Russia is facing new challenges in securing doctors. Despite an unprecedented increase in requests for specialty positions, many of these positions remain unfilled. This situation is due to new laws that require graduates to sign employment contracts before graduation.
Challenges in Attracting Doctors to Rural Areas
About 1,500 specialty positions in major Russian medical universities remain vacant. The universities of Pirogov and Sechenov have been unable to fill 289 and 211 of their specialty positions, respectively. These shortages include high-demand specialties such as anesthesia, intensive care, surgery, and oncology. While over 591,000 applications for state-funded positions have been registered at the Ministry of Health universities, the new laws seem to be the main barrier to attracting doctors, especially in rural and small areas.
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Consequences of the New Hiring Laws
As of March 1, all state-funded specialty positions are being allocated purposefully. Students are required to sign contracts with their future employers and must commit to working in hospitals covered by mandatory health insurance for a period of 18 months to three years after graduation. If they fail to fulfill their commitments, graduates are obligated to repay their tuition costs and pay fines. These conditions clearly deter students from rural areas, where living conditions and income are significantly lower than in large cities.
The fact that young doctors are reluctant to work in rural hospitals clearly indicates deeper challenges. Sparsely populated areas and harsh weather conditions, especially in Siberia and the Far East of Russia, exacerbate this problem. While Siberia covers 77% of Russia's land, only 36 million people live there, most of whom are located in the Trans-Siberian cities. In these areas, winter temperatures typically drop below -40 degrees Celsius.
The shortage of doctors in the Far East of Russia is acutely felt. For example, in the Kamchatka region, local doctors have reported being forced to cover multiple hospital departments simultaneously. During the COVID-19 pandemic, five doctors in this region lost their lives, which, according to local doctors, is a catastrophic loss for such an area. Similar conditions have been reported in Yakutia and Krasnodar, where hospitals rarely have specialty coverage.
Given that this specialty allocation system resembles past Soviet systems, there are concerns about potential abuses and negative impacts on attracting doctors. During the Soviet era, universities were directly supervised by ministries, and graduates were required to work in designated areas. While this system is undergoing significant changes, relevant authorities still need to find solutions to attract doctors to sparsely populated regions.
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