Our researcher, Dr Niamh Humphries, travelled to Australia last year to understand why so many Irish hospital doctors move there as part of our Hospital Doctor Retention and Motivation research project. In her opinion piece here, originally published in The Journal.ie, Niamh writes about the Irish doctors she met in Australia and their reasons for staying there.
Last year, 300 Irish doctors got visas to work in Australia, many of whom were recently qualified.
Although medicine is regarded as a high-status, highly-skilled occupation that has traditionally provided access to good quality jobs and relatively high salaries in Ireland, the numbers of recently qualified doctors opting to continue their medical careers abroad suggests this may be waning.
I travelled to Australia last year to understand why so many Irish hospital doctors move there as part of a research project within the Royal College of Physicians of Ireland funded by the Health Research Board.
Of the doctors I interviewed, 40 had lived to Australia since 2008. Of those, 38 had last worked as Non-consultant hospital doctors before leaving Ireland and only 14 were planning to return to work in Ireland.
The stories they told illustrate some of the underlying reasons for their emigration and demonstrate how a seemingly good quality job can change over time in response to family circumstances, personal preferences and relative to what is available in other countries.
Most of the doctors I interviewed felt the Australian health system offered better working conditions, the opportunity to progress in their careers and to achieve a better work-life balance.
In contrast, their jobs in Irish hospitals resembled extreme jobs – highly stressful and pressurised, involving long working hours, high levels of responsibility and set within a context of a health system under strain.
They described a health system (in Ireland) where heavy workloads were accepted as the norm, despite the negative impact this has on all frontline health workers.
“Everyone’s overworked, that’s the hospitals in general, the nurses are overworked, the doctors are overworked, it means there’s a lot of antagonism all of the time,” one doctor said.
They spoke of the challenge of working long hours in a fast-paced environment within which everyone was “flat-out working really hard” and where they struggled to find time to take adequate rest breaks.
Even taking time off work for major life events was difficult, as this doctor explained: “My wife had complications and I was rostered to be on in the obstetric hospital… Rather than get someone else to cover my shift, they’ll roster me in the intensive care unit, so if she deteriorated it would mean [that it was] my problem anyway.”
Several doctors spoke about the negative impact this way of working had on their wellbeing.
“Nothing terrible… ever happened, but I just felt secluded and alone,” one said.
Irish health employers must acknowledge that hospital doctors are opting to emigrate, rather than accept the jobs on offer in the Irish health system.
The deterioration of medical job quality and the normalisation of extreme working since 2008 is a key driver of doctor emigration from Ireland.
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.