Departing Doctors: The Toll on Russian Healthcare

Doctors are fleeing Russia in their thousands, some to escape the army, others to seek safety for themselves and their families.

Within days after Russian forces invaded Ukraine in February 2022, medical professionals started to flee Russia, seeking refuge in neighboring countries and beyond. 

Among the departing medical professionals are doctors with international reputations, chief physicians from reputable Russian hospitals, researchers, and educators, according to RFE/RL’s Current Time news channel, saying that 1% to 2% of the country’s doctors may have fled.

How many doctors have emigrated is hard to say with any certainty. What is known is that doctors are just part of a much larger exodus of highly skilled professionals. Along with young men fearful of being drafted, these groups make up a significant fraction of the approximately 1 million emigres – the biggest wave of emigrants from Russia since the Soviet Union fell apart, and possibly even since the Russian Revolution, The Moscow Times says.

Popular destinations for Russian doctors include such post-Soviet countries as Georgia, Armenia, and Kazakhstan, while others venture to Israel or Europe. Although some are able to successfully validate their diplomas and continue practicing, others find themselves compelled to seek employment in unrelated fields or resort to practicing illegally.

Doctors Choose Mobility Over Mobilization

The outflow of doctors took a big jump when President Vladimir Putin announced a military call-up in September 2022 as Russian combat losses mounted. Medical professionals were included in the conscription drive, although the chairman of the State Duma healthcare committee, Badma Bashankaev, stated that the mobilization of doctors should be done “reasonably and without excesses.”

No more than 3,000 medical workers would be mobilized, Bashankaev said, beginning with graduates of military medical universities with training in field medicine and doctors with combat experience. The military would also need surgeons, anesthesiologists, and trauma specialists, he said.

Thousands of Russian citizens, many of them men of military age, crossed the border into Georgia in the days and weeks after the Russian military began conscripting civilians on 21 September 2022. Some arrived at the border after walking or cycling for hours, as seen here at the Lars crossing on 28 September 2022. Reuters video.

The independent Russian news outlet Meduza reported that doctors started receiving call-up notices on the first day of mobilization. Doctors said they were handed a summons at work or home, while others received a call from a military recruitment office asking them to turn up. Some had previously served in the military; others had not.

Given the scarcity of official information, estimating the number of medical professionals called up for military service is guesswork.

Yanina Sartison of Free Russians, a group representing the interests of Russian speakers in Germany, said last year that hundreds of doctors had approached the organization for relocation assistance.

Doctors have sometimes found creative ways to leave Russia. A “Forbes list billionaire” chartered a plane for 250 doctors last September, Current Time reported. For a nominal payment of 40,000 rubles (about 460 euros), the doctors received forged invitations to a nonexistent medical congress in Yerevan. When the burgeoning number of charter flights forced the airport in Yerevan to stop granting them landing privileges, the medical aircraft’s destination was swiftly relocated to the Kazakh capital, Astana.

One estimate of the impact of the mobilization call on the medical profession was made by HeadHunter, a major Russian job recruitment company. In the month following the start of the conscription drive, it reported a 42% surge in job vacancies for medical professionals. Sparsely populated regions faced the most challenging situation, with vacancies in some Siberian and Far Eastern regions soaring threefold or more, while the figures were less than 30% in Moscow and St. Petersburg.

In the Transbaikal region, a huge territory with just 1 million inhabitants that was already facing a shortfall of doctors, almost 100 medical personnel including 21 doctors were assigned to serve in Ukraine, including the chief physician of a large regional hospital, Transbaikal Deputy Prime Minister Inna Shcheglova said in March 2023.

Some medical schools were also involved in disseminating military propaganda, according to Meduza. A student at Dagestan State Medical University said that students there were threatened with expulsion for participating in protests against mobilization. “If I received a notice, and there was a choice between mobilization and prison, then, probably, it would be prison,” he said.

Why the Best Are Leaving

There are many reasons for the spike in emigration by medical professionals, as several Russian publications have reported.

The Insider wrote that young doctors, especially those from large cities and unburdened by childcare responsibilities, are leaving to restart their professional lives abroad. While opposition to the war in Ukraine is motivating some doctors to flee, others have fled to keep themselves and their loved ones safe.

Ilya Fomintsev, an oncologist and the founder of a professional training organization for his specialty, as well as the cancer charity Not in Vain, took the difficult decision to emigrate after being targeted by the security forces. Earlier, he had been arrested and detained for 20 days for participating in protests against the war. Initially torn between his commitment to his colleagues and ongoing projects, the presence of security forces near his home compelled him to relocate with his family and children.

