Implementation of the reform of the intern year second interim report on the implementation of recommendations of the National Committee report on the intern year phase 2: July 2010 – July 2011

摘要

Internship in its current form has been in place in Ireland for decades with, until veryudrecently, little reform or development. Intern training has developed from a predominantlyud“apprenticeship” model to being a structured, properly resourced training programme forudmedical graduates. There is no doubt that the implementation of the recommendations ofudthe NCMET Report has greatly improved the structure of intern training, has brought a highudlevel of transparency to the recruitment of interns and has allowed graduates to experienceudthe realities of clinical practice in a wider range of specialties.udImplementation of the reforms recommended in the report of the National Committee onudMedical Training has continued, following the initial implementation phase in 2009/10.udPrincipal among the reforms introduced during the second year of implementation included:ud• The formal establishment of the Mid-West Intern Training Network;ud• The establishment of an additional 30 intern training places;ud• The implementation of the National Intern Training Programme;ud• The introduction of the requirement for demonstration of English language proficiency.udHowever, challenges remain. Key amongst these challenges are (i) graduate retention andud(ii) the number of available intern posts.udThe HSE undertook a survey of the cohort of interns who completed internship in July 2011.udWhile the response to the survey was low, at 44%, the feedback provided by interns isudhelpful in contributing to the ongoing development of intern training. A summary of theudsurvey results is provided in Section 8 and the composite national results are included atudAppendix C.udThe HSE undertook a tracking study of interns completing training in July 2011. It wouldudappear that approximately half of this cohort are not currently working in the Irish healthudservice. While this is understandably a matter of concern, particularly given the State’sudconsiderable investment in medical education and training and the health service’s ongoingudreliance on overseas medical recruitment, it is not unusual for Irish doctors to spend someudtime abroad after internship and most return home. It will be important to continue toudmonitor this situation to obtain a clear picture of the attrition rate from the Irish medicaludeducation and training pathway.udBy law, all medical graduates in Ireland must complete internship in order to practiseudmedicine. There is a significant deficit in the number of intern posts available for theudGovernment- funded expanded number of medical graduates. Investment in undergraduateudmedical education has not been matched by investment at intern level. The current deficit, ifudunchecked, will therefore result in a significant number of graduates of Irish medical schoolsudbeing unable to practise medicine in Ireland. This would represent a waste of significantudState resources, a missed opportunity to generate a domestically-trained medical workforceudand would have serious implications for individual students and their medical schools.