Tatarstan medics react to compulsory work placements

On 17 November, Vladimir Putin signed a law on mandatory work placements for medical students. According to this law, all state-funded residency spots will become targeted, and graduates of medical universities will have to work for up to three years in state hospitals under the supervision of a mentor (a more experienced doctor).

After that, a widespread discussion of the new law began online: medical students recorded videos mocking the new rules and threatening to drop out.

The editorial team of 116.RU spoke with healthcare workers and students in Tatarstan, and also requested statistics on students who have dropped out from universities in Kazan.

Are Kazan medical students dropping out after the new regulations?

At the main training ground for future Tatarstan medics — Kazan State Medical University (KSMU) — we were told that over the past month, 60 people have been expelled from the institution: 54 for poor academic performance, 5 by their own request, and 1 for other reasons. Five of them are senior students.

During the same period last year, 53 people were expelled: 39 for poor academic performance, 7 by their own request, and 7 for other reasons.

This statistics shows that there is no «boom» in student expulsions at the Kazan university after the signing of the new law. Now let«s hear the opinions of the students themselves.

»I«m in the acceptance stage»

Polina (name changed at the interviewee«s request), a 6th-year medical university student, said that many nuances of this law are still not entirely clear to her. For example, whether she will be able to choose the institution for her work placement.

— Among my classmates and fellow students, there is no one who decided to drop out after this. But some people»s ambitions have certainly diminished. Right now, I«m probably just in the acceptance stage. I was planning to work in a state institution anyway, that never scared me, but the realization that now it»s like an obligation with a fixed term of mentorship in a specific institution is a bit burdensome, — our interviewee said.

Polina noted that state-funded students, including herself, entered the university with high Unified State Exam scores to «truly not depend on a specific institution in the future.»

Another student, Nadir Shukrulloyev, a resident at the Department of Oncology, Surgery, and Radiation Diagnostics at Kazan Federal University, whom we already wrote about, feels calm and is not panicking.

— To be honest, nothing is clear yet. The situation seems similar to a regular work placement under a targeted agreement, I haven«t delved into the details, — he briefly replied.

»All you«ll learn is how to remove appendicitis and cholecystitis»

The 116.RU correspondent also spoke with those who have already graduated and are working. The first interviewee, 24-year-old Dilyara from Almetyevsk, graduated from medical college 4 years ago, worked for 1.5 years as a nurse in a hospital, and now works as a pharmacist.

Our interviewee studied under a targeted agreement, then worked off her placement in a hospital, but left early, paying for half of the work period.

— In Tatarstan and nearby regions, as far as I know, there have long been no state-funded spots, only targeted agreements. At first, when I was studying and signing the contract, no one cared, until the hospital management changed. Since then, everything became strict: some didn«t work it off — they were lucky, and others, meaning my cohort and the following ones — had to strictly work it off. It cost me about 300,000 rubles (approximately $3,000 at current rates) for my education, I worked for 1.5 years and paid 130,000 rubles (about $1,300). I paid the remainder and left with a clear conscience, — Dilyara recalled.

She admitted that she believes having only targeted spots is wrong. In her view, all institutions should have state-funded options as well.

— Yes, I agree, there is a shortage of medical personnel, but why is there a shortage? Because the salaries are low. Perhaps if I were graduating now, I wouldn»t go into the profession, — she said.

She recalled another story from her student days and added that at the college where she studied, targeted pharmacy students had a difficult situation with work placements.

— When you«re a nurse, it»s easy to find a state clinic or hospital; you«re assigned based on your place of residence. But pharmacists used to be tied to a state pharmacy. For example, if you were born in Almetyevsk and study under a targeted agreement at a college, you might be assigned to some village pharmacy, — she concluded.

We spoke with another 28-year-old specialist from Kazan, Aidar (name changed). He studied at the medical university on a state-funded basis (8 years, including residency), and has been working as a surgeon for 4 years now.

— In short, this is terrible, because you»re already studying for 8 years on a meager stipend. Sure, you«ll have a job placement, but it»s not guaranteed that this place will offer you a salary of at least 80,000 rubles. Or they«ll send you to work in Buinsk, and there, from a surgeon»s perspective, they don«t perform the operations that are done in Kazan. And all you»ll learn — is mainly how to remove appendicitis and cholecystitis, — Aidar explains.

Our interviewee is also concerned about family matters: how and when a male medic will start providing for his family if he needs to study for 8 years, and then work off another 3 years for an unknown salary and in an unknown location.

— There are no such specialists now, no fanatics of their craft. Plus, there«s no big money in medicine at all. Everyone says doctors earn well, but in reality, doctors earn poorly. And there will really come a time when there will be no one to work in medicine. Even before this law, young people came and said that we won»t work for such salaries, — Aidar admitted.

Maria (name changed), an ambulance worker in Kazan who graduated from medical college 25 years ago, also shared her opinion on the new rules.

— I studied on a state-funded basis, back then there was no such thing, no one worked off 3 years. I am, of course, against work placements. If someone changes their mind about working in medicine, let those who want to work, do so, — our interviewee briefly noted.

Our colleagues from NGS55.RU also surveyed Omsk doctors on their attitude towards the new regulations. One of the subjects, a Candidate of Medical Sciences, shared that top students regularly approach him, stating that they «consciously will not go to work in medicine due to the strange prospect of an eleven-year path to the profession.»