Strategic Review of Medical Training and Career Structures

Background

In July 2013 a Working Group, chaired by Prof. Brian MacCraith, President, Dublin City University, was established to carry out a strategic review of medical training and career structure. The Working Group was tasked with examining and making high-level recommendations relating to training and career pathways for doctors with a view to:

  • improving graduate retention in the public health system;
  • planning for future service needs;
  • realising maximum benefit from investment in medical education and training.

Terms of Reference for the Strategic Review of Medical Training & Career Structure (October 2013)

The Working Group completed its work at the end of June 2014 and, in all, submitted three reports and made 25 recommendations. The reports address a range of barriers and issues relating to the recruitment and retention of doctors in the Irish public health system.

Stage One (September-December 2013)

The membership of the Working Group for Stage One was:

  • Prof. Brian MacCraith, President, DCU (Chair);
  • Ms Oonagh Buckley, Assistant Secretary, Department of Public Expenditure and Reform;
  • Mr Leo Kearns, National Lead for Transformation and Change, System Reform Group, HSE;
  • Prof. Eilis McGovern, National Programme Director for Medical Education, Medical Education and Training Unit, HSE;
  • Ms Frances Spillane, Assistant Secretary, Department of Health;
  • Dr Barry White, Consultant Haematologist, St James’s Hospital.

The Working Group completed its work at the end of June 2014 and, in all, submitted three reports and made 25 recommendations. The reports address a range of barriers and issues relating to the recruitment and retention of doctors in the Irish public health system.

Strategic Review of Medical Training and Career Structure Interim Report

Stage Two (January-April 2014)

The Working Group commenced its preparations for Stage Two in January 2014. Having regard to the terms of reference, the Group prioritised work on career structures and pathways following completion of specialist training and reported on this issue in April 2014. The membership of the Working Group for Stage Two was as follows:

  • Prof. Brian MacCraith, President, DCU (Chair);
  • Ms Oonagh Buckley, Assistant Secretary, Department of Public Expenditure and Reform;
  • Dr Áine Carroll, Director of Clinical Programmes, HSE;
  • Dr Philip Crowley, Director, Quality and Patient Safety, HSE;
  • Mr Eunan Friel, Secretary, Forum of Irish Postgraduate Medical Training Bodies;
  • Dr Colm Henry, National Lead, Clinical Director Programme, HSE;
  • Dr Tony Holohan, Chief Medical Officer, Department of Health;
  • Mr Leo Kearns, National Lead for Transformation and Change, System Reform Group, HSE;
  • Prof. Eilis McGovern, National Programme Director for Medical Education, Medical Education and Training Unit, HSE;
  • Mr Barry O’Brien National Director, Human Resources, HSE;
  • Dr Siobhan O’Halloran, Chief Nursing Officer, Department of Health;
  • Ms Frances Spillane, Assistant Secretary, Department of Health;
  • Dr Barry White, Consultant Haematologist, St James’s Hospital.

The Working Group’s April 2014 report

As an input to its deliberations, the Working Group sought information on career structures for publicly funded tenured medical posts in other countries that were relevant to the situation in Ireland. The Health Research Board (HRB) conducted the international evidence review on behalf of the Working Group.

The HRB report March 2014

Stage Three (May-June 2014)

The Working Group commenced its preparations for Stage Three at the beginning of May 2014. During this phase of the work, the Group considered issues including strategic medical workforce planning, and career planning and mentoring supports. The membership of the Working Group for Stage Three is as follows:

  • Prof. Brian MacCraith, President, DCU (Chair);
  • Ms Oonagh Buckley, Assistant Secretary, Department of Public Expenditure and Reform;
  • Dr Áine Carroll, Director of Clinical Programmes, HSE;
  • Dr Philip Crowley, Director, Quality and Patient Safety, HSE;
  • Mr Eunan Friel, Secretary, Forum of Irish Postgraduate Medical Training Bodies;
  • Dr Colm Henry, National Lead, Clinical Director Programme, HSE;
  • Dr Tony Holohan, Chief Medical Officer, Department of Health;
  • Mr Leo Kearns, National Lead for Transformation and Change, System Reform Group, HSE;
  • Prof. Eilis McGovern, National Programme Director for Medical Education, Medical Education and Training Unit, HSE;
  • Mr Barry O’Brien National Director, Human Resources, HSE;
  • Dr Siobhan O’Halloran, Chief Nursing Officer, Department of Health;
  • Ms Caroline Spillane, CEO, Medical Council;
  • Ms Frances Spillane, Assistant Secretary, Department of Health;
  • Dr Barry White, Consultant Haematologist, St James’s Hospital

The Working Group’s June 2014 report

As an input to its deliberations, the Working Group sought a review of the literature on specific aspects of mentoring for postgraduate trainees. The HRB conducted the review on behalf of the Working Group.

Mentoring in postgraduate medical education and specialist training Review

Implementing the Strategic Review Reports

The Strategic Review recommendations are being implemented through a range of structures and processes across the health system, involving multiple stakeholders. Each recommendation has an identified business owner responsible for progressing implementation of that recommendation.

In addition, the Department of Health has established an Implementation Monitoring Group, comprising key stakeholders including trainee doctors, the Forum of Irish Postgraduate Medical Training Bodies, the HSE, the IMO, the Medical Council and the Health Workforce Research Group, RCSI. This Group advises on the preparation, by the Department’s Workforce Planning Unit, of six monthly progress reports to the Minister for Health.

First Progress Report – February 2015 (July 2014 – Jan 2015)

Second Progress Report – July 2015 (Feb 2015 – June 2015)

Third Progress Report – February 2016 (July – Dec 2015)

Fourth Progress Report – November 2016 (Jan – July 2016)