The shortage of doctors and health workers, especially the middle level, in the Russian health care system has been observed since the beginning of "optimization". In March, the mobilization of medical staff in covid hospitals began, and on April 27, the Minister of Health, Mikhail Murashko, signed an order, according to which students of medical universities could be involved in the work. In a voluntary-compulsory manner, as it turned out later. He did not take the Hippocratic Oath Students of the 4th and 5th years were announced that they would practice in infectious diseases hospitals. In Moscow, those who will go to the "red zone" were promised to pay their salaries, and it was even about 100 thousand rubles. It was almost impossible to give up the practice, since it was included in the curriculum and non-fulfillment threatened with academic debt and expulsion. What the officials did not expect were protests. Students refused the "honorable mission of saving humanity", motivating it simply: there are no guarantees, no compensation, and we also have families. The university administration did not give detailed explanations of what to do for pregnant and lactating women, as well as for those with chronic diseases. Several videos were posted on the Internet in which students of Moscow and regional universities directly said that "they do not owe officials anything, including risking their lives." Indeed, at that time in hospitals there was an acute shortage of PPE even for doctors, and even students were offered minimal protection. A separate issue that has not yet been resolved is on what basis students of paid departments should have been attracted, who wanted to get a quality education for their money. The cost of studying at a medical university is from 150 to 300 thousand per year. Therefore, in addition to protests, the students supported their demands with legal calculations. Moreover, by the summer they announced that the coronavirus was on the decline. As for the accusation in the spirit of "you are future doctors and took the Hippocratic oath", they really do not give it. Because there is an oath of a Russian doctor, which they take. From a moral point of view, the new generation of doctors is dissatisfied with the fact that their lives and health are controlled by people who have nothing to do with medicine. “I am a doctor and in a difficult situation I must first save myself, and then the patient. Otherwise, there will simply be two corpses instead of one. And by the way, this is the essence of the Hippocratic Oath,”wrote one of the students. Cannon fodder The fall wave of the coronavirus pandemic virtually paralyzed the regional health care system. The situation was aggravated by the fact that many doctors and paramedics themselves were sick or simply quit, unable to withstand difficult conditions. The students remained the only reserve of depleted medicine. They were asked to take the places of doctors in polyclinics, outpatient centers, to work in call centers, helping to consult patients by phone. It was decided to involve not only residency, 4-6th year students, but also third-year students. At the same time, the students themselves were also sick. So, at the end of October in Orenburg, out of 230 medical students sent to work in infectious diseases hospitals, 30% fell ill due to contact with patients with COVID-19. The university administration said that medical students will not receive any payment, even if they come into contact with patients with coronavirus. In November, students of the Bashkir Medical University rebelled. Fourth-sixth year students, by the decision of the head of Bashkiria, Radiy Khabirov, were to come to the aid of doctors. A storm of indignation broke out in the student group on VKontakte. The main questions are complaints: “Why are we like free labor? Someone has relatives at risk at home! Why should we put ourselves and our loved ones in danger? Why is there no watch and payment for this practice? Or why is there no reduction in tuition fees? Why have these questions been repeatedly asked, but are ignored by the leadership, the student council, the trade union? " As a result, Khabirov said that "if a student does not want, God be his judge, do not involve people in this work." Political analyst Arsen Shayakhmetov believes that the pandemic has exacerbated all the pain points of Russian health care, and especially personnel. “At the same time, there is no inflow of young personnel, although medical universities are distinguished by the presence of a large number of budget-funded places and the annual graduation of thousands of specialists. However, at the stage of employment and the first years of work, the chain is interrupted,”says Shayakhmetov. According to the expert, the reason for the departure of young doctors is that the authorities are accustomed to treating budget workers like serfs: constant machinations with saving on salaries, staff reductions, increased workload, bureaucratization, and coercion to perform additional work for free - all this reduces the reputation of the profession and forms rejection among young people. The prestige of the profession is still high Despite the refusal to obey orders, it cannot be said that the younger generation is insensitive. Many of the students go to volunteer in hospitals. Because for them the main thing is not coercion, but free choice. They deliberately chose a profession, they understand the importance of a doctor's mission, responsibility for the lives of patients. And, apparently, this is why they are so critical of empty slogans and coercion. According to Yuri Belonozhkin, President of the Union of Distance Learning Professionals, future doctors understand that they will be able to protect not only other people, but also their loved ones. “I have to work with doctors, I see responsibility and pride for my calling and being in demand. Their profession is a unique hybrid of humanitarian, special medical and technical knowledge. This is an eternal profession,”Belonozhkin believes. The fact that the profession has not lost its prestige is evidenced by the high competition in medical universities. So, at the Kazan State Medical University, the average passing score for admission in the summer of 2020 was 244 points, at the Nizhny Novgorod Privolzhsky Research Medical University - 242, in Bashkir honey - 232. This is not much lower than in the most prestigious universities in Russia - the First Moscow Media University. I. M. Sechenov (259 points) and the Medical University named after N. I. Pirogov (249 points). Political scientist Alexander Semyonov believes that the persistence of high competitions in medical universities may have several reasons. “Parents often play a decisive role in choosing a university. And the parents of the applicants still retain the idea of the prestige of the professions and their possibilities for vertical mobility. This, of course, is more of an irrational than a pragmatic approach, but the professions of such a choice also include the professions of a lawyer and an economist,”the expert said. So why, despite the mobilization, high workload and low salaries, young men and women choose the profession of a doctor? Aleksey Kurinny, a member of the Duma Committee on Health Protection, Candidate of Medical Sciences, commented to the FederalPress editorial office: “The profession of a doctor has always been respected with us, despite the low salaries. Therefore, something has been preserved in the form of traditions, something in the form of family dynasties, something associated with the glorification of the profession of recent times. " He recalled that some of the doctors are now really making good money (both officially and unofficially).“A modern doctor is a well-trained specialist, and it is difficult to achieve this without an appropriate selection (competition) of candidates. Therefore, the authorities should be vitally interested in increasing the prestige of the profession, and in the growth of support measures, and in high competition,”says Aleksey Kurinny. The Russian government, having assessed the situation, intends to solve the personnel problem, starting with universities. So, in a number of regions they plan to increase the number of budget places next year. In the Volga Federal District, this will affect the Nizhny Novgorod, Penza, Samara regions, Bashkortostan, Tatarstan, Udmurtia. Political scientist Alexander Semenov notes that the most important thing is not the level of competition for admission, but the percentage of graduates of medical universities who go to work in the healthcare sector. “And the situation of the pandemic has shown that practically everywhere we have a shortage of medical personnel,” he sums up. Photo: FederalPress / Polina Zinovieva
