*Re-upload of slides originally posted 10th July 2019* An ever-increasing number of Irish people are emigrating to study medicine abroad, with the intention of returning home after qualifying. Additionally, a great many non-national doctors from around the world apply for work in the HSE every year. The Irish healthcare system can benefit greatly if the best of these individuals are able to add their abilities and training to our hospitals. This presentation was made to outline the application process that newly-qualified medical doctors in EU/EEA countries must complete in order to qualify to work as an intern in Ireland. Presented by Dr. Robert Ferris. Sample questions are taken from the HSE guide to intern application 2018. Sources for all imagery and sources listed in references section where possible. Slides for educational purposes only. No payment or financial gain was received for this work.

1. APPLICATION FOR MEDICAL INTERNSHIP IN IRELAND
for graduates of Polish and other non-Irish EU/EEA medical schools
Dr. Robert Ferris

2. DISCLAIMER
 PLEASE NOTE: this presentation is not made with any affiliation to the Irish Health Services
Executive (HSE), Health Business Service (HBS) or the Medical Council of Ireland. Its purpose is to
provide beneficial information to EU/EEA students on the process of applying for medical internship
in Ireland.
 These slides are accurate, to the best of my knowledge, as of June 2019. Some details may differ
from the actual application process, and your own dates/deadlines will not be the same as those
listed; it is your own responsibility to double and triple-check the official instructions,
provided by the aforementioned bodies, in order to obtain the correct information for your
application!
 This information applies specifically to applicants from medical schools in Poland. The process is
very similar when applying from other countries, particularly those in the EU/EEA, but some
differences will arise. Be aware of this, and find out the specifics for your country of study as early as
possible.
 Future changes/updates to these processes cannot be accounted for, therefore, if you are applying
for an internship position it is vital that you research dates, sources of information
etc. yourself, in order to ensure that you have correct and up-to-date information.

3. THE APPLICATION PROCESS
 Applications open in October on the HSE website, at https://www.hse.ie/eng/staff/jobs/job-
search/medical-dental/nchd/interns/.
 Once your initial application form is submitted, the process is handled by HBS (Health
Business Services); contact will come from HBS Recruit, at applyintern@hse.ie, so add
them to your email address book/safe list to avoid losing important emails in your spam
folder.
 The complete application process occurs in 3 stages, including the Intern Employment
Eligibility Test (IEET).
 Following the completion of these 3 stages you will also be required to register with the
Medical Council, in order to receive licensure to work as an intern.
 This process only applies to applicants to the Republic of Ireland. Matching
to Northern Ireland requires registration for the NHS Foundation Programme, and
completion of the two-part Professional and Linguistic Assessments Board (PLAB)
test.

4. INTERN APPLICATION - STAGE 1

5. STAGE 1
 Online application opens at the end of October, and remains open for roughly 10 days only (in 2018
the application was open from 19th – 28th October)
 Complete the online application form (name, contact info, medical university, previous studies etc.).
This window is VERY BRIEF – have the required paperwork from your university ready before the
opening date!:
• Section D: Conferral and Centile Confirmation Date
• Section E: IEET payment form AND proof of payment via bank transfer (these are not the same
thing). The cost for the IEET is €200.
• Scan of the ID page of your passport
• For non-EU/EEA nationals, proof of permission to work in Ireland (see Appendix 6 of HSE Guide to
Online Application and Appointment to Intern Training in Ireland– link at the end )

6. SECTION D - CONFERRAL AND
CENTILE DATE
SECTION E –IEET PAYMENT
FORM

8. After your application is submitted (approx.
3-5 days), if you are studying in a country
which concludes medical studies with a
nationally standardised final exam (e.g. the
LEK in Poland) you will be emailed with a
declaration to fill out and return.
It is vital you find out from your university, in
good time, whether or not this exam is
required for you to graduate. Completing
this exam could potentially place you above
the level of intern training, and therefore
render you INELIGIBLE for intern year
in Ireland!

