Doctors also leaving wealthy countries

Photo: Toomas Tatar

Estonia is not alone in its problem of physician migration. Doctors are also leaving wealthier countries like Germany and UK. However, while these nations find replacements from Poland and Estonia, for instance, no one shifts jobs from West to East.

Polish cardiologist Grzegorz Chodkowski’s company  Med Pharm Group mediates doctors to work abroad and organises international professional exchange events for medical workers, one such event hosted in Tallinn, last Friday.

According to Mr Chodkowski, the European doctors’ Eldorado is currently UK, for a simple reason: «UK just pays the most,» stated Mr Chodkowski.

Still, high wages are not keeping doctors in the UK, either, currently short on anaesthesiologists and emergency medicine specialists. For the sake of experience, better offers or weather of lifestyle, doctors are leaving for New Zealand and Australia, as well as Singapore and Malaysia – to work in private clinics.

Checking to see who replaces them, it is not Romanians or Polish, according to Mr Chodkowski. Rather, it is the Germans – most numerous as foreigners in the medicinal system of UK. «There are almost 4,000 German doctors working in Great Britain. The British doctors, however, leave for Canada or Ireland – where the pay is even higher. Canadian doctors, in turn, are coming to UK,» says Mr Chodkowski. According to him, the jobs exchange happens in all possible directions – except for the West-to-East direction. «German doctors are not coming to Estonia or Poland. This is inevitable.»

Vacant jobs in periphery

According to Walter Herrmann, recruiter of PVMed mediating doctors to Germany, the German doctors are also leaving for Scandinavia. «Mainly, they are leaving for Sweden, Norway and also Switzerland, as the wages there are higher,» said Mr Herrmann. At the same time, large cities like Munich and Berlin are overcrowded with doctors. «Therefore, for Estonians, jobs mostly open up in periphery,» added Mr Herrmann. For instance: doctors are in demand Sachsen, East Germany, bordering with Poland and Czech Republic – in the industrial Chemnitz, for instance, as well in Bayreuth, a university town in Bavaria.

Mr Chodkowski says that, in UK, jobs are vacant in Scotland and Wales, an outside of large cities. «As all would like to work in London.»

«The wages are equal, all over. However, those coming to work in rural areas and small towns have a slight advantage, as renting a home is cheaper. In Munich, the entire salary would go to cover the rent,» said Mr Herrmann. Germany lack doctors in all fields. Naming a few: cardiologists, neurologists, pulmonologists, gastroenterologist, general surgeons. «Estonians are heartily welcome – having a good education, being resilient and hardworking,» said Mr Herrmann.

The salary is up to experience. A doctor straight from school will ear gross €3,944 a month, for the first year, keeping about €2,361. The tariff raises yearly. If an assistant doctor has worked in Germany for six years, the wage tariff is €5,070. However, according to Mr Herrmann, they net only €2,925, approximately.

According to Mr Chodkowski, it is as easy for Estonian doctors to also find work in the UK, as any other European nationals. All you need is to speak English. «Well, there are the stereotypes of Western educated doctors being better – Spanish or German doctors are preferred to Polish doctors. But in reality it is all up to prior experience in the hospitals. Having had a poor experience with a Polish doctor, they tend to generalize.»

Mr Chodkowski said that in UK, temporary jobs are in demand. «For European doctors the most attractive are the replacements jobs for three months, a month, a week or even for a day. These doctors earn twice as much as doctors with long-term contracts,» said Mr Chodkowski. For example: an experienced replacement doctor, according to Mr Chodkowski, may earn up to a hundred pounds an hour (€117). «For that money, a European doctor will board a plane, fly to UK for a 24 hours shift, and return home with £2,400. All you need to be is motivated and speak English, as no one will make you these offers in the streets.»

Those entering into permanent contracts, will, according to Mr Chodkowski, be able to make up to £100,000 a year as basic salary (€117,000), equalling up to £8,000 (€9,358) a month.

Asking the job mediators what could Estonia do to keep from bleeding doctors, Mr Chodkowski says there is not much we can do. «Throughout the ages, people have travelled to find the most fitting and best place for themselves. Doctors are especially lucky, as their knowhow is international.»

Doctors not inclined to stay

According to Mr Chodkowski, Poland was helped by the 2008 wage rise: school leavers now earning €1,000, practicing doctors €2,000-5,000 a month. In some specialties, there is lack however. The situation being worse with nurses, as educated nurses will not work in the state medical system due to low wages.

Also, Mr Chodkowski thinks it would help if there would be more respect toward medical workers in the nation.

Diana, working in a Tallinn hospital as radiology technician and attending the event to find a new job, said that according to her patients do treat doctors respectfully. However, it is unpleasant with frictions among colleagues, sometimes on basis of nationality.

«I do not understand at all why the difference is being made between Estonians and Russians, I think we are all equally Estonians,» she said. Diana plans to go work in Sweden, Norway or Denmark. On Friday, she filed an application and will be waiting for feedback. «In these countries, economic situation is good, life is secure. I have five years’ experience as radiology technician, having worked in two hospitals in Tallinn. And I feel there is no more development for me, here,» she said.

Should Diana find work abroad, she is never coming back to Estonia. Taking her child and husband with her. In case she is chosen, mediating company MediCarrera offers both Diana and her family a 20 week language course in Barcelona or Budapest. During the course, they are promised a monthly salary of €700 plus €70 on each child, free lodgings and plane tickets, as well as school or kindergarten places for children.

Kristina and Olga, also working as radiology technicians, admit that it would be easiest to go to Finland. Still, they came to check out what is offered by other countries. «We would not like to leave, but we mainly consider this because