Having lost hope of employment in their profession, Ukrainian medics leaving Estonia

TALLINN - Ukrainian medical professionals have started to leave Estonia because they are unable to get work in hospitals due to the strict requirements valid in this country, Postimees reported. 

A total of 163 Ukrainian nurses are looking for any kind of employment in Estonia at the present moment. In order to start working as a nurse, they must first obtain a work permit, but most of them cannot do so because their qualification does not meet valid requirements.

"The majority of the nurses who have arrived from Ukraine do not meet the requirements to be registered," Katre Trofimov, an official at the Ministry of Social Affairs, told Postimees. Regardless of their work experience, Ukrainian nurses must undergo training in the Estonian language at a healthcare college here before they can apply for registration as a medical professional.

It is also a problem that many of the Ukrainian medical professionals have been trained as medical assistants, a qualification that requires retraining in Estonia.

"In Ukraine, the education of medical assistants is very diverse and they are not always at the level of a nurse's qualification, which is why longer-term training is justified in their case," Trofimov said.

The Estonian state has decided to take a uniform approach to all those trained as medical assistants in Ukraine, even though some of them have upgraded their skills and worked as nurses in Ukraine for many years.

Oleksandra Pissorenko, who comes from the Ukrainian city of Chernihiv devastated by the occupiers, was initially lucky. When she arrived in Estonia in the spring, she immediately rented an apartment, which she shares with a friendly Russian who is fluent in Estonian, and also a job. At first, she helped perform health checks on fellow war refugees at the Confido private clinic. When that job ended, she was offered a position as a nurse's assistant in another clinic of the same group, Kordamed, where her job is to handle samples and administer intramuscular injections.

Nurses from Ukraine can currently do simpler jobs as nurse's assistants -- measure blood pressure or read heart rate, but they are not allowed to blood samples from the vein or insert a cannula, although their skills would allow.

Pissorenko does not complain, although in Ukraine her responsibility and benefits for patients  were greater. She has been a nurse for ten years, the last three of which she worked in the ambulance service, which she describes as her dream job.

"Compared to many other Ukrainian nurses who have to clean wards as caregivers in Estonia, my current job allows me to apply my skills at least to a small degree," she said.

"At the Health Care College, they told me and another woman that we would not be accepted for the course starting in the autumn," Pissorenko said.

Both women have been trained as medical assistants, which means nothing in Estonia.

"In order to be able to work as a nurse here in the future, we have to go through nurse's training  from the start," she said.

There were five candidates per place in Estonian-language nursing education in the application for enrollment earlier this summer. Although Pissorenko already speaks some Estonian and understands basic Estonian, she is not yet ready to compete with locals in a language that is foreign to her at the entrance exam, although she has mastered a large part of the curriculum.

Pissorenko sent a letter to the Estonian Ministry of Social Affairs, which responded that they don't have a solution for medical assistants at this point, but will let them know when a solution has been devised.

Last week, a person attending the same Estonian language course as Pissorenko relocated to  Finland, where she is allowed to do some real nursing work while studying.

"In Germany, too, there's no problem getting on the nurses' register straight away," says a teacher with knowledge of the field.

Last week, the news portal of the public broadcasting company of Latvia reported that 113 doctors who have fled the war in Ukraine have received work permits in Latvia. Estonia has not issued a single work permit to date, Postimees said.

"The war in Ukraine brought us large numbers of health professionals, but their employment has been prevented by the absence of political will," Nikolai Tover, head of nursing at the Oncology and Haematology Clinic of the North Estonia Medical Center, said. Tover added that he doesn't think it's right to turn anyone away at a time when there is a big staff shortage in healthcare.

According to Tover, laws should be changed, but so far policymakers have not responded to the joint appeal of four Tallinn hospitals.

Trofimov has learned that the government plans to start discussing the issue in the fall. He argued that it is necessary to find another way to get Ukrainian nurses with higher education into the register.

"For example, by means of a compliance examination, which would be preceded by an apprenticeship and why not also courses," he said.

An additional obstacle is the legal framework of Estonia, which requires that a nurse must have studied for three and a half years before obtaining a work permit. In the rest of Europe the minimum length of the training period is three years. Harmonization of the requirements would require a change in a regulation.

The Tallinn Health Care College will open a study group for Ukrainian nurses in September, if there are at least 15 applicants.

"We received 20 applications," vice-rector Ulvi Korgemaa told Postimees.

After acquiring the necessary level of proficiency in the Estonian language, the would-be nurses will embark on a two-year professional training program.

"We will make a timetable that enables the students to work while they study. All the guarantees valid for students will also apply to them from the autumn," Korgemaa said.