A new paper published by RCPI in BMC Human Resources for Health has added to the weight of evidence showing that deterioration in medical job quality and normalisation of extreme working is a key driver of doctor emigration from Ireland, and deterring return.
Entitled ‘Everything was just getting worse and worse’: deteriorating job quality as a driver of doctor emigration from Ireland, the paper considers how the normalisation of extreme working is driving doctor emigration.
Semi-structured qualitative interviews were conducted with 40 Irish emigrant doctors in Australia who had emigrated from Ireland since 2008. The interviews were conducted by our researcher Niamh Humphries in July–August 2018.
Respondents reflected on their experiences of working in the Irish health system, describing hospital workplaces that were understaffed, overstretched and within which extreme working had become normalised, particularly in relation to long working hours, fast working pace, doing more with less and fighting a climate of negativity. One respondent likened their workplace to ‘a war zone’.
The combination of intense working, long working hours and 24/7 availability extended into their personal lives in other problematic forms. Respondents frequently reported that they felt they could not take time off work, even when they were sick, as there was no one to cover their workload in their absence.
Only 14 of the 40 (35%) respondent emigrant doctors intend to return to work in Ireland.
‘after working for 29 hours . . . straight . . . I got maybe an hour or two sleep, and then my boss asked me to operate with him . . . I went to operate with him, but then I drove home and crashed my car’
Doctor interviewed for Hospital Doctor Retention and Motivation
The publication of this paper marks a milestone for our Hospital Doctor Retention and Motivation project, a four-year research project (2018-2021) hosted by RCPI and funded by the Health Research Board.
This research is seeking to find out why Ireland's highly-trained hospital doctors are emigrating and how best to motivate them to either stay in Ireland or to return to practice medicine in Ireland.
The project will contribute to our understanding of doctor emigration, retention and workplace morale, and seeks to inform national health workforce policy.
Doctor emigration poses a significant threat to the Irish health system. The question is whether there is a willingness to change the underlying conditions that are driving this exodus of doctors from Ireland.
Dr Niamh HumphriesLead author 'Everything was just getting worse and worse': deteriorating job quality as a driver of doctor emigration from Ireland
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Dr Niamh Humphries is a Reader in Health Systems Research who joined the Royal College of Physicians of Ireland in April 2016. She holds a PhD in Sociology and has worked in health workforce research since 2006. In 2017 she was awarded a prestigious HRB Emerging Investigator Award for a 4 year research project focussed on hospital doctor retention and motivation, which will involve fieldwork in Ireland and Australia. Her current research interests are health worker migration, health worker retention and the working lives of health workers.