NITP

These section gives further information on YOUR National Intern Teaching Programme

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NITP

Congratulations

Many congratulations on your graduation and welcome to the medical workforce. Most doctors have good and happy memories of their internship year and hopefully your experience will be no different.

In signing this National Intern Education and Training Agreement (NIETA) you and the Medical School, University College Cork (the administrative body for the South Intern Training Network) commit to the education and training principles contained therein. Each Intern is being asked to sign the agreement at the commencement of internship. Please note that this NIETA does not relate to employment matters, which are governed by the NCHD Contract 2010, between the Intern and their individual employer(s).

Interns should consult the National Intern Training Programme (NITP): Education and Training in the Intern Year, approved by the Medical Council in May 2011, which outlines the professional competence requirements for interns. The NITP is appended to this Agreement in Appendix A (beware this link will download a large file - pdf).

The South Intern Training Network is responsible for the provision and coordination of this training programme and is accredited by the Medical Council (of Ireland) for this purpose. In the South Intern Network University College Cork is the body responsible for the administration of the programme. Each Intern Training Network is led by a consultant-grade Intern Network Coordinator who, in collaboration with the Intern Tutors, is responsible for overseeing intern training in their Network. The contact details for the Intern Network Coordinator, the Intern Tutors and the Administrative office in the South Intern Network are provided in Appendix B.

The 12-month internship in the South Intern Training Network comprises predominantly 4 x 3-month rotations. The South Intern Training Network is committed to supporting you throughout the year. If difficulties do arise you should seek support, in the first instance, from your designated specialist Trainer, next your Intern Tutor and, if necessary, the Intern Network Coordinator.

The purpose of intern training is to educate and train the newly qualified medical graduate to a level which will lead to being awarded a Certificate of Experience by the Medical Council of Ireland. The granting of a certificate of experience is dependent on the intern satisfactorily completing the education and training programme. The Intern Network Coordinator will recommend interns to the Medical Council for the award of the Certificate of Experience based on the intern’s progression through the Intern Training Programme, including the completion of mandatory and other training elements and the completion of assessments to the required standard as outlined below. The issuance of the Certificate of Experience by the Medical Council testifies that the Intern has satisfactorily completed the Intern Training Programme.

The areas that will be included in the assessment of each intern’s overall performance include:

  1. Attending the 2-day Intern Induction Course in the Brookfield Health Sciences Complex, prior to commencing internship in addition to the induction sessions arranged in the individual hospital / general practice to which the Intern is assigned.
  2. Achieving an 80% attendance rate at the dedicated intern-specific teaching sessions. The timing and number of these sessions in any one week vary from site to site. A sign in sheet is in operation.
  3. Attaining competency in the 8 Domains of Good Professional Practice and captured in the Intern Assessment Form.
  4. Acquiring sign-off, to the greatest possible extent, in the domains detailed in the National Intern Training Programme (see Appendix 1); they include:
    1. Clinical Judgement
      • Clinical History and Examination
      • Clinical Skills
      • Infection Control
      • Managing the Acutely Ill
      • Prescribing
      • Continuous Learning
    2. Communication
      • Patient confidentiality
      • Clinical Note Taking
      • Informed Consent
    1. Professional Development
      • Understand the legal framework for medical practice in Ireland
      • Registration with the Medical Council of Ireland
      • Professional Approach
      • Maintaining competence
      • Ensure appropriate professional indemnity
      • Disciplinary Action
      • Adhere to high ethical standards
      • Completion of Formal Documents
      • Develop an informed career plan
      • Enhance Teamwork Skills
      • Recognise Limitations and Manage Stress
  5. Current certification in Basic Life Support (BLS), or certification within 4 weeks of employment
  6. Attaining certification in AHA/IHF approved Advanced Cardiac Life Support (ACLS) *
  7. Completion and certification of attendance at the Early Warning Scoring System course (COMPASS) – the acute medical emergency recognition and treatment workshops currently being rolled out throughout the country
  8. Current certification in a manual handling course, or certification within 6 months of employment
  9. Evidence of satisfactory participation in the On-Line National Intern Education & Training programme. The Clinical Judgement module of this eLearning initiative that includes tutorials and MCQs covering the 6 headings outlined in 4 (a) above are completed. This On-Line education tool will be available to ALL interns nationwide; each will have their own unique access code. Participation will form part of each intern’s overall assessment at the end of the year.
  10. Detailed in Appendix C are additional training courses/workshops currently being provided by some but not all Intern Networks. Participation in these educational activities is mandatory for Interns affiliated to these Networks. As the national programme evolves and the required funding is made available it is intended that ALL Interns will have access these training workshops, regardless of Network base.
  11. Satisfactory attendance in the workplace, with no unexplained period of absenteeism.
  12. Intern Assessment Form ÍomharAs an intern YOU are responsible for ensuring that the Intern Assessment Form is completed and signed by the supervising consultant and you at the end of each rotation. YOU are also required to bring this form to the Intern Tutor in your clinical site for review and final sign-off. In the South Intern Training Network you will have a maximum of 6 Intern Assessment Forms to complete during your 12-month internship. Failure to comply with this requirement will delay processing your full registration with the Medical Council.

