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Working Together to Improve the Trainee Experience

Your Training Counts has highlighted some challenges relating to trainee doctors experience in education and training in Ireland. The statistical findings highlighted in the report enables the Medical Council to open dialogue with medical educators and policy makers around the issues of trainee health and wellbeing as well as the medical education and training field.

Since the launch of Your Training Counts in December of 2014, the Medical Council has sought to enhance experiences for trainees and to ensure doctors receive the highest standard of education and training.

We have met with a wide range of national stakeholders to present the views of trainees and discuss how their experience of postgraduate training can be enhanced, including:

  • The Department of Health 
  • Presidents and Deans of Postgraduate Bodies
  • Intern Network Coordinators
  • Deans of Medical Schools
  • HSE
  • IMO and IHCA, NAGP

As well as this, we have taken a number of our own actions on foot of the survey results.
At the Medical Council we have:

  • Developed a new induction programme, known as Safe Start, for doctors new to medical practice in Ireland;
  • Developed a new Framework which will guide reform of intern training in Ireland and have also started discussions with partner organisations as to how this will be implemented. 
  • Highlighted the issue of bullying in trainee learning environments locally, nationally and internationally to bring about a coordinated response; 
  • Used Your Training Counts data to inform the accreditation of training programmes and to prioritise clinical site inspections 
  • Represented trainees’ views on the quality of learning environments in a Department of Health taskforce for improving training. And;
  • Reviewed the Guide to Professional Conduct and Ethics to ensure that it reflects issues raised through Your Training Counts.

We also asked our partner organisations what changes they’re making and here's what they told us:

Department Of Health:
A working group was established to carry out a strategic review of medical training and career structure. The group was tasked with examining and making high-level recommendations relating to training and career pathways for doctors with a view to:

  • Improving graduation retention in the public health system.
  • Planning for future service needs
  • Releasing maximum benefit from investment in medical education

Over 25 recommendations were made to address the barriers and issues relating to recruitment and retention of doctors in the Irish public health system. These recommendations are being implemented through a range of structures and processes across the health system. The Department of Health also established an Implementation Monitoring Group to ensure recommendations are implemented efficiently.

On Site Training

Health Service Executive:
The HSE have rolled out the ‘Lead NCHD’ initiative to 31 sites, which will provide a valuable link at management level between the NCHD cohort, NCHD committee and the clinical directorate/hospital management structure, thereby enabling a structured, continuous two way flow of engagement and communication between management and NCHDs'. A workshop was arranged for NCHD leads in which the Dignity of Work policy was specifically focused on during the programme.
With regard to education governance, the HSE – National Doctors Training & Planning (NDTP) is exercising its role in this area and have assessed the requirement for a network of Consultant Training leads to be established within Hospital Groups.

Intern Training Network, Dublin North East
The Intern Training Network, Dublin North East, delivers an intern boot camp, which is run as part of intern induction, which covers topics such as clinical skills, prescribing, common scenarios encountered and stress management.

Intern training Network, North West
The North West intern training network enhanced its training with a focus on preparedness for clinical practice. A programme called Human Factors for Interns (HUFFI) was developed and delivered in the North West intern training network.

Postgraduate Training Bodies

College of Psychiatrists of Ireland:
The College of Psychiatrists have made a number of improvements to their specialist training, from July 2015, their basic specialist training trainees have known where they will be located for their 3 year programme post-foundation year.

Royal College of Physicians of Ireland:
Under RCPI, the Faculty of Occupational Medicine insists all trainers undertake and regularly update their training and mentoring skills. The faculty is also involved in the Physician Wellbeing programme as well as a Developing Resilience programme provided within the College of Physicians.
RCPI also offers sessions on health, wellbeing and stress management, as well as developing workshops for trainers on how to identify and support trainees who may be distressed due to burn-out or mental illness.

Royal College of Surgeons, Ireland:
RCSI has implemented scenario based learning methods with an emphasis on doctor empowerment, teamwork, giving and receiving feedback, dealing with conflict and identifying and dealing with bullying behaviour. RCSI has also produced an Msurgery.ie app which contains information regarding the management of stress and difficult situations. A training the trainer programme was also introduced in December of 2015.

Medical Schools

National University of Ireland, Galway
A programme called IJuMP (intern junior mentoring programme) was introduced by NUIG to establish an intern teaching and mentoring group for teaching specific intern tasks and for improving awareness around intern training posts and the role of the intern.

Trinity College, Dublin
Trinity College has introduced seminars on career advice, professionalism and wellbeing. The introduction of a post call debriefing session allows trainees to discuss any difficult cases and raise issues of concern to them.