James Reilly (Dublin North, Fine Gael)

There is already a structured pathway in place for persons who have been awarded a basic medical qualification following completion of a course of study in one of the medical schools.

The first year of postgraduate medical training, the intern year, is undertaken in a teaching university hospital following which doctors can apply to commence training in the area of medicine in which they hope to specialise. They do this by either entering a basic specialist training programme and then a higher specialist training programme in the clinical specialties, public health, occupational health, microbiology, radiology and pathology or by entering a general practice training programme.

Basic specialist training, which generally takes two years to complete, involves working in a series of senior house officer posts in supervised clinical settings, which include structured training opportunities. Upon successful completion of their basic specialist training, doctors are eligible to apply for higher specialist training. However, as these posts are very competitive many doctors work as registrars, under the supervision of a consultant, for a year or two before progressing to higher specialist training.

Higher specialist training, at specialist registrar level, takes four to seven years and is overseen by the relevant postgraduate training body. It involves rotating through a number of supervised training posts across the breadth of the relevant specialty, undertaking in-house and external training activities and sitting a number of postgraduate training body membership examinations in that specialty.

Doctors who have successfully completed their higher specialist training are entitled to registration in the specialist division of the register of medical practitioners and are eligible to apply for a consultant post in their specialty.

Doctors who wish to become general practitioners must complete a GP training programme following completion of the intern year. This consists of two years at senior house officer level in supervised clinical posts, followed by two years at GP registrar level in a GP training practice. Formal training opportunities are provided throughout and trainees must sit the general practice membership examination.

I have asked my Department to consider the scope for the creation of a new hospital specialist grade which would make for a more appropriate and sustainable model of service provision. While consideration is at an early stage, it is envisaged that this would be a non-training post filled by doctors who have completed specialist training.

Additional information not given on the floor of the House.

In addition, I am setting up a group to carry out an immediate review of career structures and paths for non-consultant hospital doctor, NCHD, posts. This group, which will include the Department, the training colleges and other key stakeholders, will examine issues such as designation of training posts, career structures for NCHD service posts and working hours and conditions and is aiming to complete its work by the autumn. We will endeavour to match undergraduate numbers to consultants and GP numbers required and provide a clear career path.

See this speech in context