*The ACLS is funded by the HSE. Payment is made upon receipt of certification.

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NITP

NIPT

National Intern Training Programme (NITP): Education and Training in the Intern Year approved by Medical Council on 31st May 2011).

A. Introduction to the NITP

  1. Purpose of Programme

The intern year is a supervised year of transition from medical student to doctor. The Programme for Intern Training is designed to ensure that on completion of the intern year every intern will be able to practice medicine in a competent and safe manner and that patients whom they treat will receive the best possible care.

The Curriculum (Section B) is based upon the Medical Council of Ireland’s Eight Domains of Good Professional Practice, National Committee of Medical Education and Training Suggested Core Competencies for Intern Year and the Guide to Professional Conduct and Ethics for Registered Medical Practitioners (Medical Council Ethical Guide) 1-3.

  1. Definition of Internship

Internship, the first year of postgraduate training, is the period of transition from medical student to registered medical practitioner. An intern is a medical doctor who has completed their medical degree and is registered to practice medicine in supervised training posts; the intern year is the first level of postgraduate medical training and is an essential step in every doctor’s career. The intern year should provide a balance between education, training and clinical responsibility, enabling interns to develop the professional and personal competencies that result in good patient care and provide a foundation for lifelong learning.

  1. Intern Training Networks

The Medical Practitioners Act 20075 states that the Medical Council of Ireland is responsible for defining the role and responsibilities for internship. Internship is normally of 12 months duration during which the intern trains in clinical practice and spends time in different clinical placements across a range of specialties that can also include elective areas in hospitals and other clinical sites recognised by the Medical Council.

Recent reforms to the intern year have led to the establishment of Intern Training Networks that are based around the existing medical schools in Ireland (Figure 1). Within each of these networks, the regional Medical School and the Postgraduate Training Bodies are charged with the responsibility for delivering the National Intern Training Programme. Each Intern Network is centred around an existing Medical School and is led by an Intern Coordinator who is responsible for organising and overseeing intern training within their network and ensuring the provision of the appropriate, agreed educational programmes for interns.

  1. Certificate of Experience

After satisfactory completion of the intern year, interns are awarded a Certificate of Experience by the Medical Council4, 5 (Appendix 1). This certificate entitles the intern doctor to apply to the Trainee Specialist Division or General Division of the Register of Medical Practitioners maintained by the Medical Council and, therefore, to proceed with a medical career in the Irish health service. The Certificate of Experience is also required by most other competent authorities in order to register in other countries.

  1. Aims of Internship

Internship should provide a period of clinical practice that enables the transition from medical student to medical doctor. Clinical practice is based around the traditional working week during which the intern works in a supervised environment. While clinical duties and responsibilities, graded according to their level of experience, are at the core of internship it must be balanced with an education and training programme that enables the intern to learn the knowledge, skills and attitudes that are necessary to provide safe medical practice.

  1. Principle objective of the Internship

Clinical service takes place within the contract of employment between the intern and employing authority (i.e. Health Service Executive (HSE), HSE-funded hospitals such as voluntary hospitals, General Practices and possibly accredited specialist and private hospitals. Most commonly, interns work as part of a multidisciplinary team where the intern is the most junior doctor of a hospital based medical or surgical team. The intern works in a supervised structure with their senior house officer (SHO), registrar, specialist/senior registrar and consultant guiding and overseeing their work. Interns also work with other allied health professionals as part of the multidisciplinary team. During this time the intern will learn to make clinical decisions in a supervised environment and have direct responsibility for patient care, the extent of this responsibility being monitored and graded according to their level of experience.

