Letter: NCHD changeover

The current way of treating NCHDs is archaic, stemming from a time where the majority doctors were young men with little responsibility

Dear Sir,

“I’ve yet to hear one good argument for why NCHDs are made move all over the country for years on end”

While people all over Ireland are getting ready to go on summer holidays, NCHDs across the country are getting ready for a somewhat less pleasant journey. Every July, the majority of NCHDs in Ireland are uprooted from their current job and sent to a different hospital around the country – the involuntary nomadic lifestyle of the NCHD in Ireland

Over a decade ago, having to frequently move around the country as part of their training, was highlighted as major source of dissatisfaction amongst NCHDs in Ireland. Little has changed since. As Dr Rachel McNamara recently put it: “That’s the way it has always been”, referring to inability to improve working conditions for NCHDs in Ireland for decades. At present, most NCHDs remain on one-year contracts, making you feel like a temporary staff member. It’s a year-by-year lifestyle.

While the average person in the UK (no Irish stats available) move approximately eight times in their lifetime, NCHDs in Ireland may easily surpass this number during their training with some trainees reporting having moved house 10-14 times during their training and fellowships. I’ve only worked as a doctor for two years, but already moving to my fourth house come July.

Moving house every year puts a strain on relationships and makes it difficult to raise a family, as you might very well be required to move away from your family to the other side of the country. The fact that there’s little to no help from the HSE and the hospitals when it comes to finding accommodation, combined with the current state of the rental marked, makes simply finding a place to live a stressful experience, never mind the move itself.

Currently, NCHDs are only told where they are going for the next two to three years, making it difficult, if not impossible, to plan a future. I know where I’m going in July 2022, but have no idea where I’m going in July 2023. Only time will tell, the only thing I do know is that will be asked to move once more.

What makes this nomadic lifestyle even more difficult is the complete lack of reason for moving NCHDs around the country for years. Although some moving is necessary to ensure exposure to subspecialties like neurosurgery or paediatrics, and smaller regional hospitals, the yearly or sometimes six-monthly move does not in any way enhance training. If anything, the negative effects moving and uprooting has on mental health might very well have the opposite effect on training.

The current way of treating NCHDs is archaic, stemming from a time where the majority doctors were young men with little responsibility outside of work. NCHDs deserve stability, consistency and predictability throughout their training.

I’ve yet to hear one good argument for why NCHDs are made move all over the country for years on end, but there’s plenty of good arguments for putting an end to this nomadic lifestyle.

Dr Ola Løkken Nordrum
Anaesthesiology Trainee,
Galway University Hospital

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