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Hospital Staff Recruitment

Dáil Éireann Debate, Tuesday - 12 March 2019

Tuesday, 12 March 2019

Questions (392)

Michael Harty


392. Deputy Michael Harty asked the Minister for Health the way in which internationally trained non-consultant hospital doctors' qualifications are assessed and evaluated; and the agency responsible for the oversight of same. [12023/19]

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Written answers (Question to Health)

The Medical Council (Council) is the regulatory state body for all registered medical practitioners. It has a statutory role in protecting the public by promoting the highest professional standards among medical practitioners practising in the Republic of Ireland. It is responsible for setting the standards of medical education and training in Ireland and it maintains a register of all doctors who are legally permitted to practise in Ireland.

The Medical Practitioners Act 2007 (MPA) is the legislation governing the Council’s work and determines the Divisions of the Register and the terms and conditions for registration of doctors on the Register. Section 7 of the MPA sets out the functions of the Council, one of which is to establish procedures and criteria for registration including the issue of certificates of registration and renewal of registration.

In order for a medical practitioner to practice medicine in Ireland they must be registered with the Council.

All EEA nationals can avail of the recognition of professional qualifications laid down in Directive 2005/36/EC which enables the free movement of professionals and sets the rules for automatic recognition for professions with harmonised minimum training conditions such as doctors. The Medical Practitioners Act also provides for the registration of a medical practitioner who is a national of a Member State who has been awarded a qualification in medicine or a certificate of acquired rights by a competent body or authority designated for that purpose by a Member State, pursuant to Directive 2005/36/EC.

All doctors who graduate from non-EU/EEA countries may be required to sit the Council’s Pre-Registration Examination System (PRES). The purpose of the PRES is to assess a doctor's competence in two areas; Clinical Knowledge and Clinical Skills.

In 2016, the Council made the PRES easier for applicants outside of Europe to apply for registration. Instead of having to pass the PRES Level 2 exam, applicants were required to provide evidence as part of their initial application for registration that they had passed an acceptable equivalent exam. The Council accepted 4 alternative examinations in lieu of the Level 2:

Professional and Linguistic - Assessment Board (PLAB), Part 1

- United States Medical - Licencing Exam (USMLE), Steps 1 and 2

- Medical Council of Canada - Evaluating Examination (MCCEE)

- Australian Medical Council - (AMC) MCQ Exam

Applicants applying with a pass in one of these examinations could directly access the PRES Level 3 (OSCE) exam.

The PRES Level 3 is an assessment of doctors’ clinical skills, knowledge and attitude in the main clinical disciplines of Obstetrics and Gynaecology, Paediatrics, Psychiatry, Surgery, Medicine and General Practice. The Level 3 is also based on the Eight Domains of Good Professional Practice as devised by the Council. It is assessed through an Objective Structured Clinical Exam (OSCE) and a written ‘Data Interpretation’ paper, which is a one-hour long test involving interpretation of laboratory results, X-Ray images, ECG’s etc.

There are three types of skills being assessed namely Practical, Communication and Interpretation. The cases that are used represent the kinds of patients and medical conditions normally encountered during medical practice in Ireland and are specifically designed to demonstrate, through the process of examining a candidate’s practical, communication, and interpretation skills, the examinee's clinical ability.

The pass mark for this exam is standard set using the ‘modified Angoff’ method for the data paper and ‘borderline regression’ for the OSCE. Candidates are expected to meet a level equivalent to an Irish graduate at end of intern year.