The consequences of Ireland’s culture of medical migration

Abstract

BackgroundIn recent years, Ireland has experienced a large-scale, outward migration of doctors. This presents a challenge for national policy makers and workforce planners seeking to build a self-sufficient medical workforce that trains and retains enough doctors to meet demand. Although, traditionally, medical migration has been considered beneficial to the Irish health system, austerity has brought a greater level of uncertainty to the health system and, with it, a need to reappraise the professional culture of migration and its impact on the Irish health system.MethodsThis paper illustrates how a culture of migration informs career and migration plans. It draws on quantitative data—registration and migration data from source and destination countries—and qualitative data—in-depth interviews with 50 doctors who had undertaken postgraduate medical training in Ireland.ResultsOf 50 respondents, 42 highlighted the importance of migration. The culture of medical migration rests on two assumptions—that international training/experience is beneficial to all doctors and that those who emigrate will return to Ireland with additional skills and experience. This assumption of return is challenged by a new generation of doctors whose professional lives have been shaped by globalisation and by austerity. Global comparisons reveal the comparatively poor working conditions, training and career opportunities in Ireland and the relative attractiveness of a permanent career abroad.ConclusionIn light of these changes, there is a need to critically appraise the culture of medical migration to determine if and in what circumstances migration is appropriate to the needs of the Irish health system. The paper considers the need to reappraise the culture of medical migration and the widespread emigration that it promotes.

Tracking the leavers: towards a better understanding of doctor migration from Ireland to Australia 2008–2018

“…A further indication of the challenging recruitment environment is the situation whereby 127 hospital doctors are working as consultants without being registered on the Specialist Division of the Medical Register (which would generally be considered a pre-requisite for a consultant post) [12]. Post-2008, Australia has emerged as the main destination country for emigrant Irish-trained doctors ahead of the more traditional destinations of the United Kingdom and the United States of America [17]. As Ireland does not track the emigration or return of its doctors, the authors cannot say whether this emigration is temporary or permanent.…”

“…Post-2008, Australia has emerged as the main destination country for emigrant Irish-trained doctors ahead of the more traditional destinations of the United Kingdom and the United States of America [17]. As Ireland does not track the emigration or return of its doctors, the authors cannot say whether this emigration is temporary or permanent.…”

Doctor Retention or Migration: From Ireland to the World? Comment on "Doctor Retention: A Cross-sectional Study of How Ireland Has Been Losing the Battle"

“…17 Yet, in the age of coronavirus disease 2019 (COVID-19) it is surely possible, above all, to provide better workplace experiences for all health workers, and ensure a superior 'new normal. ' As everywhere else, Irish doctors will continue to migrate (usually with their families) but they will need to be assured of a warm welcome when they return, 18 amidst the ever optimistic belief that all health workers should be valued much more highly. 19 The room to manoeuvre within neo-liberal political economic systems greatly limits the scope for effective changes yet equity and empathy demand nothing less.…”

Hospital doctors in Ireland and the struggle for work–life balance

“…In Ireland, the failure to address changing work preferences and improve working conditions has driven a decade of high doctor emigration. 1 , 17 …”