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Medical Workforce Intelligence Report 2015

A Report on the Annual Registration Retention Survey, 2014

The Medical Workforce Intelligence Report highlights information gathered by the Medical Council during the annual retention of registration process.

The purpose of this report is to enhance patient safety and better support good professional practice among doctors through generating and providing intelligence about the medical workforce in Ireland.

Who is in the Irish medical workforce? - View the infograph

19,049

doctors registered, highest in a decade

23%

of doctors are aged 55 or older

36%

of doctors practising in Ireland qualified elsewhere

62%

of doctors under the age of 30 are women

6%

of doctors exited the register

1,958

doctors joined the medical workforce

More Information

Key Points
  • The Medical Council oversees standards for good professional practice among doctors in Ireland, and establishes and maintains a register of doctors who may, under law, practise medicine in Ireland. 
  • Each year, the Medical Council invites doctors to retain registration and, since 2012, has invited doctors to complete a survey which gathers up-to-date information about their practice arrangements. This information is used to develop the Medical Workforce Intelligence Report.
  • Medical workforce intelligence underpins the work of the Medical Council in setting and monitoring standards for doctors.
  • The Medical Council shares this report to enhance the capacity and capability to effectively plan, develop and maintain a strong and sustainable medical workforce that responds to a changing healthcare landscape and better enables doctors to fulfill their potential to meet the public’s health needs.
Profile of the Medical Workforce: Doctors Retained in the Medical Council Register
  • 17,688 doctors were invited to retain registration for the period July 2014 to June 2015. 
  • 16,673 (94.4%) of doctors retained registration. 
  • The female: male ratio among doctors retaining registration was 4.1:5.9 and 23.3% of doctors who retained registration were aged 55 years and older.
  • 31.9% of specialists were aged 55 years and older; the proportion of older doctors varied across specialty with Public Health Medicine (54.5%), Occupational Medicine (51.2%), Psychiatry (39.9%), General Surgery (37.8%) and General Practice (35.7%) among the larger specialties with higher than average proportions of older doctors. 
  • 64.3% of doctors retaining registration with the Medical Council graduated from an Irish medical school.
  • The Specialist: General: Trainee Specialist Division ratio among doctors retaining registration was 4.0:3.6:1.
  • The top three areas most commonly reported by doctors as their current area of practice were General Practice, General (Internal) Medicine, and Anaesthesia.
Medical Practitioner Density in Ireland
  • At the end of 2014, there were 413.3 doctors per 100,000 people in Ireland. Taking only those who were working in Ireland, there were 361.7 doctors per 100,000 people in Ireland. 
  • Areas of practice with the highest density of specialists were General Practice (64.0 specialists per 100,000 population), General Internal Medicine (14.3 specialists per 100,000 population), Anaesthesia (12.0 specialists per 100,000 population), Psychiatry (10.2 specialists per 100,000 population) and Radiology (7.6 specialists per 100,000 population).
  • Estimates for licensed to practise and professionally active doctors in Ireland are compared with a selection of OECD countries. 
  • The density of General Practitioners varied significantly between counties. Galway, Cork, Waterford and Westmeath had the highest density of General Practitioners per 100,000 of the population, with Longford, Kilkenny and Monaghan having the lowest.
Doctors Exiting the Register in 2014
  • 5.6% of doctors exited the Register at the time of the annual retention process in 2014; the exit rate for graduates of Irish medical schools was 4.2%.
  • The exit rate among males was higher than the exit rate among females (5.9% compared to 5.2%).
  • For doctors aged under 65, the exit rate was higher among younger doctors, 7.2% and 5.9% for doctors aged 25-29 years and 30-34 years respectively (all doctors); and an exit rate of 5.5% and 4.3% for doctors aged 25-29 years and 30-34 years respectively (graduates of Irish medical schools).
  • Among graduates of Irish medical schools aged 25-29, there was a relative decrease of 44% in the exit rate between 2013 and 2014 (7.9% in 2013 to 5.5% in 2014).
  • Across the divisions of the Register, the highest exit rate was observed in the Supervised Division. Since registration in this Division is limited under law to a 2 year period, the high exit rate among doctors registered in the Supervised Division is expected.
  • A relatively low exit rate was observed among doctors registered in the Specialist Division (3.5%). However, a higher than average exit rate was observed among some specialties including Cardiology (8%), Child and Adolescent Psychiatry (7.2%) and Histopathology (6.9%).
Doctors Entering the Register 2014
  • During 2014, 1,958 doctors entered the register for the first time. 
  • Over half (53.7%) of new entrants were aged under 30 years.
  • During 2014, 666 doctors entered the Specialist Division for the first time, bringing the proportion of doctors registered with the Medical Council who were specialist to 41.6%.
  • 63.8% of new specialists were aged 40 years or under at the time of entry to the Specialist Division; the age profile of new specialists varied across specialties.