9.  The next communication you receive
should be the outcome of your application,
hopefully confirming your eligibility, with
your IEET information booklet attached.
This is usually in early December (in 2018
it arrived on Tuesday the 4th).
 At this point you have a roughly 1 week
to upload proof that you have booked
travel to Dublin, in order to sit the first part
of the Intern Employment Eligibility Test
(IEET). If you are already in Ireland, and
will sit the first exam before returning to
your country of study, provide proof of
your last journey back to Ireland.

10. INTERN EMPLOYMENT ELIGIBILITY TEST (IEET)
 The IEET is taken in two parts:
 Part 1 – written, early January (in 2019 it was Friday the 4th)
 Part 2 – OSCEs, early February (in 2019 it was Friday the 1st)
 Both tests place heavy emphasis on professionalism, ethics and basic knowledge of Irish medical law
 The single most important study source for this exam is the Medical Council’s Guide to Professional Conduct
and Ethics for Registered Medical Practitioners (8th Edition, 2018), found at
https://www.medicalcouncil.ie/News-and-Publications/Reports/Guide-to-Professional-Conduct-Ethics-8th-
Edition.html. Read this text from cover to cover!
 The Medical Council guidelines make reference to various acts of Irish law, relevant to medical practice. You
should also familiarise yourself with these acts.
 You should be familiar with the workings of an Irish hospital, the roles of its various staff and departments, and
the structures and processes in place to help with the various tasks a hospital doctor must perform. Clinical
electives are a great time to learn all of this.
 Knowledge of proper prescription practice is also important: at both exams you will be provided
with a British National Formulary (BNF) for referencing specific drugs and their doses, side-effects,
interactions etc. Get comfortable using this book over the course of your preparation, so that you can
find what you need quickly, and not waste time during the tests.

11. IEET PART 1
 120 minutes total, allocate your time as you please. The test is broken into three sections:
 Section 1 – 10 question stems, each with 5 true/false questions, for a total of 50 MCQs
1 question = 1 mark. This section is worth 50% of the total exam.
Sample question – answer True or False for each
In the Irish Healthcare system, you may be asked by the consultant in charge to refer a patient to an occupational
therapist (OT). Which of the following roles or tasks does an occupational therapist undertake in the Irish
healthcare system?
a. The OT assesses ability to swallow and safety of oral feeding in patients who have had an acute cerebrovascular
accident (stroke) – False
b. The OT assesses whether or not the patient is fit to return to their occupation – False
c. The OT primarily undertakes health assessment and provides advice to healthcare workers on issues such as
vaccinations, whether they are fit for work etc. – False
d. The OT will provide assessment of a patient’s ability to safely carry out tasks of daily
living, where these may have been affected by their illness – True
e. The OT will provide or recommend aids or adaptations necessary to a patient’s home,
in order for them to return to independent living – True

12. IEET PART 1, CONTD.
 Section 2 – 12 clinical scenarios, each followed by a question, with 5 options (possible responses)
for each question. Select the SINGLE best response. 1 question = 2.5 marks. This section is worth
30% of the total exam.
Sample question – pick the single best response
You are a house officer on an acute medical team where Mary, 65, has just been admitted with an acute stroke
(CVA). She had thrombolysis, which was only partially successful, and has a left sided hemiplegia. She tells you
that she is very concerned that she will never be able to live independently again in her own house, and that she
does not want to “spend the rest of my days” in a nursing home. She is very anxious and tearful.
What is the most appropriate response in this scenario (choose one)?
a. You should explain to Mary that, in reality, she is unlikely to recover any additional function and would be better off in
a nursing home, pointing out that there are some very nice ones which will look after her needs very well.
b. You should suggest to Mary that she might be depressed after her stroke, and offer to have a psychiatrist specializing in
old age mental health come to assess her.
c. You should explain to Mary that she will have multidisciplinary stroke rehabilitation, and that she might make a good
recovery and return to full or supported independent living.
d. You should point out to Mary that she was lucky to get expensive thrombolysis to give her the very best chance of
recovery, as many patients you have seen in her situation did not have that chance.
e. You should tell Mary that it is too soon to make any plans, and that there is no point in discussing any of these
issues until she has been in hospital for at least a week.
Best Answer: C

