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Objectives & Background

Emergency Medicine (EM) is facing a worsening recruitment and retention crisis in Ireland. We sought to document the numbers of doctors applying to, resigning from, and completing Core Specialist Training in EM (CSTEM), as well as applying to and resigning from Advanced Specialist Training in EM (ASTEM).


Records of CSTEM and ASTEM data were interrogated by hand search following approval from the Irish Committee for Emergency Medicine Training (ICEMT) for the time periods from 2011 to 2015 for CSTEM and 2007 to 2015 for ASTEM.


Following a peak in 2013, the numbers of CSTEM applicants decreased by 28% by 2015 (75 to 54). The percentage of CSTEM trainees who resigned during their 3-year Training Programme increased from 4% in 2011 to 15% in 2014. Only 1–2 CSTEM trainees out of up to 26 who started first year applied to ASTEM on completion of CSTEM each year. Following an increase between 2007 and 2009, the number of doctors applying to ASTEM decreased by 66% between 2009 and 2015 (29 to 10 trainees). The number of doctors accepted to ASTEM decreased by 70% from its peak of 10 in 2012 to 3 in 2015. A total of 7 trainees who completed CSTEM since it was established have been accepted for ASTEM. There has been no attrition from ASTEM in recent years.


ICEMT data demonstrates a dramatic decrease in the number of doctors applying to both CSTEM and ASTEM in Ireland, coupled with an increase in the number of trainees resigning from CSTEM. Significant improvement in terms and working conditions must be implemented if we are to recruit and retain trainees, and make EM a more attractive and sustainable specialty in Ireland.

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