SCALPEL, PLEASE: Lithuania is seen as an attractive place to practice medicine by doctors from the east.
KLAIPEDA - Statistically speaking, Lithuania employs one of the largest armies of doctors and nurses per 10,000 inhabitants within Europe, but when it comes time to visit a doctor, particularly one of a narrow specialization, it may take a couple of weeks or longer to get an appointment. While all agree that the emigration of doctors to richer European countries is unstoppable, no one can yield up the exact data showing the real scale of this emigration. While local cash-strapped doctors lose their hopes to see an economic improvement, and instead flee to where similar work is paid at least thrice better, foreign doctors have started swinging the door of Lithuanian medical facilities more and more often, hoping to nail down a job in the land of their dreams – Lithuania.
Grigorij Poluchin is a licensed urologist in Ukraine and Russia, but he sweats over traumatized patients, including numbers of raucous and belligerent bums, in Klaipeda University Hospital’s emergency room. For the 30-year-old Ukrainian, cherishing big professional hopes, this could be a setback in normal circumstances, but in Lithuania, all is different. Not yet being allowed here to perform what he had been apprenticed to in the Medicine Academy in Kiev, Ukraine, and then in Saint Petersburg, Russia, he does not falter, still hoping for the day to come.
Facing the dilemma, to work in Ukraine or Russia, or try his luck and patience in a European Union country, he has opted for the latter, ending up in Lithuania, where he does not regret his decision so far.
It has taken him over eight months to put all his papers in order, which finally have brought him a much sought-after reward – permission to practice medicine in Lithuania. When he remembers the stressful jogging from one institution to another, explaining why he is here and what he wants here, he cannot speak calmly. “Dozens of different institutions have already checked out my papers and conducted lengthy interviews. The marathon is not over yet, as I am determined to obtain permission allowing me to work as a urologist. However, if I had known how bumpy the road is, I would have probably come to study here. It would have been much simpler,” he admitted.
Grigorij is one of the hundreds of Ukrainian, Russian and Belarusian doctors who scorn their homelands and see their dreams come true in Lithuania, a downturn-stricken country, but still a member of the magical EU club. “I know for sure – as a fresh doctor, I would earn approximately 1,000-1,500 litas ( 280-429 euros) in Saint Petersburg, while my salary in Lithuania reaches as much as double or sometimes triple that,” he says proudly.
Vincas Janusonis, chief doctor of Klaipeda University Hospital, admits that he has been swamped lately with letters and calls from other countries, mostly from Latvia, Belarus, Russia and Ukraine, over getting a job slot in the hospital. “As a rule, most of the time, surgeons, anesthesiologists and anesthesiologist-reanimatologists are on the look-out,” Janusonis said.
Jonas Salyga, chief doctor of Klaipeda Seafarers’ Hospital, also acknowledged that he had received a call from a Latvian cardiologist inquiring about an opening in the hospital. Alas, the chief doctor could not propose anything to her. Other Klaipeda medical establishments also were heard talking about such Latvian doctors’ inquiries. They pour in because of the shutting down of a hospital in Riga.
Rita Kasetaite, a recent graduate from Vilnius University’s Medicine Faculty, has always cherished dreams of staying and mastering her doctoring skills in her homeland, Lithuania. After completion of her internship in Klaipeda Seafarers’ Hospital, she hoped that she would be able to stay in it for the desired vascular surgery residency. However, her dreams were shattered a year ago, when Lithuania’s Ministry of Health allocated only two slots for the residency, leaving her off the list. Having realized that her chances to succeed next year are very slim, and left without a job due a massive layoff in Klaipeda Seafarers’ Hospital, she applied to a German-based medicine resident recruiting company, which quickly offered her a vascular surgery residency in Lipstadt, a 70,000-inhabitant town in Dusseldorf’s proximity. She has already successfully blended into the hospital’s community, seeing her future only in Germany. “As much as I love my homeland, professional-wise, I do not see my future in it.
