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Medical Workforce Intelligence Report 2016

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 provide intelligence about the medical workforce in Ireland to enhance patient safety and better support good professional practice among doctors.

55%

of specialists were aged 55 years and older

441.7

doctors for every 100,000 people in Ireland

6.4%

of doctors exited the Register

1,958

doctors entered the Register for the first time

76.8%

of doctors who worked as non-consultant hospital doctors were international medical graduates

41%

of registered doctors were female

More Information

Key Points
  • The Medical Council Oversees standards for good professional practice among doctors in Ireland;
  • It establishes and maintains a register of doctors who may, under law, practise among doctors in Ireland;
  • Each year it invites doctors to retain registration and, since 2012, to complete a survey which gathers up-to-date information about 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; and,
  • The Medical Council shares this report to enhance understanding of the make-up of the medical workforce and to enhance the capacity and capability of the sector to plan, develop and maintain a strong and sustainable medical workforce that responds to a changing healthcare landscape.
Profile Of The Medical Workforce - Doctors Retained In The Medical Council
  • 18, 766 doctors were invited to retain registration for the period July 2015 to June 2016;
  • 17,571 (94%) of doctors who retained registration;
  • 23% of doctors who retained registration were aged 55 years and older;
  • 31% of specialists were aged 55 years and older;
  • The proportion of older doctors varied across speciality with Public Health Medicine (57%), Occupational Medicine (54%), Psychiatry (38%), General Surgery (35%) and General Practice (34%) among the larger specialities with higher than average proportions of older doctors;
  • 62% of doctors retaining registration with the Medical Council graduated from an Irish medical school;
  • The Specialist: General: Trainee Division ratio among doctors retaining registration was 4.1 : 3.7 : 1; and,
  • The three most common areas of practice were General Practice (25%), General (Internal) Medicine (7%), and Anaesthesia (7%).
Medical Practitioner Density In Ireland
  • At the end of 2015 there were 441.7 doctors for every 100,000 people in Ireland;
  • There were 379.1 specialists, who retained registration in 2015, per 100,000 population;
  • Taking only those who retained registration and were working only in Ireland, there were 285.2 specialists per 100,000 population;
  • Areas of practice with the highest density of specialist were General Practice (68.6 specialists per 100,000 population), General Internal Medicine (14.6), Anaesthesia (12.9), Psychiatry (10.5) and Radiology (7.9);
  • Estimates for licensed to practise and professionally active doctors in Ireland are compared with OECD countries; and,
  • The density of General Practitioners varied significantly between counties. Galway, Westmeath and Waterford had the highest density of General Practitioners per 100,000 of the population with Meath, Kilkenny and Leitrim having the lowest.
Doctors Exiting the Register in 2015
  • 6.4% of doctors exited the Register at the time of the annual retention process in 2015; the exit rate for graduates of Irish medical schools was 4.4%;
  • The exit rate for males was higher than that for females (6.7% compared to 5.9%);
  • Of the under 65s, exit rates were higher among younger doctors - with an exit rate of 6.4% for doctors aged 25 - 29 years and 30 - 34 years who were graduates of Irish medical schools;
  • Among graduates of Irish medical schools aged 25 - 29, there was a relative increase of 16% in the exit rate between 2014 and 2015;
  • Across the divisions of the Register, the highest exit rate was observed in the General Division ( 10.5%); and,
  • A relatively low exit rate was observed among doctors registered in the Specialist Division (3.7%). However, a higher than average exit rate was observed among some specialities including Otolaryngology (9.4%) and Obstetrics and Gynaecology (7.5%).
Doctors Entering the Register 2015
  • During 2015, 2,576 doctors entered the Register for the first time;
  • Over half (51%) of new entrants were aged under 30 years;
  • During 2015, 737 doctors entered the Specialist Division for the first time, bringing the proportion of doctors registered with the Medical Council who were specialist to 40.9%;
  • 61.9% 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;
  • 52.8% of new specialists were graduates of an Irish medical school and 53.4% had completed an Irish training programme;
  • The relative growth in specialists from 2014 - 2015 was 6% and varied by specialty;