Clinical Training: clinical training incorporates both formal teaching of clinical skills and the more informal training that occurs as part of clinical service. It is through this combination that the intern gains the necessary skills such as basic life support (BLS), appropriate clinical note keeping, phlebotomy, cannulation, obtaining informed consent.

Clinical Education: medicine is an extensive subject and it is important that the Intern continues to learn and expand their knowledge base. Through a structured clinical education programme the intern will learn important practical knowledge such as the management of acute medical problems but also learn equally important matters such as the importance of infection control, communication and gain an appreciation of evidence based medicine.

The ‘Standards for Training and Experience required for the granting of a Certificate of Experience to an Intern’ and the ‘Guidelines on Medical Education and Training for Interns’ have been approved by the Medical Council and are outlined in Appendices 1 and 2.

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Network

College Networks
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NITP

Curriculum

B. Intern Curriculum

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Curriculum development

1. Development of Curriculum

Following reform of the intern year and the establishment of Intern Training Networks, it was agreed that the Intern Training Networks would work together to provide a nationally agreed intern educational programme. This curriculum is the result of collaboration between the Intern Coordinators from each Network in conjunction with those involved in intern training within their network, the Postgraduate Training Bodies and the other stakeholders represented on the Medical Council’s Intern Training Sub-Committee.

The programme is fully consistent with the aims and objectives of internship as outlined above; in addition, the Medical Council’s Eight Domains of Good Professional Practice (Figure 2) have been incorporated into 3 overlapping and interdependent modules each of which emphasises specific aspects of Intern Core Competencies and the Guide to Professional Conduct and Ethics for Registered Medical Practitioner adopted by the Medical Council (Figure 3). From these three modules each Intern Network will take responsibility for devising content for specified modules which will then be available to all networks, forming the basis of the NITP. This will be centred around 12 months of clinical service and training supported by a structured education and training programme that will allow interns to become competent independent doctors providing high quality and safe medical care to patients.

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NITP

Clinical Judgement

2. Clinical Judgement Module

Good clinical judgement is central to safe patient care and describes the process through which clinical decisions are made; patient care comprises of a series of clinical decisions, each clinical decision being based on a combination of clinical information and clinical knowledge. Clinical information is gained through detailed history taking, physical examination and investigations while clinical knowledge merges theoretical knowledge, understanding of disease processes and clinical experience.

During the intern year, the intern embarks on a process of lifelong learning in a supervised environment where interns will work to develop, improve and enhance their clinical judgement. This will combine learning of clinical skills, continuing the process of scholarship begun as an undergraduate, undertaking responsibility for patient care so that interns will become competent independent practitioners with knowledge and understanding to inform and maintain best practice.

The principal components to clinical judgement are:

  1. Clinical History and Examination: the basis of all clinical practice is the ability to communicate with patients so as to record clear, thorough and complete clinical histories along with being able to perform physical examination in a structured purposeful manner respecting a patient’s autonomy. From the information gained through history and examination, doctors establish a principal or working diagnosis from which a plan of management that includes investigations and treatments is generated.

By the end of the intern year the intern must understand the importance of clinical history, physical examination and appropriate investigations to determine clinical diagnosis and management. The intern must be able to:

The possibility of pregnancy should be considered in all women of reproductive age undergoing surgery, anaesthesia and procedures involving ionising radiation; similarly the possibility of pregnancy should be considered when prescribing medication.

Clinical assessment of a patient often involves a physical examination as well as relevant history-taking. Interns should explain what this examination will entail and seek permission from the patient before making a physical examination.

Where an intimate examination is necessary, interns should explain to the patient why it is needed and what it will entail. Interns should also let the patient know that they can have a chaperone present if they wish.

  1. Clinical Skills: during the intern year, interns will learn how to perform a variety of clinical procedures; initially these will be performed with supervision until the intern has achieved the appropriate level of competence for each procedure.
    While interns will be exposed to a range of clinical procedures depending on their specialty attachments, there are certain skills that are common to all intern posts and “on-call” duties so that by the end of the intern year, all interns are able, in a safe, confident and competent manner, to:
  1. Infection Control: infection control is an essential aspect of clinical practice as it addresses factors related to the spread of infections within healthcare settings. It encompasses preventative strategies, surveillance and outbreak investigation and management of outbreaks of nosocomial or healthcare-associated infection. It is important that all practising healthcare staff have an understanding and awareness of Infection Control.

