Dr. Shane Considine:

I am hoping to start on a specialist training programme in the next year or two. It is extremely unsettling to be facing into a huge commitment of time, money and dedication without any real guarantee that there will be anything for me at the end of the programme. Efforts have been made to streamline training in Ireland. Credit must be given to some of the training bodies such as the College of Anaesthetists of Ireland and the Faculty of Radiologists at the Royal College of Surgeons. The Royal College of Surgeons has actually changed its training schemes in the current year so that they take the form of a run-through model. It is also planning to align the number of trainees it takes on with the projected number of consultant posts and also with the specific specialties where they are needed. Some credit is due for that but for the vast majority of us who are still in the system, or in all other specialties, there is a definite uncertainty as to where we will go at the end of our long training.

Deputy Ó Caoláin suggested that adverse events may occur. I suggest that such events happen every day. What we often think of are errors lead to patient harm. These things do happen. I refer to medication errors, inappropriate prescribing and incorrect doses being given. What we do not hear so much about are the adverse events which befall those who are delivering the care. We do not hear about the doctors involved in car accidents when they are driving home following 24, 36 or 72 hour call periods. We do not hear about those who receive needle-stick injuries following these long work periods. We have only begun to hear about the mental health issues that arise, such as depression, anxiety and, in some cases suicide. Obviously, all of those cannot wholly be attributed to our working conditions but those conditions certainly do not help. Adverse events occur all the time and that is something of which we must be wary.