As the Deputy might be aware, to legally practise in Ireland all doctors, nurses and midwives must be registered with the appropriate statutory regulator – the Nursing and Midwifery Board of Ireland in respect of nurses and midwives and the Medical Council in respect of doctors. The Nursing & Midwifery Board of Ireland’s (NMBI) statutory functions are established under the Nurses and Midwives Act, 2011 (as amended). This Act provides the legislative basis for the regulation of nurses and midwives in Ireland, including registration, recognition of qualifications, and the protection of the public. In addition, the Nurses and Midwives (Recognition of Professional Qualifications) Rules 2018 (SI No. 220 of 2018) were made under Section 13 of the 2011 Act (as amended). These rules form the secondary legislative framework governing NMBI’s recognition processes for applicants educated outside Ireland. Internationally educated nurses who have completed their education and training outside Ireland must undergo an education assessment for their qualifications to be recognised and to ensure they meet the appropriate standards and requirements. Applicants initially complete an online assessment to determine the appropriate application route, in line with the Act’s provisions on qualification recognition. Applicants are required to provide identity documentation, qualification transcripts, professional references, and verification from their home regulatory authority. NMBI’s authority to review such documentation is grounded in Part 6 of the 2011 Act (as amended). Identification checks include likeness and liveness checks, along with utilising technology to detect anomaly in identity documents. Essential documents (Certificate of good standing) are verified by NMBI with the primary source or competent authority. NMBI will assess the applicant’s training and experience against Irish standards, informed by the Recognition of Professional Qualifications Rule 220/2018). These assessments are undertaken by a team of education assessors within the NMBI and compare the transcripts, syllabus and curricula provided by each applicant against the NMBI standards and requirements. Where applicable, an applicant must demonstrate English language proficiency. These requirements align with NMBI’s statutory objective to ensure safe and competent practice, as set out in the 2011 Act (as amended). Decisions may include direct recognition of a qualification (e.g. the primary qualification is directly comparable to an NMBI approved undergraduate programme), a requirement to complete a compensation measure (adaptation or aptitude test), or ineligibility and the qualification is not recognised. The Medical Council is the statutory agency responsible for the registration and regulation of doctors in Ireland. In order to protect patients, it has a responsibility to ensure that all doctors registered to practise medicine in Ireland meet the requirements to practise, as set out in its legislation. The Medical Practitioners Act 2007 (as amended) makes provision for doctors to access the register depending on their qualifications. Doctors are eligible to apply for registration in the General, Specialist or Supervised Division of the register, depending on their qualification and training. The EU Directive 2005/36/EC sets out the minimum, harmonised standards for basic and specialist training within the EU. This Directive lists the documents to be provided from each EU member state as evidence of having achieved the minimum standard in basic medical education or higher specialist training. For doctors coming from EU countries, where the doctor’s qualification is not verified by their Certificate of Good Standing which is issued by the regulatory body in the country they hold registration, it is Medical Council policy to verify their degree directly with the medical school/university which issued the medical degree. Non-EU qualified doctors must have graduated from a medical school listed in the World Directory of Medical Schools (WDOMS) and are required to pass or be exempt from the registration exams, the PRES, if applying for General Registration. The PRES exams are set to the standard attained by a doctor completing an internship here and on passing these exams, a doctor is eligible for General registration. Exemptions can be granted to applicants if they have attained a Higher Qualification, e.g. Membership of the RCSI/RCPI, or have completed an internship which the Council recognises to be the equivalent of an Irish internship. Doctors qualified in non-EU countries are required to have their medical credentials primary source verified by the Educational Commission for Foreign Medical Graduates (ECFMG also known as Faimer/EPIC), a body which has developed expertise in primary source verification of credentials issued by the world’s medical schools. This process also requires each applicant to provide a ‘selfie’ photograph which is compared by Medical Council staff to the proof of identity (i.e. certified photograph of passport) that was provided by the applicant when applying for registration. Applications for specialist registration from doctors qualified in non-EU/ EEA countries, are sent to the relevant postgraduate training body (PGTB) for assessment. The applicant’s training and experience are evaluated by comparing them to the training attained by a doctor in a relevant training programme here. The Medical Council then makes a decision based on the recommendation of the PGTB as to whether the applicant can be granted registration in the Specialist Division. There are also a number of third country specialist qualifications which are automatically recognised by the Medical Council as meeting the standard for entry in the Specialist Division. All applicants must provide evidence of basic medical qualifications and, where appropriate, a certificate of good standing or professional status for the jurisdictions in which they have previously practised. In addition, each doctor is asked a series of questions, and if registered and/or previously registered in another jurisdiction they are also asked to declare:
• Whether their registration is subject to the imposition of conditions,
• Whether their registration or licence to practice has ever been suspended, withdrawn, or removed/cancelled,
• Whether any application for registration or licence to practice has been refused and
• Whether they are or have been convicted of a crime whether in or outside the State.
Applicants are also required to declare if they have any health condition which may impact on their ability to practise the profession. Prior to granting registration, checks will be carried out with other professional regulators throughout the world to ensure that there are no recent decisions regarding that applicant in addition to checking the Internal Market System Interface (IMI) to ensure that there are no recent or previous alerts relating to that applicant. Where any of the above matters are disclosed or revealed via third-party checks relating to the skills, knowledge, health or character of an applicant, the Fit and Proper principles (included in the Fit and Proper Policy as published on the Medical Council website) are applied on a case-by-case basis by the Registration Adjudication Committee (RAC) which is a Committee of Council. The RAC will use its discretion to consider relevant and proportionate factors when making decisions to determine whether additional information is required, whether to grant or refuse registration, or grant registration subject to conditions. For employment in the HSE, all candidates are obliged to demonstrate that they meet the relevant minimum eligibility criteria, together with satisfying the screening and contracting standards as outlined, both in legislation and in HSE policy. Prior to any appointment in the HSE, in addition to the professional registration by the regulator of the candidate as already outlined above, the candidate will:
• Have successfully met that standards in a competency-based interview (which include two senior managers from the profession and an independent chair).
• Satisfied the personal verification standards of the HSE (Passport, driving licence etc.).
• Satisfied the HSEs referencing requirements, which are sought directly from previous employers by the HSE.
• Completed Garda vetting, in line with the legislation.
• Completed International police clearance for any jurisdiction in which the candidate has lived for 6 months or more.
• Had relevant previous service verified.
• Completed occupational health screening- in line with HSE policy.