By the end of the intern year, the intern should be able to:

  1. Managing the Acutely Ill: Managing acutely unwell patients is an integral part of all clinical practice: it requires doctors to determine clinical information in an efficient manner; perform basic procedures; make clinical decisions; implement management plans; analyse and respond to such clinical decisions and be aware of one’s own limitations.

Over the course of the intern year, and in particular when rostered “on-call”, interns will have to respond to patients who are acutely unwell. The intern is expected to perform an immediate assessment, initiate resuscitation, formulate a differential diagnosis, select the relevant urgent investigations and call for help if necessary; the intern should also be able to accurately interpret the results of urgent investigations, initiate a management plan and reassess the patient as required.

The following are common medical emergencies that the intern is expected to be able to manage in a safe and competent manner by the end of intern year:

  1. Prescribing: It is a medical responsibility to prescribe drugs, intravenous fluids, blood components or blood products. Prescribing is a critical component of clinical practice and must be done in a thorough and safe manner to ensure patient safety.

To prescribe drugs safely an intern must:

To prescribe blood and blood products safely an intern must:

  1. Continuous Learning: as a science, medicine continues to evolve and thus medicine requires not only a broad base of knowledge but a lifetime commitment to continued learning and education. While much of the intern year is about practical knowledge, interns must continue to maintain and further their knowledge of medicine. This should be achieved through self-directed learning as well as utilising medical education opportunities throughout their intern year, common examples of both of these would include:
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Communication

3. Communication Module

Interns should read the Medical Council’s current Ethical Guide Section C (Medical Records and Confidentiality).

The ability to communicate is essential to clinical practice; medical practitioners must have effective verbal and written communication skills to enable the exchange of information between patients and their families as well as with clinical and non-clinical colleagues.

To ensure good communication interns must at all times:

Certain features of communication that are critical in providing safe patient care and that are more specific to medical practice include:

  1. Patient confidentiality: Confidentiality is a fundamental principle of medical ethics and is central to the trust between patients and doctors3. Information disclosed to a doctor during the course of a doctor-patient relationship is confidential and patients are entitled to expect that such information will be held in confidence. Patient information remains confidential even after the death of the patient. Where it is necessary to obtain patient information from third parties this information is governed by the same rules of confidentiality. It is important that patient’s privacy is maintained at all times and that accidental disclosure of confidential information does not occur. Consequently, it is important that patient information is maintained securely and in compliance with data protection legislation.
  2. During the intern year, interns will receive, record and discuss confidential information from their patients with their senior medical colleagues so as to provide appropriate medical care. As the management of confidential information is a central component of a doctor’s career it is important that by the end of the intern year the intern should understand the importance of:
  1. Clinical Note Taking: All clinical notes are indispensable to patient care as they provide an accurate account of the patient’s progress and management decisions. Interns are involved in recording written clinical notes including:

Clinical notes are critical in providing safe patient care, are often the only reliable means of charting a patient’s progress and may also be used as a legal document. Considering this, on completion of the intern year, the Intern must understand both the clinical and medico-legal importance of good note keeping including that all clinical notes:

  1. Informed Consent: before any medical intervention is performed it is essential that the patient has given informed consent; informed consent is central to good clinical practice as it ensures that the patient’s autonomy and that their right to control their own life is respected3. Informed consent is the exercise of a voluntary choice by a patient and it requires effective communication between doctors and patients.

At the end of the intern year an Intern should understand the appropriate procedures to obtain informed consent including the following:

Interns are advised to read the Medical Council’s current Ethical Guide Section D (Consent to Medical Treatment) and Appendix A (Information for patients prior to giving consent) 3.

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NITP

Development

4. Professional Development Module

All medical practitioners must demonstrate a commitment to fulfilling professional responsibilities and duties; the Medical Council of Ireland has outlined these duties in its Ethical Guide. Throughout the intern year, interns are expected to understand their professional and personal responsibilities as doctors both as they relate directly to their intern year but also to their professional career as a whole.