While, generally, the doctors’ preparation level is rather high in Lithuania, the future for most medical school graduates seems bleak here. Therefore, people seek places where they can quickly realize their professional goals, be paid decently and work in state-of-the art facilities. Unfortunately, Lithuania cannot provide all of that yet,” Kasetaite pointed out to The Baltic Times.
Jonas Korsakas, president of Lithuania’s Young Doctor Association, reiterates her words, claiming, “Set strict medical systems both in the UK and Germany guarantee that a young doctor there would perform a sufficient number of procedures, obtain the necessary amount of work skills, supervise a needed number of patients and, ultimately, in the process of residency, would become a good specialist. Unfortunately, it does not always go this way in Lithuania.”
Young Lithuanian doctors are a sought-after commodity in most Western European hospitals, though the bulk of them settle in Germany, Great Britain and Scandinavian countries. “It is hard to say how many young graduates decide to seek their luck abroad but, no doubt, the number is high – I would put it at half of all graduates,” Laura Duksaite, a representative for a residency abroad agency, claims.
Liutauras Labanauskas, president of Lithuania’s Doctor Union, describes the continuous exodus of young Lithuanian doctors, as well as more seasoned ones, as alarming. “No one knows how many of our doctors have emigrated for good and how many keep going back and forth. In fact, after a large emigration during the Russian crisis, back in the late ‘90s, we are witnessing a second emigration wave today. However, rich Western countries have changed their tactics – instead of luring our best specialists to move forever, they tend to set such working conditions that puzzle even our lawyers, trying to figure out whether the doctor fits an emigrant status or is just a long-term worker abroad. Thus, our doctors sign contracts with foreign hospitals and work in them from two weeks to one month. After that, our doctors come back to Lithuania, where they usually hold a quarter of a position at a hospital and, in a week or so, hurry back to either Germany or Ireland. I call them emigrants. Often their short-term contract abroad turns into a permanent settling,” Labanauskas revealed to The Baltic Times.
Statistically, Lithuania has one of the highest emigration levels among doctors within the European Union, though the Ministry of Health downplays this fact, stressing an uneven repartition of doctors in the country. Labanauskas sees the emigration as “unavoidable,” as only economic recovery and a boom can stop it. “All Eastern European countries are experiencing the same, which is a result of the EU’s open job market. For example, at the Czech Republic’s border side with neighboring Austria, you will hardly find Czech doctors, as they nearly all work in richer Austria, while being replaced by immigrant doctors back home. Luckily, we do not have an Austria at our border – otherwise most of our doctors would have left by now,” Labanauskas says. Last year, doctors’ salaries were slashed three times in Lithuania, dropping several thousand litas for some specialists.
However, despite the murky trends, the president of the Association does not push the panic button yet. “Personally, I do not believe that, five years from now, only foreigners will heal our patients. Considering that the number of doctors in Lithuania is rather high, most of them are settled, and not eager to assume major changes in their lives; the situation likely will not go to such extremes like in the Czech Republic’s frontier with Austria. However, quality-wise, we see many young skilled doctors in narrow specializations leaving, such as interventional cardiologists, cardio surgeons, vascular surgeons and some others. We do have very few specialists of these kinds, so their leave is particularly alarming,” Labanauskas maintained.
Responding to The Baltic Times’ inquiry over the emigration of doctors last year, as well as in 2009 and 2008, specialists at the Ministry of Health claimed that 279 doctors and 211 nurses were issued diploma re-evaluation certificates last year, while the numbers were 94 and 215 in 2009, and 88 and 272 in 2008, respectively. “However, the certificates should be seen as doctors’ intentions, not as real emigration facts – not all doctors and nurses, having obtained them, leave Lithuania,” the response said.
“The Ministry sees a bigger problem in lesser medical staff proportions in villages and unsatisfied demand for doctors of certain specialties. With the open EU job market and severe crisis aftermaths in Lithuania, the Ministry can just hope that emigration of doctors and nurses will slow down, following economy recovery,” the letter of the Ministry’s Communication Department suggested. It also disclosed that nine foreign doctors were granted work permits in Lithuania last year, but the actual number can be much higher as private medical facilities, due to a lengthy process of licensing, may be employing foreigners illegally.