Over 1,100 doctors left the medical register in 2019 citing reasons such as excessive hours and lack of support, a new report has shown.

The Medical Council, which is the regulatory body for doctors, has published its Medical Workforce Intelligence Report for 2019/2020. This is an annual study that provides key information on the Irish medical workforce, including the reasons why doctors choose to remain or leave the health system.

According to the report, by the end of 2019, there were 23,558 doctors on the medical register in Ireland, 85% of whom were reported as being clinically active here.

Last year also saw 1,135 "voluntary withdrawals" from the medical register - a decrease of 22% when compared with the previous year and the first decrease recorded since 2014.

Of these 1,135 voluntary withdrawals, just 84 were retirements, with the majority (70%) planning to practise medicine in another country. Some 27% said they were withdrawing from the register for family/personal reasons, while 16% said they were leaving as a result of limited career progression.

Comments by some of the doctors involved in the report included:
-Poor working conditions - hours, workload, support, pay"
-"Poor employer support, poor options for progression, poor pay, poor conditions"
-The amount of bullying and disrespect I had to witness, the lack of support of junior staff I have never experienced in any other country I have worked. Lack of permanent consultant posts. This all made me feel too uncomfortable to continue"
-"It is completely unreasonable to expect doctors to work over 90 hours in a week and then provide no time to recover. Doctors are not robots"
-I felt undervalued and overworked at home. I did not want to become burnt out so I moved to Australia to gain more experience and work in a more supported environment".

Figures for 2020 show that between January and August of this year, 862 doctors had voluntarily withdrawn their registration from the medical register. The majority of those left to practise medicine in another jurisdiction.

However, some stated they were leaving the register due to personal reasons as a result of the COVID-19 pandemic.

Some doctors who left the register in 2020 stated they were not returning to practise in Ireland due to poor working conditions in comparison to the country in which they are currently practising. In some cases, experienced doctors who had qualified outside of the EU could not access formal training programmes here.

These challenges impact directly on patient and professional safety, the Medical Council said.

According to Jantze Cotter, director of professional competence, research and ethics with the Medical Council, this report is a "vital source of medical workforce planning data", which can be used to inform a range of policies, including recruitment and retention strategies.

"The provision of safe, quality patient care is challenged, as doctors report working in poorly resourced services, working in excess of the European Working Time Directive hours, poor pay and burnout.

"This results in ongoing attrition of Ireland's highly trained and experienced medical workforce. The patterns highlighted in previous reports are repeating themselves in 2019 and 2020," she noted.

According to the president of the Medical Council, Dr Rita Doyle, while it is a positive development to see withdrawals from the register decreasing, "much works remains to be done on making Ireland an attractive long-term prospect to our colleagues who completed their medical education outside the EU, and would like to specialise here in their chosen field".

"Recent changes to legislation to remove the barrier to access training for non-EEA qualified doctors is very welcome, but more needs to be done and training places need to be increased, so we can fill vacant consultant roles," she insisted.

The Medical Council's CEO, Philip Brady, added that this report "gives rise to concern about the safety of both patients and medical professionals".

"Action and engagement are required to really effect change for doctors. This report presents data that can be used to support effective planning to develop and retain a strong and sustainable medical workforce," he commented.

The full report can be viewed here.