13. IEET PART 1, CONTD.
 Section 3 – 2 short-answer questions. 1 question = 10 marks. This section is worth 20% of the
total exam.
Sample question – open-answer. Answer ALL PARTS of the question in the answer book. You may use the British National
Formulary provided.
You have been asked to discharge a patient who has been started on warfarin for new onset atrial fibrillation
while an inpatient.
Patient name: Mary O’Connor, 13 James Joyce Crescent, Dublin 7. Medical Records Number 1000000 .
dob 01/01/41
a. Write a discharge prescription for warfarin
b. What major risk of this therapy should be discussed with this patient ?
c. Requirements before she leaves hospital?
d. What follow-up arrangements do you make before she leaves?
e. What do you tell her to do if the risk described in (b) actually happens?
(There is no limit to how much you can write, so do this section last)

14. IEET PART 2
 Passing IEET Part 1 allows you to progress to Part 2. You will, again, need to provide
proof of travel to Dublin in order to sit this exam.
 This is an OSCE exam; ~14 stations, most of which are interactive, and feature an
actor playing a patient or another hospital staff member.
 You will be presented with a wide variety of scenarios, including patient consultations,
medical errors and staff conflicts.
 Some stations are entirely written, e.g. preparing a prescription. Some written
stations are used as preparatory stations for the following interactive station.
 You will not have to perform any clinical skills, i.e. physical exam.

15. IEET PART 2, CONTD.
 You have 8 minutes per station,
including the time it takes you to
read the scenario. So, don’t take too
long (roughly 1 minute should suffice),
but make sure you’ve understood the
station correctly.
 As is also the case in Part 1, you are
expected to have an appropriate level
of knowledge for a final year medical
student, and you will need to draw on
this during the exam, but for the most
part it is not being directly tested. The
primary focus of the exam is to test
your professionalism, your ability to
communicate effectively and the
ethical standard of your responses to
challenging scenarios.

16.  Ethics and professionalism: Again, you should be intimately familiar with the Medical
Council guidelines for this exam.
 Communication: practice is vital, especially if you have little OSCE experience. Even if no
one else in your school is sitting the exam, any interview practice will help. For example,
join people who are practicing for the NHS SJT or for the USMLE Step 2 CS exams, Skype
practice with IEET applicants from other medical schools, and, most importantly, interview
real patients! The main thing is to get comfortable with challenging scenarios.
 Get plenty of practice on the written aspects of intern work; know how to do things like
writing a prescription correctly, fill a drug kardex, write an admission/discharge/referral
letter etc. Your clinical electives are an excellent time to work on these skills.
 PATIENT WELFARE IS PARAMOUNT: regardless of what scenario you are presented
with, if in doubt, trust your instinct on what course of action will be best for your
patient, and trust the official guidelines. In almost every case,
this will see you through.
IEET PART 2: PREPARATION

17. INTERN APPLICATION - STAGE 2

18. STAGE 2
 Accessible after passing IEET part 2; in 2019 the invitation to apply arrived by email on the 22nd of
February
 Application opens in early March
 Have your documentation ready
 Proof of passing IELTS: ≥7.0 band score overall, and ≥6.5 in each section (get this exam done as
early as possible, as it is valid for two years)
 BLS certification: can be obtained in the normal course of many medical degrees, but make sure
the accreditation is recognised by the HSE; American Heart Association (AHA) accreditation is
definitely accepted
 Section E and Section F forms: only available when stage 2 opens. Section F must be signed and
witnessed, e.g. by a solicitor or notary public
 Garda vetting – 4 documents: Cover Sheet, ID Document Checklist, NVB1 vetting form and Garda
Vetting Invitation (available when stage 2 opens)
 Rank your posts after this: list your preferred intern posts in order from 1-50
 Submission of your centile is required in late May, so be sure to complete all necessary requirements to
receive your diploma from your dean’s office ASAP after finishing your final module/exam
 VERY IMPORTANT: some medical schools do not confer in time for the Irish application
deadline, meaning those students have to wait until the following year to apply. Find out your
university’s conferral date and check it with HBS as soon as you can!

