Ireland has long been a source of high net emigration, with an estimated 10 million emigrants leaving the western European island since 1800. However, the past two decades have seen an unprecedented increase in the number of foreign health care workers in Ireland. The Irish health care system has experienced notable growing pains in its attempts to retain domestically-trained doctors, who often follow a decades-long trend of looking abroad to Australia, Canada and the U.K. for hire.

As Irish doctors continue to move abroad, internationally trained medics bridge the gap. Here is a look at the path ahead as Ireland copes with shortages in professional health care and works toward a more accommodating workplace for Irish doctors.

Brain Drain: Doctors Leave Ireland Behind

A telltale shift in the Irish health care industry came in the late ’90s, when rapid economic growth and demand for nursing services outpaced Ireland’s supply of workers. Since 2000, Irish doctors, most of whom depart from Ireland during or after their training, have remained similarly scarce. This period of economic expansion marked an inflection point in Irish health care, where Ireland’s historical role as a major exporter of Irish nurses reversed.

Ireland’s trend in poor doctor retention seems to mirror a similar trend affecting northern and western Europe as a whole.

Unstable Working Conditions Disillusion Doctors

Most doctors born and trained in Ireland intend to work domestically. Yet, various factors keep these workers looking for work abroad. Notably, a 2018 survey of Irish training doctors found that only 45% intended to find work domestically, hinting at an underlying push factor in the Irish medical field. A 2021 study accredits Ireland’s exodus of domestically-trained doctors to short staffing and poor training, which catalyze stressful conditions in the workplace.

The fulfillment that Irish doctors don’t find in their work environment at home, they pursue abroad. About 72% of emigrant Irish doctors prefer employment in the U.K., Canada and Australia. Naturally, international recruitment programs call on foreign-trained health care workers to compensate for Irish staffing shortages.

Foreign health care workers in Ireland must bridge the gap that Irish emigrant doctors leave behind. Nevertheless, recent assessments of Ireland’s health care system indicate that this international recruitment practice is neither sustainable for foreign-trained workers nor the communities they serve.

Challenges for Foreign Health Care Workers in Ireland

A 2025 World Health Organization study assessing nine European countries (including Ireland) found that the number of foreign-trained nurses increased 67% in these regions from 2014 to 2023 alone. Higher wages and more benefits than are available in a foreign health care worker’s home country incentivize such high immigration trends. However, a significant disconnect exists between foreign workers’ expectations and the working conditions they receive upon arrival in Ireland, perpetuating brain waste in the Irish medical field.

This occurs as foreign doctors trained in a specific setting are assigned arbitrarily to any position lacking staff, thus depriving both their origin country and their receiving country of their talent. A study interviewed foreign health care workers in Ireland and found such instances of dissonance between the position to which individuals apply and the actual role to which they are called. Due to the costly financial and emotional investment of choosing to migrate, many cannot withdraw their commitment in pursuit of a better opportunity.

Thus, many foreign doctors bear the brunt of the poor working conditions that prompt Irish-trained doctors to go abroad.

Local Implications of Sending and Receiving Health Care Workers

Local communities, either on the sending or receiving end of foreign doctors, become more vulnerable as professional health care access is redistributed across international borders. Subsequently, Ireland’s understaffed health care force leaves marginalized and low-income communities, domestic and abroad, under strain. In attempts to compensate through international recruitment, the community in Ireland outsources for doctors and the spread is thin.

Foreign health care workers in Ireland become more vulnerable to poverty as they pay the exorbitant costs associated with migration. Consequently, individuals seeking health care may not have the financial means to compete for a spot in their health care provider’s overbooked schedule. Ireland has introduced noteworthy doctor retention programs, seeking to break this cycle, with varying results.

The Path Forward for Strong Doctor Retention in Ireland

To promote universal access to quality health care, Ireland has to sustain an equitable, stress-reduced working environment for its domestically trained doctors. A shift away from brain drain in Irish health care is an uphill battle. This is largely due to systematic flaws such as hostility from or poor connections with mentors and coworkers, which weakens a newly trained doctor’s support system.

Noteworthy doctor retention efforts began in 2015, when Ireland’s Strategic Review of Medical Training and Career Structures oversaw adjusted working conditions and training opportunities for doctors training domestically. However, a 2021 study revisiting the success of these doctor retention programs found them ineffective and out of proportion to the problem’s scale. Going forward, it will take increased investment in strong mentorship for Irish training doctors and more compatible training programs to see the Irish health care industry draw a greater appeal to its workers.

Fortunately, a successful doctor retention policy, such as Romania’s, provides a hopeful template as Ireland pursues an equitable health care system benefitting workers and patients alike.

– Isla Hansen

Isla is based in Spokane, WA, USA and focuses on Good News and Politics for The Borgen Project.

Photo: Wikimedia Commons