  • Eight specialities experienced a relative reduction in the number of specialists who retained registration in 2015.
Globalisation of Medical Practice in Ireland
  • In 2015, 37.9% of doctors retaining registration with the Medical Council graduated with a basic medical qualification from a medical school outside Ireland; this compares with 35.7% in 2014;
  • Ireland's reliance on international medical graduates is among the highest of OECD countries;
  • The five leading countries of qualification for doctors who did not qualify in Ireland were Pakistan, Sudan, the United Kingdom, South Africa and Romania;
  • The skill mix and roles of international medical school graduates were different to Irish medical school graduates. 27.5% of doctors who graduated from Irish medical schools were registered in the General Division, compared with 64.2% of international medical graduates;
  • 76.8% of doctors who worked as non - consultant hospital doctors (not in training) were international medical graduates; and,
  • The proportion of international graduates in the medical workforce varies across areas of practice; the areas of practice with high proportions of international medical graduates were Obstetrics and Gynaecology (58%), Emergency Medicine (56%) and Surgery (53%).
Skill Mix and Models of Care
  • The three most common roles held by doctors who retained registration in 2015 were General Practitioner (26%), Hospital Consultant (26%) and Non - Consultant Hospital Doctor in Training (20%);
  • Among doctors registered in the Specialist Division, the most common role was Hospital Consultant (47%) followed by General Practitioner (36%);
  • 47% of doctors who retained registration 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% of doctors working in the Medical Ophthalmology were specialists), other areas were predominantly delivered by non - specialists (e.g. 17% of doctors working in the Emergency Medicine were specialists); and,
  • The blend of roles also varied across areas of practice; with some areas, such as Emergency Medicine (51%), Surgery (30%), Paediatrics (27%), and Obstetrics and Gynaecology (27%) 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 in 2015 had not practised medicine in the previous 12 months;
  • Among doctors aged 65 years and older, 13% reported that they had not practised medicine in the last year;
  • 77% of doctors who retained registration in 2015 practiced only in Ireland;
  • Compared with graduates from an Irish medical school (90%), a lower proportion of international medical graduates reported that they practised medicine in Ireland only (56%);
  • The proportion of doctors who practised medicine only in Ireland varied across area of practice. Rates for practising only in Ireland were higher than the average Public Health Medicine (90%); General Practice (86%) and Psychiatry (83%) and lower than average in Surgery (68%), Radiology (67%) and Emergency Medicine (66%);
  • Almost 15% of doctors who retained registration reported that they had practised medicine on a part - time basis. Compared with men, a higher proportion of women practiced medicine part - time (11% and 20% respectively);
  • The proportion of doctors practising medicine part - time is greater among older doctors;
  • Part - time practice of medicine were more common in some areas of practice, for example Sport and Exercise Medicine (45%), Public Health Medicine (31%), Ophthalmology (30%) and General Practice (26%); and
  • Among doctors registered in the Specialist Division, 4.9% reported that they were practising in an area which was different to their registered specialities.
Womens' Participation in Medical Practice
  • In total, at the end of 2015, 41% of registered doctors were female;
  • 56% of doctors who retained registered in the Trainee Specialist Division were female;
  • Among graduates from Irish medical schools, aged less than 35 years, 73% of doctors retaining registered in the Specialist Division were female;
  • The proportion of women working in different roles varied : 80% of Community Health doctors were women compared with 30% of Hospital Consultants;
  • Among Hospital Consultants who graduated from an Irish medical school and were aged less than 35 years, 62% were female;
  • Among specialists, gender patterning of specialisation was evident. In some specialities there was a higher than average proportion of women practising: Public Health Medicine (71%), Psychiatry of Learning Disability (70%), and Genito - Urinary Medicine (67%), while in other specialities there was a lower than average proportion of women practising: Neurosurgery (8%), Oral and Maxillo - Facial Surgery (6%) and Trauma and Orthopaedic Surgery (6%);
  • Practice arrangements reported by female doctors were different to those of males; with women being more likely than men to work less than full-time across all age categories.
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