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Opinion Are international doctors only here to fill the roster gaps?

Dr Liqa ur Rehman writes that non-EU doctors working in our health system are in a constant battle of survival.

AS THE PRESIDENT of a non-EU doctors’ association, I am contacted by anxious non-EU doctors everyday for advice.

They ask me if Ireland is an optimal destination for career growth and family settlement. I tell them the truth – that there are ongoing problems on equal training access, family and social stability for non-EU doctors which haven’t been highlighted for decades – but I hope to change that.

Non-EU doctors make up nearly half of the Irish health system. Every year, dozens are imported to Ireland and then exported to neighbouring countries because they have no other alternative.

It’s not merely the lack of training and static career growth but also family and social suffering that evokes this nerve-wracking experience and leaves permanent scars in their memories.

  • Read more here on how to support a major Noteworthy project to investigate the obstacles international doctors continue to face. 

Family and social instability

The majority of non-EU medics relocate to Ireland with family and children. Of course, to leave their homeland, parents, friends and permanent jobs is a life-changing decision.

The very first welcome they receive are short, unstable contracts. This means they cannot obtain a Critical Skills Employment Permit (CSEP) – a Green Card type permit which is only issued for job offers of two years’ duration. This deprives them of the benefits of this permit, including the ability of spouses and dependents to seek employment.

Unstable, short employment contracts mean their fortune for the next job is decided by a few lines of reference from their employer, which also opens the doors for bullying at the workplace and the cycle of social and family difficulties.

If their fate remains in Ireland it might be in an isolated part of the country where the financial and physical struggle of visa renewals, adequate housing, relocation expenses, registration for GPs and finding schools for children is a hard blow.

Though they are registered as highly skilled professionals, they are made to work on a General Employment Permit. This also means that their spouses, who are often qualified professionals too, cannot work and contribute to the economy of this country.

For the newly-settling skilled medics, this is a glimpse of the struggle every six months until the five-year mark when they are finally eligible for residency. The majority exit to neighbouring countries who attract them with greener pastures.

Static career growth

Meanwhile, those non-EU doctors who remain are in a constant battle of survival; their career and training remains stagnant due to inequalities in the system. As a result almost all of this group – that makes up nearly half the doctors in the Irish health system – end up with lack of formal training and static career growth.

On a normal day at the workplace an international doctor burns the same blood, sweat and tears, shares an equal workload, responsibility and job stress. However, all the support – whether it is career and training, financial or logistical – is allocated to a cohort of which more than 95% of non-EU doctors are not a part.

Ironically, the same cohort in formal training are also trained by skilled non-EU doctors at different levels. They become certified consultants and supervisors of the non-EU doctors who trained them. This is due to the lack of certified recognition of the work of these non-EU doctors which would have made them eligible for consultant.

Exploitation and instability makes them ask themselves: Why did we choose to come here?

Non-EU doctors are facing the same storm but in a different boat. The pandemic has taught many lessons to the global health system and the continuous supply of an experienced medical force is in dire need to fight this long battle.

This system needs them more than ever. It’s the prime time to value their contribution with dignity and empathy. Equality for all is the only solution for a stronger health system and optimal patient care.

To future non-EU doctors I hope to tell them – Ireland is indeed a favourable destination for non-EU doctors and their families.

Dr Liqa ur Rehman is currently working as a senior paediatric registrar. He is an advocate for the rights of non-EU doctors and president of Train Us For Ireland. 


Do you want to find out if we are looking after our intern doctors, specialist trainees and non-consultant hospital doctors?

Through freedom of information (FOI) requests, we want to investigate the response from the HSE and Department of Health to the conditions that intern doctors and specialist trainees experience as well as obstacles international doctors continue to face.

Here’s how to help support this proposal> 

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Dr Liqa ur Rehman
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