast their votes on the newest poll at www.imt.ie, which asks: ‘Is the Medical Council’s professional competence scheme an over-regulation of the profession?’

pat.kelly@imt.ie