Doctors concerned over growing use of Russian as working language in medicine

TALLINN - The Estonian Medical Students' Association, the Estonian Junior Doctors' Association, the Estonian Medical Association, and the Estonian Nurses Union have expressed concern in a new public statement about the growing use of the Russian language in Estonian medicine.

"The official state language of the Republic of Estonia is Estonian. Its use in official institutions and professional communication is required by law and should be natural and self-evident. Healthcare is a field where clear and unambiguous communication is critically important for patient safety and quality of care. Additionally, it ensures a safer, more supportive, inclusive, and effective work environment," the statement reads.

"In recent years, a language barrier has emerged among healthcare professionals, with Russian being used in the workplace for professional tasks, a language not all young healthcare professionals and students understand. This practice can negatively impact work organization, the professional environment, and the quality of patient care," the medical professionals note.

"In healthcare, a large part of critical information exchange happens orally: discussions of a patient's condition, shift handovers, coordination of treatment plans, and daily work organization. If this communication takes place in a language that not all parties understand, important information may not be conveyed or may be misunderstood. Consequently, the risk of medical errors and misunderstandings increases, which can endanger patient safety," the statement says.

The language barrier also significantly affects the work environment. "Healthcare is inherently a high-stress field where effective teamwork and mutual trust are essential. If some employees are excluded from collective communication due to language, it can create tension, reduce the sense of belonging, and affect employee satisfaction and retention in the profession," the signatories state.

"In Estonia, higher education in healthcare is acquired in Estonian. The Language Act also establishes Estonian language proficiency requirements for healthcare workers. A regulation issued under Section 23(4) of the Language Act stipulates that care workers must have at least B1-level proficiency in Estonian, midwives and nurses B2-level, and doctors C1-level (State Gazette, 2011). Therefore, there is a justified expectation that professional communication in Estonian healthcare institutions takes place in Estonian," the statement reads.

"It is important to emphasize that this position primarily concerns professional communication - the transmission of patient-related information, work organization, and professional communication between colleagues," the medical professionals stress.

The Estonian Medical Students' Association, the Estonian Junior Doctors' Association, the Estonian Medical Association, and the Estonian Nurses Union (EÕL) advocate for Estonian to be the working language in Estonian healthcare institutions, as professional communication must be understandable to all colleagues. Reducing the language barrier promotes a safer, more supportive, inclusive, and effective work environment. A common working language ensures standards of patient safety and quality of care.

"We call on healthcare institutions, professional organizations, educational institutions, and other stakeholders to formulate clear positions that stand for the use of Estonian in professional communication in healthcare; to raise awareness in their institutions and organizations about the legal language requirements; to ensure that foreign language requirements are not mandatory in healthcare sector job advertisements and that the required level of Estonian is assessed upon hiring; and to find means and sustained support for developing the Estonian language skills of employees at all levels if they are insufficient for performing their duties," the appeal states.