The major professional and personal duties expected of interns are:

  1. Understand the legal framework for medical practice in Ireland: the Medical Council of Ireland is the body that regulates doctors working in Ireland; a doctor’s clinical practice is also influenced by pieces of legislation:
  1. Registration with the Medical Council of Ireland: the Medical Council regulates doctors and its primary role is to protect the public by promoting and ensuring high standards of professional conduct and professional education, training and competence among registered medical practitioners. All doctors practicing medicine in Ireland must be registered with the Medical Council. It is the responsibility of each doctor to ensure that they are correctly registered with the Medical Council and must practice in the name(s) under which they are registered. All doctors registered with the Medical Council of Ireland are expected to adhere to the Medical Council’s current Ethical Guide.
  2. Professional Approach: The patient-doctor relationship is a privileged one that depends on the patient’s trust in the doctor’s professionalism. To ensure professionalism doctors are expected to attend work on time; they should dress appropriately and act in an appropriate manner with patients, their relatives, colleagues and other healthcare professionals. During times of absence, either planned or unplanned, it is part of doctor’s professional duties to ensure that the safety and welfare of your patients is protected during their absence.
  3. Maintaining competence: All doctors must maintain competence throughout their professional career. The intern year is a structured training year and each intern must attend and complete the necessary training as determined by their Training Network so as to be eligible for the Certification of Experience. Additionally, interns should be aware of the ongoing need to maintain competence, in line with the Medical Practitioners Act 2007, once they have passed beyond internship.
  4. Ensure appropriate professional indemnity: it is the responsibility of all doctors to ensure they have adequate professional indemnity cover for all healthcare services they provide.
  5. Disciplinary Action: all doctors who fail to achieve and maintain the necessary standards of practice and care are liable to disciplinary action.
  6. Adhere to high ethical standards: the patient-doctor relationship is a privileged one that depends on the patient's trust in the doctor's professionalism. Doctors must understand their ethical and professional duties to patients respecting their rights as individuals and in particular:
  1. Completion of Formal Documents: doctors are frequently required to issue certificates, (medical) reports, prescriptions and other formal documents. Interns must have an understanding of those formal documents they are eligible to complete (e.g. prescriptions, sick leave certificates) and those they are not eligible to complete (e.g.: MDA prescriptions, death certificates, cremation forms). All formal documents must be accurate, legible and include the name and Medical Council Registration Number of the completing doctor. Doctors must not complete forms on patients unknown to them and should only sign a certificate or other such document for a patient following review of that patient.
  2. Develop an informed career plan: internship is the first year of postgraduate training and for most interns is a mandatory stepping stone to a postgraduate training scheme in a specialised area of medicine. Over the course of the intern year it is important that the Intern has an understanding of the career structures in medicine; in particular they should have:
  1. Enhance Teamwork Skills: when working in multidisciplinary teams it is important that doctors maintain clear lines of communication and systems of accountability. Doctors must treat all healthcare workers with dignity and respect. Senior doctors must create an environment in which junior colleagues are encouraged to consult their senior colleagues where a patient’s condition gives cause for concern. When disputes arise between colleagues, they must not impact on patient care and should be settled as quickly as possible with intervention by senior colleagues as necessary.
  2. Recognise Limitations and Manage Stress: the intern year is both an exciting and demanding year. It is important that during this year interns learn to identify their limitations and seek assistance and support from (senior) colleagues. It is also important to maintain both physical and psychological health during the year and seek medical or other advice or treatment as required.
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Assessment

C. Assessment of Intern Training

The Medical Council of Ireland is statutorily responsible for granting Certificates of Experience to medical practitioners who have successfully completed a period of internship7. To ensure that all interns are adequately trained each Intern Network will provide and oversee an Intern Training and Education Programme. This programme will comprise of on-site clinical training, formal curricular elements and e-learning elements7.

Each intern will be expected to satisfy the Medical Council’s criteria for the granting of a Certificate of Experience, in accordance with requirements set by the Medical Council. The relevant Intern Network Coordinator will formally sign-off for each intern in a dual capacity as Intern Network Coordinator and a registered specialist affiliated to their Postgraduate Medical Training Body.