19. INTERNATIONAL ENGLISH LANGUAGE TESTING
SYSTEM (IELTS)
 This is an absolute requirement as an applicant from a country where English is not the primary
language, regardless of your own country of origin/background.
 Two versions: General and Academic. You must select the Academic version.
 You must pass the exam with a score of at least 6.5 per section, and an overall band score of at
least 7.0.
 There are many centres in a large number of cities, so you can find one close to you. They can fill
up quickly, however, so try to book well in advance. If you can’t find the date you want near you, it
may be available in a different test centre. Find your nearest centre at https://www.ielts.org/book-a-
test/find-a-test-location.
 Your IELTS certificate is valid for two years after completion, so you can complete the test
far in advance of your intern application, and have it out of the way. Just make sure that
you don’t sit the exam so early that your certification expires before Stage 2 of your
application!

20. IELTS FORMAT
 The exam has four sections:
 Listening – 4 recordings presenting a variety of situations in various accents. There are 10 questions per
recording (40 questions total), each worth 1 mark. You will hear each recording only once. This section
lasts for 40 minutes.
 Reading – 3 long texts, ranging from prose to scientific reports. 40 questions total, each worth 1 mark.
This section lasts for 1 hour.
 Writing – 2 open-answer questions. You have 1 hour in total to complete both tasks.
 Task 1 – shorter (at least 150 words). You must respond to a piece of information provided to you, e.g. explaining
the information shown in a scientific graph. You should aim to spend no more than 20 minutes on this part.
 Task 2 – long answer (at least 250 words). You must write an essay in response to a point of view, argument, or
problem provided on the test paper. This should be given the bulk of your writing time.
 Interview – You will converse with an examiner, who will assess your spoken English in three parts,
lasting 11-14 minutes in total.
 Part 1 (4-5 minutes) – general questions about yourself, your family, job, studies, interests etc.
 Part 2 (3-4 minutes) – you are given a specific topic. You then have 1 minute to prepare, before speaking for up to
2 minutes uninterrupted on that topic, with one or two specific questions at the end.
 Part 3 (4-5 minutes) – you are asked more general questions about your Part 2 topic, allowing you to
branch into more abstract ideas and topics of conversation. This is a good opportunity to link to topics
which you are comfortable discussing.

21. IELTS: PREPARATION
 Cost may vary, depending on the testing centre. In Dublin (UCD centre), the cost of the test
was €200.
 PRACTICE! This is vital, especially if English is not your first language. Identify your weak
areas (for most people this is essay-writing) and start practicing early with a wide variety of
topics.
 The interview can often feel unnatural, especially during the 2 minutes of uninterrupted
speaking. This can be distracting if you aren’t well-prepared, so practice speaking at length
on different subjects. Try to be comfortable when speaking, take your time explaining your
thoughts, stay on topic and speak until the examiner stops you.
 Timing is crucial, especially for the reading and writing sections.
 For the listening section, pay attention! There is no negative marking so, if unsure, answer
with your best guess, rather then leaving a blank.
 Test results take at least 2 weeks to come back, so factor this into your application plans.

22. Section E – Applicant Declaration Section F – Statutory Declaration

23. GARDA VETTING
Cover Sheet ID Document Checklist NVB1 Vetting Invitation form
Following your consenting to commence the process as part your Stage 2 online application,
you will receive a separate email to continue the Garda vetting process.
The deadline for submission is the second week of March (in 2019 it was Friday the 8th).

