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Issues in Surgical Training 2011

The Royal College of Surgeons in Ireland highlights pressing issues in surgical training and staffing, revealing a total workforce of 1,200, including 400 consultants and 400 non-consultant hospital doctors (NCHDs). An annual loss of approximately 20 staff due to retirement, illness, and resignation poses significant challenges. With a graduate intake of only 30-40 each year and 80 BST training positions available, a crisis in staffing persists. Immediate reforms are essential, including increasing training places, enhancing nurse specialist roles, and considering the introduction of physician assistants to create a stable healthcare workforce.

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Issues in Surgical Training 2011

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  1. Issues in Surgical Training 2011 Royal College of Surgeons in Ireland

  2. Surgical staffing 2011 Total = 1200 Consultants 400 General register NCHDs 400 Training register NCHDs 400+ Figure 1

  3. Dynamics 1. Average age at appointment – 38 Vacancies – retirement, illness, resignation ~ 20 / year 4very few doctors in non-training posts progress into Consultants posts (EU equivalence process, IMC) 20 3Training 12 years + Graduates 30-40/year Match depends on vacancies at the time Consultants ? 30-40 2.BST intake 80/year withdrawals over years 1-4 other specialities General register NCHDs 400 30+ Training register NCHDs 5. some non-EU doctors do progress into BST posts numbers ? 80 Figure 2

  4. Medical Migration Figure 3 National Geographic 2010

  5. Staffing issues 2011 Total = 1200 Consultants 400 General register NCHDs 400 Training register NCHDs 400+ 60-80 vacancies Figure 4

  6. World medical workforce Inhabitants per doctor Ireland 360 (includes all registered doctors) Ireland 1,700 Pakistan 1,400 Figure 5 http://goo.gl/YVRm5 http://goo.gl/7kavT

  7. RCSI Worldwide Figure 6

  8. Surgical staffing 2011 Consultants Training register NCHDs Figure 7

  9. Surgical staffing 2011 Consultants Reconfiguration Training register NCHDs Physician assistants Specialists nurses Figure 8

  10. Strategy, plan, execution • Crisis in staffing has been addressed with a short term solution • More radical approach needed to prevent recurrence/progression • Rapid work by a high level group to report in a short time frame is required • Opportunity and need to restructure medical workforce • grow consultant numbers (consultant-provided care): • Increase training places (to accommodate growing numbers of Irish/EU graduates , provide those consultants and create more stable workforce structure • Rapid development and extension of the role of nurse specialists • Consider (quickly) creation of new roles such as physician assistants • Reconfiguration of specialist services to provide critical mass and to ensure that patients have access to services of high quality will be crucial to this process. • Redeploy, reskill and/or retrain where necessary Figure 9

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