Perm State Medical University has reported a significant shortfall in student enrollment for its state-funded and targeted programs. Out of 400 available state-funded positions, only 140 applicants submitted documents, a situation that has raised concerns and become a topic of discussion among medical professionals and students.
Specifically, the university failed to attract enough students for its residency programs under the targeted admission scheme. This scheme involves an employer funding a student`s education, with the student then obligated to work for that organization for a set period after graduation. Out of 400 state-funded positions, only 140 applications were received, with not a single application for the `Pediatrics` specialty.
Interestingly, there was a higher demand for targeted admissions among those seeking employment at the Perm Regional Oncology Center and Pichugin Children`s Clinical Hospital, where the number of applicants exceeded the available state-funded slots.
Overall, in the Perm Krai region, there is limited interest in pursuing free medical education tied to a contract with regional hospitals or polyclinics. As of August 1st, only a third of the targeted state-funded residency positions at Perm State Medical University had been filled.
This situation stands in contrast to statements by Health Minister Mikhail Murashko, who spoke of high competition in medical universities and successful enrollment in targeted programs. However, regions, unlike the capital, experience a reluctance among graduates to work in rural areas or small towns due to low salaries. Even in Perm, a major regional center, salaries in city polyclinics hover around 50,000 rubles. An anesthesiologist-resuscitator shared that his base salary is 35,000 rubles, with hazardous duty and incentive payments bringing it to about 70,000 rubles. To earn 140,000, he must work two shifts, totaling approximately 300 hours per month.
A recent graduate of Perm State Medical University, specializing in General Medicine, explained that her decision to decline targeted enrollment was due to the medical institution, with which she had a prior contract, not requiring specialists in her preferred fields. Furthermore, significant penalties for failing to complete the mandatory five-year work term are a major deterrent. Young professionals fear being `tied` to a specific hospital. She noted that after her specialization, she can work as a local general practitioner earning 40-50,000 rubles, with additional payments for working in a small town of up to 50,000 residents. According to her conversations with other doctors, the salaries of narrow specialists after residency can even be lower than those of general practitioners in polyclinics.
The shortage of specialists in regional hospitals and polyclinics is attributed to clear reasons: high workload, low pay, and bureaucratic hurdles. Nevertheless, targeted students are offered support measures. Sponsoring institutions commit to providing financial bonuses. In Perm Krai, these additional payments for successful students typically range from 5,000 to 30,000 rubles, and there are also preferential programs from regional authorities. A former chief physician of a major hospital in one of Perm Krai`s cities shared insights into the support measures provided by a large industrial enterprise:
The former chief physician mentioned sign-on bonuses upon employment and interest-free mortgages for 10 years, where the organization covered the interest payments. Young specialists received grants for introducing new treatment methods or mastering equipment, and paid stays at sanatoriums were also provided. Despite all these support measures, staff retention `was far from perfect`. Regarding salaries, he emphasized that the common perception of low doctor incomes is not always accurate. In his hospital, the average salary (including everyone except the chief physician and his deputies) was around 96,000 rubles, which significantly exceeded the target of 65-68,000 rubles at that time.
Despite a severe shortage of specialized doctors in Perm Krai hospitals and a national deficit of over 23,000 medical professionals across Russia, many graduates choose to terminate their contracts with healthcare institutions. Perm-based journalist Maxim Anfimov elaborates on the reasons for this trend:
Maxim Anfimov notes that while some doctors fulfill their contract terms, others do not. Court records show that medical institutions often seek to recover funds from those who breach their agreements. The reasons for this are diverse, ranging from a lack of social amenities for young families to personal circumstances like relocation. He emphasizes that to retain and attract young specialists, a chief physician must offer not only a decent salary but also additional benefits, such as assistance with living conditions or a flexible work schedule.
This year, the number of places in medical universities was increased by three thousand (10%), and the minimum Unified State Exam score for targeted applicants was lowered. Nevertheless, the under-enrollment problem persists annually. For the `General Medicine` program this year, only 222 out of 285 planned targeted students were enrolled. For `Pediatrics,` only 88 out of 135 allocated spots were filled. Perm Medical University reported a total of 674 applications, nearly three times the available spots, though without specifying the proportion of targeted admissions or residency applications. The admissions campaign remains open until August 11.
Rupert Blackwood 
Clement Ashworth