The Intern Training Curriculum comprises of three fundamental elements; Clinical Judgement; Communication and Professional Development (Figure 3b) which are derived from the Eight Domains of Good Professional Practice (Figure 2). Each intern will need to demonstrate a competence in all three elements. While each Intern Network will vary in the exact method of assessment the major tools used to assess intern progress and capability will include:

  1. Intern Assessment Form: at the end of each clinical attachment during the intern year, an Intern Assessment Form must be completed by the supervising consultant (the Trainer) and co-signed by the Intern (see Appendix 4). This form will address key elements of clinical knowledge, professionalism and overall competence. The trainer assessments will be incorporated into the online intern training programme over time. The Trainer will also sign off as a representative of his/her training body. A copy of these assessment forms, on completion, will be forwarded to the Training Bodies.
  2. eLearning Portfolio: the Intern Networks will develop eLearning modules; these modules will include interactive compulsory stations that must be completed correctly by the intern. These stations may include demonstrating clinical understanding of prescribing as well as case vignettes. The ePortfolio will include an eLogbook element where interns will record clinical procedures completed and experience gained during the intern year.
  3. Bedside Clinical Assessment: includes assessment of both doctor/patient interaction and direct observation of clinical skills that are essential to providing quality patient care.
  4. Certificate of Experience: In compliance with the Medical Council’s responsibilities under Part 10 of the Medical Practitioners Act (section 88 (3) (d) the standards for training and experience required for the granting of a Certificate of Experience to an Intern were adopted and published by the Medical Council in September 2010. The standards are described under seven headings namely rotations, accreditation, content of training, supervision, assessment, professionalism and resources.
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NITP

Remediation

D. Remediation

Each year a small number of interns are likely to have behavioural, performance or educational difficulties; remediation is the process of addressing such difficulties. Effective remediation requires the prompt recognition of underperformance in a structured and transparent manner. This allows an accurate definition of problems which can then be managed appropriately. Through assessment, investigation, review or appraisal, remediation aims to enable interns in difficulty to practice safely.

Interns are subject to the grievance and disciplinary procedures in place in their employing authority. In the case of HSE hospitals and services, details are provided in the “HSE Employee Handbook” and “Disciplinary Procedures for the Employees of the Health Service Executive”, which is available online and from the employing hospital8,10. Interns employed in voluntary hospitals/services and private hospitals will be subject to the grievance and disciplinary procedures in place in that hospital/service, a copy of which should be sought from the HR department in the hospital/service. In the case of interns in General Practice, interns will ordinarily be contracted through the “base” hospital for the period of the GP rotation and will be subject to procedures in place in that hospital8,9,10.

The NITP seeks to establish a single robust remediation process that will enable the prompt identification and support of interns in difficulty. The support offered will include simple advice, formal mentoring, further training, re-skilling and rehabilitation. This process is currently under development.

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Domains

Eight Domains of Good Professional Practice

8 domains good clinical practice

Patient Safety and Quality of Patient Care

Patient safety and quality of patient care should be at the core of the health service delivery that a doctor provides. A doctor needs to be accountable to their professional body, to the organisation in which they work, to the Medical Council and to their patients thereby ensuring the patients whom they serve receive the best possible care.

Relating to Patients

Good medical practice is based on a relationship of trust between doctors and society and involves a partnership between patient and doctor that is based on mutual respect, confidentiality, honesty, responsibility and accountability.

Communication and Interpersonal Skills

Medical practitioners must demonstrate effective interpersonal communication skills. This enables the exchange of information, and allows for effective collaboration with patients, their families and also with clinical and non-clinical colleagues and the broader public.

Collaboration and Teamwork

Medical practitioners must co-operate with colleagues and work effectively with healthcare professionals from other disciplines and teams. He/she should ensure that there are clear lines of communication and systems of accountability in place among team members to protect patients.

Management (including Self Management)

A medical practitioner must understand how working in the health care system, delivering patient care and how other professional and personal activities affect other healthcare professionals, the healthcare system and wider society as a whole.

Scholarship

Medical practitioners must systematically acquire, understand and demonstrate the substantial body of knowledge that is at the forefront of the field of learning in their specialty, as part of a continuum of lifelong learning. They must also search for the best information and evidence to guide their professional practice.

Professionalism

Medical practitioners must demonstrate a commitment to fulfilling professional responsibilities by adhering to the standards specified in the Medical Council’s “Guide to Professional Conduct and Ethics for Registered Medical Practitioners”.

Clinical Skills

The maintenance of Professional Competence in the clinical skills domain is clearly specialty-specific and standards should be set by the relevant Post-Graduate Training Body according to international benchmarks.

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Standards

Standards for Training and Experience required for the granting of a Certificate of Experience to an Intern.

These standards have been drawn up in fulfilment of the Medical Council’s responsibilities under Part 10 of the Medical Practitioners Act 2007 to specify and publish in the prescribed manner the standards for training and experience for interns which is required for the granting of a certificate of experience (section 88 (3) (d)).

