Junior doctors should have fewer geographical ‘rotations’ and better working conditions, report says

Junior doctors should no longer have to move regularly between hospitals in different locations during their training, under a key recommendation in a report to be published on Wednesday.

Limiting the number of rotations, or geographical moves, required of non-consultant hospital doctors (NCHDs) during their training period is called for in the final report of the NCHD taskforce, which was set up by Minister for Health Stephen Donnelly in 2022.

The proposal, which is likely to be accepted by the Minister, is part of a significant overhaul of the training of doctors aimed at achieving a better work/life balance and improved work conditions.

Currently, NCHDs have to do a rotation every six months. This often requires doctors – and their families – moving to different parts of the country, where accommodation must be sourced.

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[ National taskforce to help improve experience of junior doctors ]

This challenge has increased as rents have soared and short-term accommodation has become difficult to find in many towns and cities. The Irish Medical Organisation last year called for tax relief for doctors who have to pay double rent or who have a rent and a mortgage.

The report says there should be just one rotation requiring a geographic move “where possible” over the four to five years an NCHD spends in training.

The number of NCHDs has reached 8,700, up more than one-quarter since December 2019. However, education and training supports have not kept pace with this level of growth, the report says.

It calls for improvements to the infrastructure in the hospitals where doctors train to support their working experience. Work on improvements to showers, rest and administrative facilities is already under way in some sites following recommendations in an interim report last year.

An expansion of jobsharing opportunities in all training programmes, as well as greater flexibility in working and training options, is also envisaged, subject to discussions between the Health Service Executive and postgraduate training bodies.

Further increases in the number of postgraduate training places are expected this year.

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There is a “clear need” to improve the working environment through the provision of rest, showering and changing facilities, providing food and drink, improved IT services and other supports, the interim report advised.

It called for the creation of an additional 2,000 hospital consultant and 1,000 junior doctor posts by the end of the decade.

Standardised induction for all new NCHDs, and additional induction of the 500 or so international medical graduates starting each year in Irish hospitals, was also recommended.

Doctors should have access to healthy food 24/7 and those on overnight shifts should have access to a private space for rest.

The taskforce was established by Mr Donnelly with the brief to put in place sustainable workforce planning strategies to improve the working experience of junior doctors and help to retain them in the health service. The HSE’s difficulty in recruiting and retaining sufficient medical and other staff is recognised as one of the main causes of hospital overcrowding.

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