protected professions


#41

Been there. Done it. Better half the medic - and had friends in both years ahead and behind. About 50% of the Émigrés back - so you’ll have a fighting chance - the “where” is the tricky bit!

I’ll see your Alec Baldwin with an Emma Thompson:


#42

Not to turn this into a commercial but…we’d love to recruit Irish doctors in Newfoundland and Labrador. On the specialist side, anybody who has finished training would be immediately eligible for consultant-level employment if they can get a licence. For all the new hires, pensions are defined contribution although government contributes annually to each salaried physician’s pension plan. Overall, we earn less here (although some fee for service docs do very well) but we become consultants sooner. The physician hierarchy is more cylindrical than pyramidal, with fewer junior staff.


#43

independent.ie/national-news … 48807.html

Not sure if this is off topic, but seems to belong here.


#44

The people who gave this doc her scholarship are taking an unusually militant line here and although I can sympathise with both sides I have to give the bold Dr. Breatnach one cheer at least. We have sponsored many doctors who swore blind they loved our town until they passed their exams and scarpered pronto for the bright lights. Over the years, such behaviour does tend to erode one’s faith in the medical profession and there’s not a whole lot you can do if they give the money back.

One way around the Mwangi problem is to train doctors in their own country. Canada is involved in several such initiatives in East Africa.

A related issue is recruiting doctors from developing countries. A significant proportion of rural Canadian doctors come from South Africa. The vast majority are white and of middle class background at least. Should Canada and Ireland be poaching professionals free of charge whose education has been heavily subsidized by a much poorer state? But don’t they have the right to flee a dangerous country and seek a better life abroad? I would like to see developed countries paying for these people but you’d have to wonder where the money would end up.


#45

Brilliant money saving idea - educate 10 times the number of doctors we need. Then weed out ‘the weak’ with examinations.

Ahm hold on a second … isn’t weeding out the weak what the Leaving sort of does already?

And these other routes into medicine - contolled by politicans, prone to corruption - care to elaborate a bit more about those?

My advice to you is not to try these arguments out live in front of a consultant doctor - as you will be made to feel extremely stupid and probably end up agreeing that he needs an increase in his already exhorbitant base salary.


#46

sorry, not sure. i’m in the wrong field unfortunately (for me?). the pharmacy dept negotiates directly with the companies for most of our stuff. i can ask around a bit.

i’m not sure it’s that blatant or ever in cash. i have a friend who does a lot of minor cosmetic stuff and was brought to a “conference” in the south of spain by his botox supplier.

would think that the only way to eliminate any inducements would be to introduce generic prescribing like in the nhs.

why do you want to know?


#47

not sure that this is the right forum for that! canada is already very popular for us - sick kids in particular. i’m off to vancouver next year for a mixed fellowship. will definitely try and visit newfoundland as it sounds fascinating.


#48

I think the point was that those incapable of qualifying as a doctor would fail their exams in their first or second year leaving a reduced number to finish. Can’t see any problem with that. It’s the same in most courses and careers. You can try it but if you can’t cut it, you end up out. I think that if it is felt that there is a shortage of doctors in this country, and the OECD in 2009 reckoned we had 60% of the OECD average for both GPs and Specialists per 1000 of population in 2007, then a supply side solution should at least be tried. Hanafin did announce back in 2006, a doubling of places from 300 to over 700. This is working and the OECD reports that we are third in the OECD for medical graduates per 1000 of population and second in the OECD for medical graduates per 1000 practising physicians. This all points to a legacy of undersupply and it wouldn’t be a ridiculous assumption to link high or overly high earnings with this demand / supply imbalance.

The leaving cert is a rather crude tool to whittle tens of thousands of people into a few hundred prospective doctors.

That’s just arrogant. I’m sure the valiant defenders of our senior counsels fees would make the same jibe. Plenty of poor doctors out there just as in any profession. Some of them even end up on the front pages of the papers.


#49

My father was in college in the fifties.
Back then anyone could show up and ‘have a go’ at pre-med.
It was just something people who felt they had an interest in the job or who were being pushed towards it by their family ending up doing.
If they had no aptitude or application they didn’t go on to being doctors and drifted towards other stuff.

