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Better Surgical Training Needed

Posted on: October 21st, 2008

Today in the Senate, I raised the issue of the need for the Minister for Health and Children to address the lack of specialist registrar training in maxillofacial surgery. This specialist area includes treatment of afflictions relating to facial trauma and cancer of the head, neck and tongue. It is a surgical specialty in which the lack of training is acute and disturbing. To qualify for this specialist medical field candidates need two primary degrees, one in medicine and one in dentistry. They also need a further five years’ training before practising. That is an extraordinarily demanding apprenticeship, which results in candidates being particularly suited for this specialist field. Unfortunately, training facilities in Ireland are non-existent.

Maxillofacial surgery is practised in four units, namely, Cork, Limerick, Galway and in St. James’s Hospital in Dublin. Each unit needs to be well staffed. Currently, anyone wishing to train in this area is obliged to go overseas for that purpose. I urged the Minister to consider the case of a constituent of mine who wishes to be trained in this specialty but who is unable to do so because training that was available through the Dublin Dental Hospital and St. James’s Hospital ceased in 2002. The person in charge went overseas to continue his own training and, accordingly, the course collapsed.

It means that those who need to be treated must endure longer queues. While those who work in this area are well qualified, they are getting older and are not being replaced. There is nobody there to replace them. One of the excuses often given is that there is little demand for this treatment. However, the figures available to me suggest that each year, St. James’s Hospital treats 1,000 facial fractures, 100 cases of mouth cancer and 200 facial deformities. Those who are qualified to do such work are being assisted by people who have been trained in dentistry and medicine but cannot be certified because they have not done the necessary extra training in maxillofacial surgery as it is not available in Ireland.

For the sake of those who wish to practice this form of medicine and those who wish to be treated, can we not make the necessary training available to ensure we have enough suitably qualified doctors to provide the treatment? If we do not do so, people will have to go abroad or the facility in question will have to close. As no training is available in Ireland, those who wish to practice this science need to go abroad to be trained. I asked the Minister of State to consider providing the necessary funding, imposing the necessary pressure or offering the necessary incentives to the hospital to make this provision.

I asked Deputy Wallace when a new training programme would be initiated but she was unable to give me a firm response other than that the Royal College of Surgeons Ireland were discussing it. We need to strengthen our medical infrastructure rather than waste our most talented students and force them to travel abroad with their skills and potential.