To whom it may concern, 

TLDR at the bottom. 

I am writing this letter on behalf of all EU trained Physiotherapists and Health Care Providers. We are currently required to undergo a lengthy recognition process through CORU before being entitled to use our degrees in Ireland. While we understand the important role in ensuring a high quality of care for patients in Ireland, something we are also deeply passionate and committed to, we feel that the current system under CORU is woefully inefficient and is detracting from the smooth running of our healthcare system and severely impacts the professional and personal development of graduates seeking to return from abroad. 

The following are a number of points that we have collectively experienced throughout the application process. 

-Constant requests for documents to be resent. 
-Misplaced documents. 
-Refusal to accept notarisations from Irish solicitors regulated by the LRSA. 
-Requests for proof of English proficiency from candidates born and raised in Ireland, presenting with an Irish passport. 
-Application processing times running 2-3 times over their projected schedule. 

Recently, whilst in contact with CORU, a graduate was informed that while a decision had been made by the assessor’s regarding their application, that this decision could not be delivered without having been first signed off on when their board convenes, which by way of CORU, is every 6-8 weeks. Upon further questioning, CORU would not reveal when the last board meeting took place, nor when the next meeting was scheduled. In speaking with already registered physios, the happenstance of these meetings is rumoured to be closer to every four months. Regardless, applications which have been completed are being further delayed due to superfluous layers of bureaucracy. 

Economic Impact
 

Beyond the personal impact this bureaucracy is having on each of us, there is a significant economic impact arising from this inefficiency. Many of us have graduated and are stuck on job seeker’s benefits, amounting to nearly a thousand each per month. In addition to that, many of us have been forced to actively turn down job opportunities, which both deprives a struggling healthcare system of much needed staff, as well as tax revenue from the employment of us graduates. Considering the quantity of students this affects, it would not be an exaggeration to state that CORU has been costing the country hundreds of thousands over the last number of years and will continue to do so until their system is amended. 

Emigration

The difficulty and obstacles which returning graduates face, is also contributing to large scale brain drain. When faced with a lengthy and costly recognition process(€410 to apply, an additional €100 to register annually), many graduates who would otherwise return, instead seek employment abroad. Countries like Australia, Canada and Switzerland circle hiring fares like vultures picking off disenfranchised graduates, making them feel needed and desired, where CORU appears to impede graduates at every step. 

Impact on Graduates from Irish Universities
Also confounding, is their impact on graduates who trained at local universities. Students trained through a programme with prior accreditation often wait a month plus for CORU to process their registration. Given that there are hundreds of graduates each year, this should be streamlined into a near automatic or instantaneous process. Even if it could not be done automatically, the process could be started in advance so that at the moment students pass their final exams, the paperwork is completed and they can be expedited into the workforce. 

Double Standards
As part of the degree recognition process, foreign educated graduates are asked to provide evidence of completed placements. A small portion of these are to be completed in an acute hospital setting. Coru states this to be around 100 hours per core physiotherapeutic discipline(Musculoskeletal, Neurological and Cardiorespiratory). Due to understaffing in the health service, hospitals cannot even meet their commitments to accept students from local universities, which has led to exclusivity agreements being signed between hospitals and universities. There are students trained locally being accepted onto the register without acute experience as they are not required to provide placement details to Coru when registering. Meanwhile EU trained graduates are impeded, despite having experience in the same settings. 

This by no means is to say that local students should not be able to practise immediately upon completion of their degrees. They absolutely should. Merely, graduates from EU countries should also be treated by the same standard. 

Compensation Measures 
Usually in the event that a foreign graduate is missing one of the aforementioned acute placements. One option is to complete a placement in the missing area, which is essentially redundant. The vast majority of physios training abroad are aware of the uphill battle to receive recognition from CORU, and do their best to secure the required placements before applying to CORU. If they cannot complete a placement before, there is little chance they will find one after. The only other alternative is to sit an exam, seldom run, which only further exacerbates the problems arising from delayed entry to practice. 

We would like to see a more regular, accessible and streamlined system for entering quickly into practice. The following are some ideas: Establishing training contracts with HSE facilities, the graduate receives their compensatory hours at a reduced rate, and the HSE receives a trained physiotherapist for a contracted period of time following the provision of compensatory hours. Introducing a similar concept to the teaching council, where teachers seeking recognition can work in vocational schools but not mainstream schools. Reducing the scope of practice to allow working in fields where competence has been proven, until the outstanding hours can be demonstrated. Creation of short courses similar to the micro-credential system implemented in UCD to allow graduates to demonstrate competency on a more regular and accessible basis. 

TLDR
Inefficiency is costing the Irish public significant amounts of money, is contributing to brain drain and keeping skilled workers from helping an overburdened healthcare system. 

There are a number of items which we would like to see addressed. 

-Transparency on processing procedure and assessment dates. 
-Refunding of application fees when CORU can not meet their projected timeline. 
-Streamlining of recognition process. When the same set of universities consistently apply each year, several steps of the process can be expedited rather than repeated. 
-Accelerated pathways to entering the healthcare service.
-Greater recognition for the high standard of education received in EU states. 
-The same should be applied to other professions regulated by CORU, not just physiotherapy. 
 

Sincerely, 

EU physiotherapy graduates