Empty ORs

After years of working long hours for low pay, an estimated 3,500 Czech doctors are threatening to quit by the end of the year and join an exodus to western Europe. Many earn less than skilled carpenters or plumbers, and face government austerity measures that will cut health care funds even further.

Neighboring Germany, where a recent study by the Hospital Institute estimated that there was a shortfall of 5,500 doctors, is interested in recruiting disgruntled Czech medics. Representatives from some 30 German clinics visited Prague at the end of October, with the aim of filling more than 100 vacancies back in Germany.

Lucie and Evzen Gorbunov were among those at the German jobs fair in Prague. Lucie is a 28-year-old anesthetist; her husband Evzen is a surgeon. They've had enough of the conditions in Czech health care.

"I finished my medical degree two years ago," Lucie Gorbunov said. "The working conditions are really bad: lots of night shifts, not enough pay. If I work an extra six to seven nights in a month I get around 25,000 crowns net, which works out at roughly 1,000 euros a month."

Most young Czech doctors have to do extra shifts or take a second job just to keep their heads above water. According to Evzen Gorbunov, low wages are only part of the problem:

"As a young doctor I'm in a difficult position," he said. "It's very hard to progress here. In the first year we're often kept busy with bureaucracy, forms and calculations, and we have little contact with patients. Young surgeons are only allowed to observe operations and pass instruments to the head surgeon in the first few years."

'Thanks, we're leaving'

That's why thousands of Czech doctors have launched an initiative called "Thanks, we're leaving." They're demanding monthly wages be increased to between 1,500 and 3,000 euros. In the meantime, many, like the Gorbunovs, are determined to try their luck abroad. In countries like Germany new graduates can earn up to five times the equivalent Czech salaries, with shorter working hours.

"I did an internship in Germany as a student and I enjoyed it," Lucie Gorbunov said. "Especially the opportunity for further training. In general I liked the more relaxed atmosphere among doctors and the financial rewards."

Roswitha Wiedemann from the East Allgaeu-Kaufbeuren Clinic in southern Germany is looking for people like the Gorbunovs. Her hospital currently has seven vacancies for junior doctors. She's hoping the Czech Republic can provide back-up.

"We're pleasantly surprised the interest is so high," Wiedemann said at the jobs fair in Prague. "We've already had some good conversations; our senior doctors are very pleased. We've made good contacts. We expect that at least one or two of them will start with us very soon."

Lucie Gorbunov has already found a hospital in Germany that she likes the look of.

"My husband and I have spoken to a senior doctor who presented his hospital to us," she said. "We really like it, so we're going to send off our applications and see what happens."

Loss of young talent

If they do emigrate to Germany, there are concerns the Czech health care system may struggle without them. Patient representatives in the Czech Republic say even if 500 leave it will put pressure on an already strained system. But the Czech Health Ministry has said it does not expect all the doctors to make good on their pledge to leave, and that the health care sector won't suffer if they do.

Wiedemann said concerns over a mass exodus of doctors should not be over exaggerated, and that there is a positive side.

"The young doctors who are coming to us at the moment will return to the Czech Republic full of experience," she said. "I think it will ultimately enrich the Czech health care system when these well-trained medics return home."

Author: Christina Janssen, Joanna Impey (IPS, Reuters)

Editor: Sean Sinico