Aid for doctors

The Prague Post

Group wants better conditions for recent graduates so fewer will leave to work abroad

Long hours, low pay and the inability to choose their workplace are just a few of the reasons more and more young Czech doctors are leaving to work in other countries, where they believe conditions are better. Frustrated with the current state of the Czech healthcare system that drives so many of their colleagues abroad, a collection of young doctors have formed a new initiative, Mladí lékaři (Young Doctors), which they hope will influence the Health Ministry and bring about the changes needed to keep doctors at home.

“Mladí lékaři is a newly formed group of young doctors who are really disappointed with the situation in the Czech healthcare system,” said Dr. Zuzana Šomlóová, one of the group’s preparatory committee members. Dr. Štěpán Sulek, another committee representative, added the group is focused on supporting young doctors and recent graduates. They believe doctors’ salaries are too low and the working hours break Labor Code rules. Their goal is to assist new doctors with these and other hurdles along the way.

The Czech Medical Chamber reports that 50 new doctors left in 2008 without ever having worked in their home country. In addition, about 200 seasoned doctors leave annually. According to Mladí lékaři, out of approximately 1,000 graduates, about 10 percent leave each year immediately after graduation; others decide to leave during their pre-attestation rotation. Both Šomlóová and Sulek said they don’t know of any doctor who hasn’t thought about going abroad at least once.

“Why are we looking for jobs abroad? Primarily, to have a work contract without slave-like conditions, to have clear specifications for specialization study and to have the feeling that [our] knowledge is adequately appreciated,” Sulek said. “Secondly, to have a normal social life without so many overtime hours.”

Šomlóová and Sulek say the working conditions for young doctors in the Czech Republic are undignified. Currently, the Health Ministry chooses the hospital where each doctor does his or her medical rotation, and the Czech Medical Chamber says many doctors are officially employed in hospitals only part-time, but in fact work full-time hours for only 6,000 to 7,000 Kč ($330-385) per month. The Medical Chamber would like to see the Health Ministry, not individual hospitals, pay the doctors and allow doctors to do their residencies at the hospitals of their choosing, thus motivating hospitals to provide a quality environment for doctors-in-training.

“Most of us have no problems with languages, as many of us were somewhere on an exchange program, and most of us know how it looks abroad,” Sulek said. “But neither the Health Ministry nor other interested parties do anything to keep doctors here. No relevant steps are taken to slow [the trend] down; there are only steps that make it quicker to decide to go abroad.”

Changing the system

The healthcare system has many challenges, as evidenced by the 17 different health ministers since 1989, a higher turnover than any other government position. The cost of replacing decades-old equipment and transforming the communist healthcare system over the past 20 years has been expensive, and VZP, the country’s main insurance company, said last November that, by 2011, the current system will be short millions of crowns unless reforms are put in place. With health care already in such dire straits, members of Mladí lékaři feel an exodus of doctors could seriously affect the quality of care received in the Czech Republic.

“There will be fewer qualified doctors and doctors with specializations, and also the better ones will go away,” said Šomlóová. “There will also be fewer people interested in medical studies.” The doctors added they can’t foresee many replacement doctors being “imported” as they would have to speak Czech, and low pay and long hours would hardly entice them to learn.

Despite all the difficulties facing the system, Mladí lékaři hopes the initiative will have some positive influences on the profession.

“We will try to discuss these topics with the Health Ministry, with the Czech Medical Chamber, with the representatives of the medical faculties, clinics and so on,” Šomlóová said. “If we have enough doctors behind us, I think it’ll be easier to put pressure on all the interested parties and we can make some changes.”