russia Without Doctors: a Personnel Crisis that the Authorities Can No Longer Control

russia’s healthcare system is entering a phase of structural collapse, which the authorities are no longer trying to hide. According to an official statement by minister of healthcare of the rf mikhail murashko, the country is short of 23,300 doctors and 63,600 mid-level medical personnel. The shortage affects virtually all key specialties, from general practitioners and pediatricians to oncologists, psychiatrists, surgeons, and radiologists. This is not a matter of isolated “problem areas”, but rather a systemic shortage of personnel in state medical institutions throughout the country.

Instead of real measures to retain staff, russian authorities are relying on administrative pressure. Innovations in the medical education system, which come into force this year, will only exacerbate the situation. Mandatory work experience for medical school graduates, mentoring, and other declared “innovations” do not increase the attractiveness of the profession; on the contrary, they reduce the number of people willing to go into medicine. Young professionals see neither financial incentives nor professional prospects.

Indicative is the situation in vladimir region, where officials decided to “optimize” the age structure of doctors by directive. By January 30 of this year, the proportion of doctors over the age of 56 must be reduced to 32%, while the number of doctors under the age of 36 must be increased to 35%. Only 10–12% of specialists over the age of 65 are allowed to remain in the system. All medical institutions in the region received the corresponding directive, signed by the acting minister of healthcare of the region, nelly zinovieva, on behalf of the deputy governor aleksei kuimov. Formally, this is explained by an increase in the “efficiency of medical care” and the introduction of new technologies.

In reality, however, it is impossible to meet these requirements. In vladimir region, there are about 30 doctors per 10,000 population, which is by about 50% fewer than the national average. The key reason remains low wages. A similar picture can be observed in kaluga, kostroma, kurgan, and pskov regions. Under such circumstances, the administrative “rejuvenation” of personnel looks not like a reform, but a direct path to an even deeper shortage.