Dr Amin A Muhammad, Professor of Psychiatry at the Memorial University of Newfoundland, Canada, returned to Pakistan recently were he heard of the issues facing doctors contemplating coming to work in Ireland.
The Health Service Executive has been extremely active in recruiting doctors from Pakistan and India in order to address the shortage of NCHDs. There was a hue and cry about their placement last year, requirements by the Irish Medical Council and other pertinent issues.
It appears that there may have been a communication error between the Medical Council and the HSE at some point. The Council had always been thorough in screening the candidates aspiring to get registration.
It has maintained its standard since our times during the years 1980s and 90s, the period when I was a trainee in Ireland. At that time, there was no requirement for sitting PRES and IELTS. Now this is a requirement for most of the candidates.
I recently visited Pakistan and had an opportunity to meet with a number of junior as well as senior doctors. Many junior doctors were undergoing postgraduate training in the fields of their choice. They asked me a number of questions related to working in Ireland, and I had all good words to say about the life and career prospects there. They expressed their predicament, which was already known to me. There were a number of doctors who had finished their medical degree with one-year internship and either had started their general practice clinics or were aspiring to get into a training programme through the College of Physicians and Surgeons of Pakistan (CPSP).
There were others who were either undergoing training towards a fellowship diploma or had completed their training and passed the fellowship examination of the college (FCPS).
There is political upheaval, violence, kidnapping and killings going on unabated in the country. Hence, a huge number of doctors are opting to leave the country for greener pastures in foreign lands.
For Ireland, the better candidates are those who had completed higher specialist training and obtained their fellowship. They are recognised in Pakistan as specialists and can take up positions as consultants.
A number of doctors who were recruited by the HSE faced a number of problems in Ireland, such as the requirement for Medical Council examination and/or assessment, placement in training posts and financial issues.
The recently recruited doctors from Pakistan, despite having postgraduate diplomas, would get a junior position in Ireland. The problem is with their placement in posts recognised by respective Royal Colleges. Many such doctors were placed in non-recognised spots that lead to great disappointment. A number of doctors had to come back because of the changed circumstances in Ireland related to requirements of registration.
It is important that the HSE should focus on candidates who have completed their fellowship as they can impart better clinical services as compared to those without fellowship qualification. Once selected, their credentials can be assessed by the Medical Council for registration; any additional requirement by the Council can then be taken care of at the primary stage.
The HSE should also seek advice from the Royal Colleges for training recognition, reciprocity and suitable training slots in Ireland. The HSE can also keep the College of Physicians and Surgeons of Pakistan (CPSP) in the loop while developing a complete dossier of the selected doctor. Then it should get all immigration requirements fulfilled and finally secure a job in an appropriate hospital.
It is only after all this procedure is duly completed that the candidates should leave the country of origin and take up the new position.
Doctors in Pakistan are keener on remaining in continuous training abroad and pursue the Royal College examination so that they can achieve a better status in terms of qualification, finances and security.
Dr Amin A Muhammad,
Professor of Psychiatry,
Memorial University of Newfoundland,