  • 49.9% of doctors with a new specialty were graduates of an Irish medical school and 43.5% had completed an Irish training programme. 
  • The relative growth in specialists from 2013-2014 was, on average, 2.6% and varied by specialty; eleven specialties, experienced a relative reduction in the number of specialists in this period, with Oral and Maxillo-Facial Surgery Cardiology and Occupational Medicine experiencing the largest relative reduction.
Globalisation of Medical Practice in Ireland
  • In 2014, 35.7% of doctors retaining registration with the Medical Council graduated with a basic medical qualification from a medical school outside Ireland; this compares with 34.3% in 2013. Ireland’s reliance on international medical graduates is among the highest compared with other OECD countries. 
  • The five leading countries of qualification for doctors who did not qualify in Ireland were Pakistan, South Africa, the United Kingdom, Sudan and India. 
  • The skill mix and roles of international medical graduates were different to Irish medical graduates. 29.7% of doctors who graduated from Irish medical schools are registered in the General Division, compared with 65% of international medical graduates; 74.8% of doctors who work as non-consultant hospital doctors and who were not in training were international medical graduates.
  • The proportion of international graduates in the medical workforce varied across areas of practice; the leading areas of practice with high proportions of international medical graduates were Obstetrics and Gynaecology (55%), Emergency Medicine (52.5%) and Surgery (50.6%).
Skill Mix and Models of Care
  • The three most common roles identified by doctors who retained registration in 2014 were General Practitioner (26.9%), Hospital Consultant (25.5%) and Non-Consultant Hospital Doctor in Training (20.9%). 
  • Among doctors registered in the Specialist Division, the most common role was Hospital Consultant (48.2%) followed by General Practitioner (36%); among doctors registered in the General Division, the most common role was Non-Consultant Hospital Doctor Not in Training (32.8%) followed by Non-Consultant Hospital Doctor, in Training (23.4%).
  • 46.1% of doctors were registered in the Specialist Division. The ratio of specialists to non-specialists varied across areas of practice. While some areas were predominantly delivered by specialists (e.g. 68.6% of doctors working in Ophthalmology were specialists), other areas were predominantly delivered by non-specialists (e.g. only 15.5% of doctors working in Emergency Medicine were specialists).
  • The blend of roles also varied across areas of practice with some areas, such as Emergency Medicine, Surgery, Paediatrics, and Obstetrics and Gynaecology having a higher than average proportion of Non-Consultant Hospital Doctors not in training.
Doctors' Participation in Practice in Ireland
  • 2.9% of doctors who retained registration did not practise medicine in the previous 12 months; among doctors 65 years and older, 13.2% reported that they had not practised medicine in the last year.
  • 78.9% of doctors who retained registration practised medicine in Ireland only; compared with doctors who graduated from an Irish medical school (90%), a lower proportion of international medical graduates reported that they practised medicine in Ireland only (59%). 
  • The proportion of doctors who reported that they practised medicine only in Ireland varied across area of practice. Rates for practising only in Ireland were higher than average in Public Health Medicine (92%), General Practice (86%) and Psychiatry (85%) and lower than average in Sports and Exercise Medicine (63%), Radiology (69%) and Emergency Medicine (70%). 
  • 13.7% of doctors who retained registration reported that they practised medicine part-time. Compared with men, a higher proportion of women practised medicine part-time (9.2% versus 20.3%) and the proportion of doctors practising medicine part-time is greater among older doctors. 
  • Part-time practice of medicine was more common in some areas of practice, for example Public Health Medicine (31%) Ophthalmology (26.3%) and General Practice (22.8%).
  • Among doctors registered in the Specialist Division, 4.7% reported that they were practising in an area which was different to their registered specialty.
Womens' Participation in Medical Practice
  • In total, at the end of 2014, 41.2% of registered doctors were female.
  • 57.9% of doctors registered in the Trainee Specialist Division were women. Among doctors aged less than 35 years, who graduated from an Irish medical school, 70.9% registered in the Specialist Division were women.
  • The proportion of women working in different roles varied: 75.8% of Community Health doctors were women compared with 29.4% of Hospital Consultants; among Hospital Consultants, aged less than 35 years and who graduated from an Irish medical school, 63.6% were women. 
  • Among specialists, gender patterning of specialisation was evident. In some specialties there was a higher than average proportion of women practising (e.g. Genito-Urinary Medicine (75%), Public Health Medicine (72%), and Psychiatry of Learning Disability (70%) while in other specialties there was a lower than average proportion of women practising (for example, Neurosurgery (4%), Trauma and Orthopaedic Surgery (5%) and Oral and Maxillo-Facial Surgery (7%). 
  • The practice arrangements reported by women doctors were different to those of men.
View Previous Reports

The second Medical Workforce Intelligence Report was published in 2014

The first Medical Workforce Intelligence Report was published in 2013