The Irish Medical Council (IMC) has set up an advisory group to assist in assessing applications from doctors whose primary medical qualifications and internships were achieved abroad, and did not deny that they told an applicant from Pakistan that it was challenging to assess intern training from that country as there was a wide variety in the type of training provided there.
Multiple communications shared on social media in online forums for Pakistani doctors make reference to delays in registration with the IMC and show correspondence to doctors explaining that careful assessment is needed because certain certificates of experience do not meet standards.
The Medical Council is the regulator of doctors in Ireland and maintains the Register of Medical Practitioners – the register of all doctors who can practise medicine in Ireland.
The Council was responding to queries from Gript Media relating to the communications purportedly issued to foreign doctors applying to register to work in Ireland. However, while the Council confirmed that the advisory group had been set up, and that there had been a “significant increase in numbers of these types of applications”, they did not respond to repeated requests to confirm correspondence, examples of which can be seen below, and which were posted on an online forum for doctors from Pakistan in Ireland.
Both communications – which the IMC has not denied came from the Council – suggest that some internships in Pakistan may not meet the standards expected for doctors by the Council.
“Intern training in Pakistan is unique in that there is a wide variety in the type of training undertaken, making it more challenging to assess its equivalence,” one letter dated January 2025 said.
“Please be advised we are still actively working to address the rotational issues with certain certificates of experience issues in Pakistan that do not meet our standard rotations ,” said another message posted to the Facebook Pakistani doctors forum on February 10th.
Asked if the IMC decided that there were difficulties in assessing intern training in regard to candidates from Pakistan, as the purported letter claimed, and if so was an advisory group set up on the matter. the Council responded:
“There are a number of pathways for registration with the Medical Council. The three most common routes are:
- Certificate of Experience route – which means a doctor’s primary medical qualification meets the international standard acceptable, and is from a World Federation of Medical Education recognised Medical School, and their internship covered the relevant rotations that would be covered on an Irish internship
- PRES exam route – which means a doctors primary medical qualification meets the international standard acceptable and is from a World Federation of Medical Schools recognised Medical School, and the doctors completes a number of clinical pre-registration exams including written and practical exams.
- Higher qualification route – which means a doctor with recognised higher qualification can proceed for registration on the specialist division of the register.
“Doctors who qualify outside the EU/EEA, who wish to register for the General Division, are required to pass or be exempt from the Pre-Registration Examination System (PRES).
The regulatory body explained that “doctors registered in the General Division can practise medicine without supervision in any field of medicine”.
“Exemptions from the PRES include a recognised Higher Qualification and/or a Certificate of Experience, or similar, which clearly demonstrates that they have successfully completed intern training equivalent to an Irish internship.
“This means that their internship must meet “Medical Council Standards for Training and Experience Required for the Granting of a Certificate of Experience to an Intern”,” the regulatory body said.
“The Certificate of Experience route is the route most applications from doctors from Pakistan use. In recent years, there has been a significant increase in numbers of these types of applications.”
For all candidates, if a doctor’s internship “is not deemed equivalent, the PRES route is still available to eligible applicants. to fulfil its statutory obligation to protect the public”, the IMC said.
They said that an advisory group had been established and that it was a “minor administrative change to allow our registration assessors to process the applications more efficiently and reduce the waiting times.”
“International medical graduates continue to play a vital role in our health system. All doctors must go through rigorous Medical Council registration and annual renewal processes in addition to employer checks before working as a doctor in Ireland,” the IMC said.
“Every application to the Medical Council is different and is assessed on a case-by-case basis. In recent years, there has been a substantial increase in the volume of applications seeking exemption from the PRES exam by virtue of having an equivalent Certificate of Experience. With this increase in volume comes an increase in the variation, diversity, and complexity of the applications we review as part of our statutory obligation to protect the public,” the IMC said.
“Due to the complexity involved, the Medical Council has set up an advisory group, which is actively advising our registration assessors on applications and internship rotations.”
“While the Medical Council does not comment on individual doctors’ applications, it is worth clarifying that the setup of this advisory group does not necessarily mean that doctors’ qualifications do not meet our standards. The Register is at an all-time high, and this is one of a number of pathways the Council has established to adapt to increasingly high volumes of registrants, and to progress applications.”