There wasn’t the same cachet about medicine then.
I’ve noticed that when a parent talks about a child they say “she’s in college” No matter if she’s an actuary student or doing a course in surfing.
but when the kid is studying medicine this differentiation is always very clear upfront. And also by the child themselves :slight_smile:


#50

As for attending college in the 1950s, that was very different than now because there were no free fees and Ireland was a third world country, many school leavers not even doing their leaving cert. If you went to college and graduated in pretty much anything you’d probably get a job. Now correct me if I’m wrong but that’s the impression I got from those times.

Comparing then and now we can still see how the average Irish person has much more opportunity these days.

The lack of doctors in Ireland is due to the poor working conditions here, low budget for facilities and lack of training opportunities. However doctors can be imported from other countries who can accept those conditions. At the same time, many Irish doctors will emigrate to find better conditions/training overseas.


#51

You make some good points there. Continuous training is essential. They should be retested every 3-5 years. GPs in Ireland just note things down, do a quick review (with no proper diagnostic tests on hand) and send 'em on to the hospital/consultant. They hardly do any hands on stuff. They are overpaid for what they do.


#52

did you hear about the woman from Montenotte* whose son fell in the river - she ran around screaming “Help! My son, the doctor, is drowning!”

*substitute Foxrock etc as appropriate

not sure about lack of cachet - even if it didn’t have intellectual cachet it showed you had the spons to pay for 6+ years of college


#53

slightly off topic

guardian.co.uk/business/irel … r-fat-cats


#54

Imagine a German reading this list of Top 10 salaries. And then imagine him reading one of the many whinging columnists in the Irish media describing how his government is imposing a Versailles settlement on Ireland, reducing us to the status of beggars in our own country.

Cognitive dissonance how are ya.


#55

Heres a better one for ya, the guys in the bottom 5 are probably pissed at the difference between themselves and the guys in the top 5 now thats Ireland for you.


#56

It sounds right, but we have a relative ability system rather than an absolute ability system. Never mind the hours for interns that forces them out of the system rather than cultivate them the appreciate to see that it needs them and they need it.

Just to clarify a relative system is where the bottom 10% every term are given the boot. A simple and totally ineffective system. Look at it this way. Imagine two nuclear physics engineering universities. One prestigious and the other ok. The bright people get into former and the average into the latter. Every semester 10% are removed until only 10 finally remain in each of the two universities. Person No. 11 in the former university is about 20 times better than person number 1 in the latter. Which might seem reasonable. But ask yourself which student would you prefer being engineer on the nuclear power plant being built in your county.

Relative grading is great for the arts where everything is subjective but horrendous in real life where real skills are needed and the lack of them can be fatal for a doctor’s patient.


#57

Nope, it subjects the non-privileged majority to crossing an irrelevant bar which the privileged minority never need even consider.

Controlled by cash mainly - if you can cough up several 10Ks a year for the duration, anyone or their pet chimp can be a doctor - many do. If not, you’d better ace the leaving cert, because that’s your only option. And that’s the way the insiders, who can trade-off having another 4x4 or private college for their kids want to keep it. It’s a near trivial expense for anyone already in the game.

Let me guess, you’re new around here?

Sorry, consultants are overpaid mechanics, nothing more. They just apply medical advances invented by others - pity the ability to fund medical research is so hamstrung by the diversion of such massive amounts of cash into the consultants pockets, likewise the ability to buy the equipment which can diagnose with certainty what consultants regularly merely guess at. The entire system needs to be rebuilt from scratch, nowhere more so than in ireland.


#58

The focus on the ‘best skills’ and the ‘highest ability’ is very narrow minded.It is much better to have somebody competent and hard working and available rather than a limited amount of hotshots who have limited availability and who are too expensive to visit when you need to get something seen to. It’s a bit like the metaphor for the knowledge economy really.


#59

+1

Especially when the ‘best skills’ and ‘highest ability’ isn’t even related to the field. But then again, the system is designed by and for insiders - the public, whether using or paying for the service, aren’t a consideration.


#60

The problem is though that Irish people show high levels of brand loyalty and a marked preference for exclusive goods. Irish people never really made the move to Pepsi, and they hate TK cola and the like. They want the real thing. When it comes to houses, they don’t want to pay less they want to pay more.

Same with professions. Irish people have a mental block when it comes to professional fees, that makes them think that more expensive = better and that haggling over prices is wrong. On the other end of the scale, Irish people who don’t immediately have a need for professional services have a deep resentment towards professionals. But, if they were to require a GP visit, the last thing they would do is shop around for the best price or even (dare I say it) ask the doctor to accept a lower professional fee.