Professor Eilis McGovern:

The issue of graduate retention has deservedly received considerable attention. Momentum began to gain in November 2011, when a workshop was held to specifically consider the issue. The workshop was attended by all the major stakeholders, including a number of trainees and out of it grew an implementation plan and a steering group. The trainees are very clear about their needs and these obviously include working conditions.

However, they are also anxious, for example, about having clarity about the training journey and Senator Burke mentioned that earlier. There is definitely progress there. There is more clarity about the marking systems for entry into training programmes. They are keen to know the duration of training programmes. They think they are too long and, again, the training bodies are starting to respond. The College of Anaesthetists of Ireland introduced a new training programme in July of last year, which is a year shorter and which is what we call seamless, where there is a single entry point and there is not a requirement to do a second interview to get into the second part of the training programme. The Royal College of Surgeons is introducing a similar programme this July, which again will be a year shorter with a single entry point without the need for a second interview several years down the line. These programmes are not pyramidal. They are almost vertical and we want to get away from a system where there is lack of clarity for doctors who start in a certain specialty about whether they will be able to complete that specialty.

They want to know about job prospects at trainee level and at the end of training when they want to enter the workforce. The blueprint for that is the Fottrell report, which is government policy. We will reach the peak number of graduates in 2014, which will be approximately 725. The report was based on projections, a consultant-delivered service and an enhanced primary care and community-delivered service. We need to ensure we provide within the training system the capacity to train 725 graduates and that is what we are trying to do. Over the next few years to accommodate the increased number of doctors, we will need to convert some of the current service grade posts back into training posts in order that every doctor who graduates has clarity about the fact that he or she will be able to access training.

Communication is one of the things they highlighted. They felt isolation and a great deal of work is going on to improve the communications between the trainees, the employer, the training bodies and the different stakeholders in their every day lives. One of the things they highlighted was the need for trust and respect, which is an important message for all of us to take on board, and which is something that should be regarded as a basic right of any employee in any system, and we are listening to them.