Russia’s health ministry has drafted a new bill that requires fresh medical and pharmacy graduates from state-affiliated programs to start working within a year of finishing school.
If they fail to do so, they’ll have to pay a fine worth three times the amount spent by the government on their education, whether it be funds from a state, federal, or local budget.
This latest version of the federal education bill, made public on Tuesday, also proposes that after finding a healthcare job, medical graduates from state-funded schools must continue working for three years. Their other option is to continue their studies.
The vast majority of Russia’s medical schools are funded by or affiliated with the government, with lawmakers saying 154 institutions and scientific organizations draw from federal, state, and local budgets.
Russian business daily Kommersant estimated in February that it costs the state about $2,480 a year to train a medical student. As such, under the new bill, if a Russian medical student undergoes the typical six years of training, they could face a fine of $42,000 or higher if they don’t find a job within a year of graduation.
Calculations for the fines would be up to the Russian government, the bill added. If these measures become law, they would take effect on January 1, 2026.
Sergei Leonov, the head of the Russian State Duma’s healthcare committee, told local media on Monday that parliament was ready to support the bill, but could tighten it with further amendments.
“In fact, they violate their obligations to the state,” he said of graduates avoiding hospital work.
A bleak outlook for Russia’s medical workers — and their country
The proposal underscores a shortage of doctors and nurses in Russia, which authorities fear will escalate into a national crisis.
In February, Russia’s health minister, Mikhail Murashko, told local media that the country was short of about 23,300 doctors and 63,500 “midlevel” personnel, which includes nurses and technicians.
That’s out of a total of about 550,000 doctors already in Russia’s workforce, per Murashko. But he added that nearly a fifth of these professionals are over 60 years old.
Meanwhile, the country is struggling to recruit young doctors and nurses, even after they finish school.
In a note attached to the new bill, the health ministry said that in state-affiliated schools, 35% of graduates from higher medical education and 40% of graduates in vocational medical education don’t work in state or public health organizations.
Low and inconsistent pay is often blamed for young medical graduates shirking hospital careers.
Russian lawmaker Galina Izotova, who serves in the government chamber that audits federal budgets, said in March that doctors’ salaries in 21 of Russia’s 89 regions hadn’t reached the minimum level mandated by law.
“There remains significant variation in salary levels between neighboring regions, contributing to labor migration. In some regions, salary differences can be three times or greater,” Izotova told the Duma that month.
When the Doctors of the Russian Federation, a professional community for medical workers, surveyed 2,030 doctors in March 2024, 78.9% of them said they had to work more than one job to make ends meet.
About two-thirds of them, including doctors in the Moscow region, said that they were drawing monthly salaries of $727 or less. That could indicate a wide imbalance in wages across the country, since Russia’s federal statistics service reported that the average physician’s salary was about $1,400 from January to June of 2024.
Russia is also struggling with a brain drain of highly educated and skilled workers since it invaded Ukraine in 2022, with a million citizens, mostly young and college-educated people, leaving that year.
The effects of the departures, compounded with the war’s toll on Russian lives, led to a reported shortage of some 5 million workers in 2023.
The UK’s Defense Ministry said in a February 2024 intelligence update that the war has likely exacerbated Russia’s shortage of doctors, with about 2% of its medical personnel fleeing the country to avoid a mobilization in September 2022.
Another 3,000 medical staff were also likely assigned to help treat the war’s wounded, the ministry added.
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