Newly-qualified doctors could be incentivised to stay in Ireland through the funding of part or all the cost of their education in return for a commitment to them working for the HSE for a set period, according to a Government options paper.A number of approaches intended to halt the departure of new doctors on the completion of their studies have been identified by Department of Higher Education officials, who Minister James Lawless has asked to develop more detailed plans in advance of budget discussions.The programme for Government commits to providing more supports for graduate entry courses, where fees are much higher, typically between €16,000 and €19,000, than for typical undergraduate courses in medicine.Lawless has also signalled an interest in providing greater supports for graduate medical students in return for a commitment to work in the Irish health service for a set period.Many newly-qualified doctors emigrate to work in different locations around the world, while the HSE is a major employer of doctors from overseas. Last year, 630 Irish doctors received visas to work in Australia.In the options paper, seen by The Irish Times, officials suggested various ways of supporting medical students in the graduate entry programmes. Lawless asked them to examine options to create a financial support scheme for graduate students, where the State would cover more of the upfront costs of studying medicine as a second degree. In return, graduates would commit to working in the Irish health system for a defined number of years.At present, graduate entry medicine is not covered by the free fees system or by normal student grants as those undertaking the courses are pursuing a second degree. This means higher costs for students, with many having to take on large debts to complete their studies. This is seen as a barrier to lower-income students entering the profession. [ One in four of students on ‘diversity’ medicine course have family incomes of more than €150,000Opens in new window ]The options paper sets out a number of possibilities, including enhanced subsidies through existing student support structures, a State-backed loan or a bursary. In return, students who avail of that support would agree to a defined “return-of-service” commitment, meaning they would work in the public health system for a minimum period after qualifying.If they fulfil that commitment, the financial support would effectively be absorbed by the State, either through loan write-off or by not requiring repayment. Those who choose not to remain in Ireland would be expected to repay some or all of the funding. There are various methods of recouping the money suggested.However, a number of concerns were expressed by officials in the options paper. They warned that any scheme would have to ensure that it does not disincentivise students from any particular courses and that it should not be “socially regressive” by tying more socially-disadvantaged students to working in particular circumstances, while better-off classmates did not have to.The paper also warned that the Revenue Commissioners would be “highly unlikely” to be willing to take part in a scheme to enforce repayment, and that therefore repayment where graduates left Ireland, or did not work in the public system, could be left to contract law and debt recovery.If the schemes are to go ahead, the paper says, it will also require the Department of Health and the Department of Finance to become involved, while some options also require legislation.