Prominent oncologist Ilya Fomintsev left Russia for Israel, the destination for a number of Russian doctors since the invasion of Ukraine in February 2022. Photo via his Facebook page.

In an interview with the independent news outlet Novaya Gazeta soon after he and his family moved to Israel, Fomintsev gave his opinion that hundreds of highly qualified medical professionals were fleeing Russia, worsening the already damaging brain drain in the medical field.

The list of doctors reported by Russian media to have emigrated features notable names. Alexei Svet, the chief physician of the First City Hospital in Moscow, resigned his post after the start of the war and left the country. Vascular surgeon Alexander Vanyukov, a signatory of a doctors’ letter urging the authorities to end the brutal treatment of jailed opposition figure Alexei Navalny, also left the country, according to Current Time. Renowned pediatrician Fedor Katasonov and oncologist Mikhail Laskov have also left the country.

Life After Emigration

Physicians who take the decision to relocate often go through a complex and convoluted process to obtain recognition of their Russian medical degree. Different medical educational systems, varying medical standards, and divergent healthcare systems create significant barriers.

Finding a job in their field can be even more challenging.

“It is very difficult for a doctor to get a job in Europe, and in France in particular,”  an ophthalmologist using the pseudonym Faina told the magazine Holod late last year.

“The Russian medical diploma is not recognized practically anywhere in Europe: almost everywhere you need to pass an exam to confirm your medical skills, and this exam in France is very difficult,” said Faina. She and her husband, who had joined antiwar protests and been arrested, opted to emigrate shortly after the war began.

Faina had no illusions about the chances of restarting a successful medical career in France. Emigration sets doctors back 10 years in their professional career and achieving the level of their former Russian income can take up to eight years, according to Current Time.

A similar situation applies in Israel. Although validating a diploma is a time-consuming enterprise, finding a job can be even more complicated, a pediatrician named Katasonov says he discovered in an interview with the Berlin-based Russian language TV channel Ost West. In his view, the current wave of emigration of Russian doctors to Israel is the largest since the 1990s, with a correspondingly strong competition for open positions in health care.

One country where Russian emigres have arrived in large numbers is longtime Moscow friend Serbia, whose government has not joined European sanctions against Moscow and where Russians can travel relatively easily. Since the onset of the war, approximately 200,000 Russians have made their way to Serbia.

BBC Russia reported that a gray market for medical services has emerged in the country, largely because the lack of fluency in either Serbian or English makes it difficult for many new arrivals to interact with the health system.

In a makeshift network involving “hundreds of doctors and thousands of patients,” the BBC says, unlicensed Russian doctors visit Russian-speaking patients at their homes.

Although around a hundred Russian doctors have applied to have their medical diplomas recognized in Serbia, the process is lengthy. A doctor who moved to Belgrade in 2022 explained to the BBC that “recognition of a diploma is only the first step, and it takes at least eight months for medical workers to obtain all the necessary permits. Many medical workers who have moved from Russia in recent months have been forced to work illegally just to survive.”

A Smoother Path in the CIS

The process of obtaining the necessary documents and licenses appears to be less onerous for Russian doctors who have relocated in the CIS (the Commonwealth of Independent States, a regional association of countries that were once part of the Soviet Union).

According to Fomintsev, two main factors have contributed to this disparity: the similarity between the educational systems of Russia and some former Soviet republics, which eliminates the need for diploma validation, and the high regard for the medical expertise of immigrant doctors.

Russia-trained doctors are particularly welcome in Uzbekistan, Kazakhstan, Armenia, Georgia, and Azerbaijan, says Fomintsev, who added: “When doctors from Moscow and St. Petersburg leave and go there, they become superstars because the level of medicine there is 20 years behind Russia.”

Drawing definitive conclusions regarding the repercussions of doctors fleeing Russia is challenging. Clearly, the departure of several thousand doctors, among them prominent specialists and researchers, means a significant loss for the Russian healthcare system and its future development. This medical brain drain can have long-term consequences for Russia once the war is over.

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Masha Denisova is a doctoral researcher in the Department of Health, Ethics, and Society at Maastricht University, the Netherlands. Her research looks at health care and new knowledge practices in the medical field, particularly in the post-socialist states. She is a fellow of the Innovative Training Network – MARKETS project funded by the European Union.

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