Standard 1: Rotations

Training and experience must comply with the Medical Council’s policy on length of internship and approved rotations; that is, a minimum of a total of twelve months, which should normally be consecutive, of which at least three months must be spent in Medicine in general and at least three months in Surgery in general. As part of this twelve-month period, an intern may also be employed for not less than two months and not more than four months in the following specialties:

Standard 2: Accreditation

The training site must be affiliated with a medical school and/or a postgraduate training body/network and/ or health system which is accredited by the relevant regulator. The responsible body for organising, coordinating, managing and assessing the training setting and the training process on the site must be clearly identified.

Standard 3: Content of training

The intern year must comprise a combination of formal and informal training in an integrated manner, including theoretical learning, and practical training during service delivery. There must be:

Standard 4: Supervision

There must be effective overarching supervision of the intern’s training and clinical practice by an identified clinician(s) of appropriately senior level, normally a specialist doctor who is recognised as a specialist by the relevant regulatory authority of the host country. The intern’s clinical practice should always be appropriately supervised by a medical practitioner of at least SHO level or equivalent.

Standard 5: Assessment

There must be evidence of regular and constructive feedback and assessment by the supervisor/trainer who has knowledge of the intern’s development and performance and can verify their satisfactory progress. The supervisor/trainer must meet any requirements set by the Medical Council regarding the policy and process of final assessment and sign-off.

The intern must achieve a satisfactory performance in any assessment required by or administered by Council. This includes any assessment of communication skills required by or administered by Council. If, in a jurisdiction outside Ireland, there is an exit examination or other summative assessment at the end of the intern year, the intern must pass it.

Standard 6: Professionalism

The training environment must emphasise professionalism and the development and maintenance of the relevant knowledge, skills, attitude and behaviour, including communication skills, integrity, compassion, honesty, adherence to professional codes, respect for patients and their families, colleagues and self-care. The intern must be aware of, and comply with, the Medical Council’s “Guide to Professional Conduct and Ethics for Registered Medical Practitioners”, and the training should support these ethical standards.

Standard 7: Resources

The training site must have:

The number of interns on a site should be appropriate to the resources of that site, including its staffing at all levels while at the same time having due regard for patient care and comfort. The training site must emphasise the primacy of patient safety, and interns must be encouraged to raise concerns about ethical issues, should they arise, with their mentor, clinical supervisor and/or the hospital authorities. The intern must have access to appropriate advice and counselling should it be required.


Approved by the Medical Council 9th September 2010 and Revised by the Medical Council 14th April 2011

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NITP

Training

Guidelines on Medical Education and Training for Interns.

1. Statutory Context

These guidelines have been drawn up in fulfilment of the Medical Council’s responsibilities under Part 10 of the Medical Practitioners Act 2007 to prepare and publish in the prescribed manner guidelines on medical education and training for interns (section 88(3) (b)).

These guidelines should be read in conjunction with the Medical Council’s “Standards for Training and Experience Required for granting of a Certificate of Experience” (click here) and “Part 10 rules in respect of the duties of Council in relation to Medical Education and Training (Section 88)” (click here) (please note that Rule 3 is the relevant rule for intern training).

2. Type of rotation

Intern rotations must comply with the Medical Council’s policy on duration of internship and approved rotations. That is, internship must comprise a minimum of twelve months, which should normally be consecutive, of which at least three months must be spent in Medicine in general and at least three months in Surgery in general. As part of this twelve-month period, interns may also be employed for not less than two months and not more than four months in the following specialties:

3. Accreditation

The intern training site must be affiliated with a medical school and/or a postgraduate training body/network and/ or health system which is accredited by the relevant regulator; in Ireland, this is the Medical Council. The responsible body for organising, coordinating, managing and assessing the training setting and the training process on the site must be clearly identified.

4. Education and Training

(a) Ethos

The intern year must comprise a combination of formal and informal training in an integrated manner, including theoretical learning, and practical training during service delivery.

(b) Training through clinical practice

Interns must:

(c) Formal education and training

Interns must have regular, pre-arranged/scheduled formal education and training sessions, with learning opportunities that may include lectures, small group teaching, tutorials, case presentations and case-based discussions, participation in clinical audit, and attendance at relevant external courses.

Formal training for interns must include instruction in:

A programme for personal professional development must be part of the intern’s training year.

(d) Self-directed learning

Interns must have, and utilise, appropriate resources and opportunities for self-directed learning.

