Doctor retention: A cross-sectional study of how Ireland has been losing the battle

Background: The failure of some high-income countries to retain their medical graduates is one driver of doctor immigration from low- and middle-income countries. Ireland, which attracts many international medical graduates, implemented a doctor retention strategy from early 2015. This study measures junior doctors’ migration intentions, the reasons they leave and likelihood of them returning. The aim is to identify the characteristics and patterns of doctors who plan to emigrate to inform targeted measures to retain these doctors. Methods: A national sample of 1148 junior hospital doctors completed an online survey in early 2018, eliciting their experiences of training and working conditions. Respondents were asked to choose between the following career options: remain in Ireland, go and return, go and stay away, or quit medicine. Bivariate analyses and a two-stage multivariable analysis were used to model the factors associated with these outcomes. Results: 45% of respondents planned to remain in Ireland, 35% leave but return later, 17% leave and not return; and 3% to quit medicine. An intention to go abroad versus remain in Ireland was independently associated (P < .05) with the doctor being under 30 years (odds ratio [OR] = 1.09 per year under 30), a non-European Union (EU) national (OR = 1.54), a trainee (OR = 1.50), and with hospital specialization, especially in Anesthesiology (OR = 5.09). Respondents were more likely to remain if they had experienced improvements in supervision and training costs. Intention to go abroad and not return versus go and return was independently associated (P < .05) with: age over 30 years (OR = 1.16 per year over 30); being a non-EU (OR = 9.85) or non-Irish EU (OR = 3.42) national; having trained through a graduate entry pathway (OR = 2.17), specializing in Psychiatry (OR = 4.76) and reporting that mentoring had become worse (OR = 5.85). Conclusion: Ireland’s doctor retention strategy has not addressed the root causes of poor training and working experiences in Irish hospitals. It needs a more diversified retention strategy that addresses under-staffing, facilitates circular migration by younger trainees who choose to train abroad, identifies and addresses specialty-specific factors, and builds mentoring linkages between trainees and senior specialists

Hibridación entre biotipos de arroz maleza y variedades resistentes a imidazolinonas: análisis morfológico y vigor híbrido

Tesis (licenciatura en biología con énfasis en biología molecular y biotecnología)UCR::Vicerrectoría de Docencia::Ciencias Básicas::Facultad de Ciencias::Escuela de Biologí

Additional file 5: of Changing times? Gender roles and relationships in maternal, newborn and child health in Malawi

Appendix 5. Focus Group Discussion guide. (DOCX 135 kb

SLAN 2007: Survey of Lifestyle, Attitudes & Nutrition in Ireland: Main Report

This report presents the main findings from the 2007 Survey of Lifestyle, Attitudes and Nutrition in Ireland (SLÁN 2007). This is the third and largest SLÁN survey and the first to include those participating in languages other than English and Irish. Previous studies were carried out in 1998 (Friel et al, 1999) and 2002 (Kelleher et al, 2003). Both these reports are available on the website www.healthpromotion.ie/publications. The main SLÁN 2007 survey was conducted through face-to-face interviews. There were two sub-group studies involving (i) measurement of height, weight and waist circumference(sub-group of younger respondents) and (ii) a detailed physical examination (sub-group of older respondents). The overall aim was to provide nationally representative data on the general health, health behaviours and health service use of adults living in Ireland. The two sub-group studies aimed to provide vital information regarding the health risk profiles of younger and older adults. The themes of SLÁN 2007 were selected based on current national policy and service priorities. Key documents were consulted, including the National Health Strategy, Quality and Fairness (Department of Health and Children, 2001); the National Health Promotion Strategy (Department of Health and Children, 2000); and the Chief Medical Officer’s 4th Annual Report (Department of Health and Children, 2005). Further consultation across the research consortium, funder and Advisory Group produced a prioritised and manageable set of items to assess. A key requirement was to provide a core set of national population health data that would enable comparison within study sub-groups (gender, age and social class), across health service regions within the Health Service Executive (HSE), with other key comparison populations (particularly Northern Ireland) and with previous SLÁN surveys. The SLÁN 2007 survey was funded by the Health Promotion Policy Unit of the Department of Health and Children. The survey and analyses were carried out by the SLÁN 2007 Consortium, consisting of the Royal College of Surgeons in Ireland (RCSI), the National University of Ireland, Cork (UCC), the National University of Ireland, Galway (NUIG) and the Economic and Social Research Institute (ESRI).</p

Relationship between surgical efficiency and production factors using Tobit and two-stage bootstrap models.

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Relationship between surgical productivity and production factors–quantile regression at 25^th, 50^th, and 75^th percentiles.

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Relative weights of production factors using CSW-DEA.

Relative weights of production factors using CSW-DEA.</p

Mean comparison of surgical productivity and most commonly surgical procedures: Average volumes of operations between January and March 2018 by country.

Mean comparison of surgical productivity and most commonly surgical procedures: Average volumes of operations between January and March 2018 by country.</p

Average value of production factors by efficiency and country.

Average value of production factors by efficiency and country.</p

Histogram of efficiency score by country.

Histogram of efficiency score by country.</p