Amid the pandemic, doctors are leaving Ukraine en masse
For surgeon Anton Avdeev, the news that the Polish Sejm had voted to simplify the employment of foreign medical workers came as a gift. He had long dreamed of working in Poland, saying he sees no professional prospects for himself in Ukraine. Until 2014, Anton worked at the city hospital in Makiivka, Donetsk region. But after the outbreak of hostilities there, he and his family had to move to relatives in the Zaporizhzhia region.
Having settled in a new place, Avdeev found a job at the district hospital in Vilniansk, a town near Zaporizhzhia. But he quickly became disillusioned with his new workplace. "There is no development there, just like in all other district hospitals. I am interested in innovative modern treatment methods. Development exists in regional clinics and oncology centers, but I cannot get into them," Anton says regretfully.
He tried to find work in Dnipro and Kyiv, but without success. "All budget-funded positions are taken, so I tried to get into private hospitals. But there they offered me a salary of 9-10 thousand hryvnias (270-300 euros), which is very little for private clinics. So I decided I need to go further, to Europe, where I could develop professionally and receive a decent salary without having to look into the patient's pocket," the surgeon explains.
Recognition of diploma in Poland opens the door to work
Anastasia Horishnia, a dentist from Kamianets-Podilskyi, also tells Deutsche Welle correspondents about the difficulties with professional development for doctors in Ukraine. According to her, she realized back in her student years that she wanted to work abroad. "In Ukraine, the medical profession is not valued as it is abroad. Our work is hard labor. So I wanted it to be financially appreciated. Besides, I understood that getting into a good clinic in Ukraine is unrealistic. The dentist market is overcrowded. I needed to find another path. And I decided to try my luck in Poland," Anastasia Horishnia says.
The woman has already moved to Poland and is now waiting for the completion of the nostrification procedure – recognition of her educational diploma by Polish state authorities. For foreign medical workers to be able to work in their specialty in Poland, they need to go through several stages: pass a nostrification exam in the basics of medicine, a Polish language exam, complete a one-year internship at a hospital, and pass another final medical exam. Anastasia has already successfully passed the first two exams.
Polish authorities try to cope with doctor shortage
The rules for employing foreign doctors in Poland, as in Western countries in general, are quite complex, but Polish authorities want to simplify them by adopting a new bill "On Ensuring Medical Personnel." It proposes that for Ukrainian doctors to work in Poland, it would be enough to have an educational diploma certified by a Polish consul, a certificate of at least three years of work in the specialty, and a certificate of Polish language proficiency.
It would also be necessary to independently find a hospital in Poland that agrees to hire a doctor from Ukraine. The Polish Sejm has already voted for the bill on simplified employment. However, the Senate, which must approve it, returned the document for revision on December 17.
In Poland itself, the bill has become the subject of numerous discussions. Public medical organizations have opposed it. "The introduced provisions lead to the abolition of any mechanisms that effectively verify the knowledge and qualifications of foreign doctors, shifting responsibility for their work onto Polish doctors who must supervise and train the aforementioned individuals," says a statement from the All-Polish Union of Doctors.
Despite the mixed attitude toward the bill within the country, its final adoption is only a matter of time. Poland is experiencing a catastrophic shortage of doctors: according to the Supreme Medical Chamber, the country lacks about 68,000 medical workers, and Polish deputies hope the new law will solve this problem. The country most needs therapists, radiologists, pediatricians, and anesthesiologists.
In advertisements on the Polish professional medical job search site HR Medica, anesthesiologists, for example, are offered 110-140 zlotys per hour (25-30 euros). Meanwhile, on Ukrainian job search sites, anesthesiologists are offered 5-7 thousand hryvnias per month (approximately 145-200 euros), and those who agree to work in "COVID" departments can expect 20 thousand hryvnias (about 580 euros).
Health Minister demands salary increases for medical workers
Salaries for Ukrainian medical workers need to be urgently raised – this is also acknowledged by the country's Health Minister Maksym Stepanov, who stated that they are "at the level of unemployment benefits." If doctors' salaries are not increased, "they will go abroad," the minister warned.
In the budget request for 2021, the Ministry of Health allocated salaries for doctors in the amount of 23 thousand hryvnias (about 660 euros), 17 thousand hryvnias (approximately 490 euros) for nurses, and 12 thousand hryvnias (about 345 euros) for orderlies. Overall, the Ministry of Health requested 300 billion hryvnias (over 8.6 billion euros) for the healthcare sector in the state budget. However, in the draft budget for the next year, the Ukrainian government provided about half of that amount.
In Ukraine, there are justified fears that the simplification by Polish authorities of the procedure for employing Ukrainian medical workers will lead to a mass exodus of medical personnel abroad. The head of the Ukrainian Ministry of Health also warned that Ukrainian healthcare workers "especially after COVID have become a magnet for all European countries." The departure of specialists could cause a shortage of doctors, nurses, and other medical staff in Ukraine. In the medical field, there is particular concern that the deficit of infectious disease specialists and anesthesiologists will increase.
Is Ukraine threatened by a shortage of medical workers?
Andriy Bazylevych, President of the World Federation of Ukrainian Medical Associations, says that the country already lacks anesthesiologists. According to him, this "artificial deficit" arose because "every hospital with an inpatient department must have two anesthesiologists on staff to receive funding from the National Health Service." "That's why they are so valuable now," Bazylevych explains.
Bazylevych does not believe in a mass outflow of medical personnel to Poland. In his opinion, "top-tier" doctors with a reputation will not leave abroad. However, young doctors may well want to find work abroad. In Ukraine, there are few opportunities for them, says the head of the World Federation of Ukrainian Medical Associations.
"Problems for young doctors begin even on the way to internship. After receiving a diploma, a medical school graduate must find a chief physician who will take them on and allocate a position for three years. And there are no such positions. Young doctors are in despair. So I understand those young people who go abroad," says Bazylevych.