(e) Eight Domains of Good Professional Practice

The content of intern training and an intern syllabus / curriculum must be consistent with the "Eight Domains of Good Professional Practice"” approved by the Medical Council.

5. Supervision

There must be effective overarching supervision of the intern by an identified clinician(s) of an appropriately senior level, normally a specialist doctor who is registered as a specialist or otherwise recognised as a specialist by the relevant regulatory authority.

6. Assessment

Interns must:

7. Professionalism

Interns must:

8. Resources

Intern training sites must have the resources to support the education and training requirements specified in these guidelines.


Approved by the Medical Council 19th October 2010 and Revised by the Medical Council 14th April 2011

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NITP

Professional Dress

Dress code is an important aspect to professional practice and forms part of a doctor’s professional responsibilities as described by the Irish Medical Council. Appropriate professional dress should be maintained throughout all aspects of professional duties including regular working day, on-call, attending education and teaching and where possible should be adhered to when on the hospital campus. Although, most hospital and institutions will have their own specific Dress Code the following is a guide to appropriate professional dress:

General Grooming:

General Attire:

The following clothing is not recommended:

Footwear

2018© Dr. ÍOS
NITP

Assessment forms

Intern Assessment Form are currently utilised by all Intern Networks, the form is completed by the Supervising Consultant at the end of each intern post/clinical attachment and is signed by both the Supervising Consultant and Intern. It addresses the key elements needed to deliver safe and effective patient care and is used to monitor progress and address and deficits in knowledge and skill. Using all currently available forms, the National Intern Training Programme has devised this standardised form to encompass all the necessary essentials.

Intern Assessment Form

(beware - large file)
2018© Dr. ÍOS
NITP

References

  1. Medical Council of Ireland, June 2010 Appendix A; Eight Domains of Good Professional Practice as devised by Medical Council.
  2. National Committee on Medical Education and Training (NCMET) Report of the Intern Sub-Committee 2008 Appendix F; Suggested Core Competencies for Intern Year.
  3. Medical Council of Ireland, 7th Edition, 2009: Guide to Professional Conduct and Ethics for Registered Medical Practitioners
  4. Health Service Executive (HSE) Medical Education and Training: Fit for Purpose, in the Irish Health Service, A Guide to Application and Appointment to Intern Training in Ireland 2010
  5. Medical Practitioners Act 2007
  6. Data Protection Acts 1988 and 2003
  7. HSE Medical Education & Training: Ireland’s Interns 2010: A Guide to Application and Appointment to Intern Training in Ireland 2010 Part 1 & 2
  8. HSE Employee Handbook, 2007 (Note deleted from HSE site!)
  9. Standards for Training and Experience required for the granting of a Certificate of Experience to an Intern (the Medical Council, September 2010)
  10. Disciplinary Procedures for the Employees of the Health Service Executive, January 2007
2018© Dr. ÍOS
NITP

Appendix B

Contact details for South Intern Training Network

Contact details
Intern Network Coordinator: Propf. paula O'Leary

Manager UCC
School of Med
Brookfield Health
Sciences Complex
College Road, Cork

Ms. Geraldine McNamee
+353-21-490-1574
 

Intern Tutors

   
BGH Dr. Peter Wieneke  
Bon Secours Dr. Lucina Jackson  
CUH Dr. Íomhar O'Sullivan Dr. Íomhar O' Sullivan
KGH Dr. Tom Higgins Dr. Tom Higgins
Living Health
Clinic
Dr. Declan Herlihy Dr. Declan Herlihy
MUH Prof. Terry O' Connor Dr. Terry O'Connor
MGH Dr. Neil Cronin Dr. Neil Cronin
Primary
Healthcare
Dr. Tony Heffernan  
SIVUH Mr. Patrick Sheahan Mr. Patrick Sheahan
Clonmel Dr. Niall Colwell Dr. Niall Colwell
2018© Dr. ÍOS
NITP

Appendix C

Additional Educational Courses / Workshops

Please note that this is an incomplete list.

Intern Network Linked Medical School

Dublin / Mid‐Leinster : UCD

South : UCC

Dublin / Northeast : RCSI

Dublin / Southeast : TCD

In preparation

Mid‐West : UL

West / Northwest : NUIG

Note: Some of the training courses and workshops listed above are financed by the intern training and education fund.

2018©Dr. ÍOS