Recruitment and retention issues to the fore in survey responses

Ms Vanessa Hetherington, IMO Assistant Director, Policy and International Affairs, provides an overview of recent surveys conducted by the Organisation

The IMO AGM will focus on the significant capacity issues and workforce deficits across the system, which are negatively impacting on patient care, on retention and recruitment, and on the health of doctors.

Many of the factors that contribute to difficulties in recruiting and retaining medical doctors have been highlighted in IMO surveys on doctor wellbeing and mental health and research on gender equality in medicine.

The IMO survey on doctor wellbeing and mental health (2022) shows that:

•   81 per cent of doctors are at high risk of burnout;

•   69.8 per cent are dissatisfied with their work life;

•   94.6 per cent reported having experienced some form of depression, anxiety, exhaustion, stress, emotional stress or other mental health conditions relating to, or made worse by, work.

These results are a shocking indictment on the Department of Health and the HSE and are a direct consequence of the failures to uphold decent working standards that respect and value medical doctors. Three-quarters of doctors were dissatisfied with their current working conditions; 72.1 per cent reported not being able to take their scheduled breaks to eat/drink during the working day; 62.3 per cent of doctors had their working week extended beyond their normal contractual hours by 11 hours or more; and 59.3 per cent reported not being in a position to take two consecutive weeks off over the past year. 

These issues are further brought to the fore through the IMO’s survey on gender equality in medicine. The survey results give an in-depth understanding of the challenges medical practitioners face across a number of key areas, including parental/carer’s leave; childcare; pregnancy and breastfeeding; bullying and sexual harassment; gender discrimination; equity of earnings; and career choice.

For those doctors in the survey that took leave to care for children or dependent relatives, just under a quarter of men and almost half of women felt pressure to return to work earlier than they would have liked. This is not a family-friendly work environment.

In terms of available and affordable childcare, both male and female doctors reported experiencing difficulties in accessing childcare. Some 51.2 per cent of female doctors and 39.1 per cent of male doctors state that they often experience difficulty in sourcing childcare options that fit their working hours, and over half of all respondents requiring childcare (50.1 per cent) are spending over €1,000 a month on childcare services. Given the demographic of the medical workforce, the onerous hours required, it is inconceivable that no plans are in place to facilitate childcare in the workplace, particularly in the context that many doctors work hours where no childcare is available. As an employer, the HSE must do more to tackle the serious and significant issues faced by their employees and support them in every way possible. There is a global shortage of medical professionals. Many countries are coming to Ireland to recruit doctors to systems that will respect, support, and value them, yet here in Ireland very little has been done to encourage doctors to stay.

The IMO survey on gender equality in medicine revealed that in terms of workplace incidents:

• 57.4 per cent of respondents reported having experienced workplace bullying;

• 41.5 per cent reported having experienced gender-
  based harassment;

• 32.4 per cent reported having experienced sexual harassment;

• While there was little difference between males and females in terms of experience of bullying, females were more likely to experience gender-based or sexual harassment;

• Of these, just under half reported recent experiences of bullying and harassment within the last two years.

When asked about their career intentions across the two surveys:

• 23.2 per cent of NCHDs planned to emigrate, of which half indicated that they have no intention to return to Ireland;

• A further 11 per cent of NCHDS were considering leaving medicine altogether; and

• Almost a third of all doctors (31.4 per cent) said they would not advise their younger self to pursue a career in medicine.

Not addressing the challenges faced in the health system has and will lead to further emigration of medical doctors abroad and drive early retirements from a system that does not support doctors nor provide them with an environment that enables them to achieve their full potential and deliver timely care to patients. The Government seems determined to be at war with doctors rather than work with the profession to achieve work environments and contracts that will enable recruitment. And improving recruitment can only be good for patients and the future of our health service.