24. RANKING YOUR POSTS
Rank your chosen posts from 1-50, in order of preference, taking into account the clinical rotations and
hospital location for each one. Most posts consist of 4x three-month rotations: two medical and two surgical
rotations, (for a total of 6 months of medicine and 6 months of surgery).
As an applicant from a non-Irish EU/EEA medical school, your are considered a Tier 2 applicant; posts are
first allocated to Irish graduates, then to EU/EEA graduates, and finally to all other applicants, based on
availability.

25. REQUIRED DOCUMENTATION FOR STAGE 3
Form A: Centile Ranking Form B: Declaration of Good
Standing
also:
• Class ranking
• schedule
due on your centile date.
This documentation must all
be completed and submitted
to HBS by your dean’s
office, by the given deadline
(in 2019 this was the 21st of
May), so let them know in
good time!

26. INTERN APPLICATION - STAGE 3
the waiting game...

27. MEDICAL COUNCIL REGISTRATION
 Contact from the Medical Council comes toward the end of April (pre-match). You have
roughly 1 month to complete online registration (the deadline in 2019 was Friday 24th May).
 Complete the online application form at www.medicalcouncil.ie/opd, and print the resulting
cover sheet – a registration fee of €310 is required to proceed
 Post your cover sheet to the address provided, along with hard copies of:
 Scan of the photo page of your passport, notarised (or attested at a Garda station)
 Letter of good standing from your university
 English copy of your diploma, notarised or apostilled
 The cover sheet from your application MUST reach the Medical Council by the given
deadline. Ideally all your documents will accompany it, but other hard-copy documents may
be submitted after the deadline (the translated, apostilled diploma copy can take quite a while
to have ready); keep the Medical Council updated on your progress at intern@mcirl.ie and
submit what you can, when you can.

28. COVER SHEET
Remember: you can only
complete your online
application, and print/post your
cover sheet, after the €310
application fee has been paid.
This charge does not require a
bank transfer, and can be paid
using a debit/credit card on the
Medical Council website, as
part of the application process.

29. MATCH
Offers arrive in mid-June.
You must confirm acceptance of your post via email in order to secure it. Know
your deadlines.
There is no option to decline and request a different post.

30. TIMETABLE
 As early as possible – IELTS, Sections D and E, BLS certification,
permission to work in Ireland (if applicable)
 Late October – Stage 1 application opens
 Early January and early February – IEET parts 1 and 2, respectively
 Early March – Stage 2 application, Garda vetting
 May – centile submission, Stage 3 documents due
 June – register with the Medical Council. Match.
 July – Congratulations Doctor. Begin work as an intern!

31. USEFUL LINKS
 HSE Guide to Online Application and Appointment to Intern Training in Ireland, Stage 1:
http://hbsrecruitmentservices.ie/wp-content/uploads/2018/10/A-Guide-to-Online-Application-and-Appointment-
to-Intern-Training-in-Ireland-Stage-1_2019.pdf
 HSE Guide to Online Application and Appointment to Intern Training in Ireland, Stages 2 & 3:
http://hbsrecruitmentservices.ie/wp-
content/uploads/2019/02/A_Guide_to_Online_Application_and_Appointment_to_Intern_Training_in_Ireland_S
tage_2__3_2019.pdf
 Stage 1 online application: https://www.hse.ie/eng/staff/jobs/job-search/medical-dental/nchd/interns/
 Stage 2 online application: http://hbsrecruitmentservices.ie/medical-interns-2019-stage-
2/?utm_campaign=website&utm_source=sendgrid.com&utm_medium=email
 Garda vetting continuation: https://vetting.garda.ie/application/invitation/HSE001-20190306-02115
 Medical Council Application: www.medicalcouncil.ie/opd
 Medical Council guidelines: https://www.medicalcouncil.ie/News-and-Publications/Reports/Guide-to-
Professional-Conduct-Ethics-8th-Edition.html
 IELTS website: https://www.ielts.org/book-a-test/find-a-test-location

32. THANK YOU