Working conditions, equipment and salaries are seen as key factors in brain drain.
By Tzvetina Borisova for Southeast European Times in Sofia - -01/07/11
Healthcare workers protested outside Parliament last November, demanding an overhaul of their ailing sector. [Reuters]
The number of doctors leaving Bulgaria to look for opportunities abroad could almost double this year, according to the union representing the profession. Most will never come back.
About 80% of those leaving have just graduated. After emigrating, they find positions in foreign hospitals and establish themselves in their profession.
In all, Bulgaria could lose around 1,000 doctors by the end of this year, the Bulgarian Doctors' Union estimates.
Svilen Stoychev is one of the many who decided to work in Germany, a popular destination for young specialists, along with France, the UK, Northern Ireland, Denmark and Sweden. "The current system [in Bulgaria] forces doctors to work in a way that is benefiting neither the patients, nor the doctors," he told SETimes, explaining his decision to move.
"The lack of medical equipment and money turn you into a Doctor Quinn," he said, referring to a character in a popular TV series set in the pioneer era. "This is not acceptable for a European country."
According to a study by the Medical University in Sofia, 84% of grads emigrate because they believe this will be better for their career. They expect that going abroad will give them access to a better organised health care system, better working conditions and technical equipment, and higher salaries.
Bulgaria's healthcare sector underwent a major overhaul in the late 1990s. The communist-era system of funding and ownership was replaced with a new model and health care establishments were granted economic, legal and financial independence.
Many specialists, however, argue the new system has turned doctors into traders. Instead of focusing on treating patients, they are constantly trying to think of a way to get around the system and survive financially.
Despite the trend towards emigration, there are young doctors who have decided to stay, at least for the time being. One of them is Klementina Gerdzhikova, who works at a big hospital in Sofia.
"I decided to stay because as every young specialist I need to gain some experience and routine in my work. For these difficult first steps, I thought Bulgaria would be better, because here I don't have to worry about things such as the language barrier and having to get used to living in a foreign country," she told SETimes.
Bulgaria's health ministry disputes the doctors' union contention that the number of those leaving has picked up in recent years.
In reality, the ministry told SETimes, the number of doctors has remained stable over the past ten years, at around 30,000 people.
But the ministry concedes there is a deficiency of specialists in some fields, such as infectious diseases and forensics. Authorities plan to increase the number of students admitted to universities in these disciplines in the coming academic year.
Meanwhile, in the wake of the union's dire forecast, Prime Minister Boyko Borisov has proposed taking steps to keep doctors in the country.
According to Borisov, medical students whose tuition is being paid by the state could be asked to sign contracts obliging them to work in Bulgaria for a certain period following graduation.
"We are taking the taxpayers' money to prepare specialists who go to work in another country. Is this right?" Borisov asked.
Echoing the suggestion, Education Minister Sergei Ivanov recalled that state-sponsored students formerly had to either sign five-year agreements to work in Bulgaria, or repay their tuition. These suggestions, however, have faced criticism, particularly from the medical community.