Hundreds of experienced doctors leave Bulgaria each year. Many young medical students go abroad as soon as they complete their studies. Poor pay is not the only reason for the exodus.
Pediatrician Snezha Teneva could have retired a year ago. Instead, she continues to work shifts at a hospital in the southern Bulgarian city of Asenovgrad. "There are just four pediatricians here. If there were only three they would have to close the clinic," she says. That would have dramatic consequences for a city with 60,000 residents and only one hospital.
Dr. Teneva says that many of her younger colleagues have left the country over the last several years. "For a while I thought about doing so myself. I even had an offer to go to France." But she decided against it. "If I were younger, I would definitely leave. But now it's too late."
'The trust is gone'
The Bulgarian newspaper "168 chasa" projects that by 2020, Bulgaria, the poorest country in the EU, will no longer have any doctors. Some 2,000 Bulgarian doctors have emigrated since 2012. Beyond that, many young Bulgarians leave as soon as they finish medical school. At the same time, around 500 foreign doctors are currently working there.
Today the country of seven million residents has just 28,000 doctors. Seven years ago that number was 35,000. It is therefore no wonder that many Bulgarian hospitals are suffering from acute staffing shortages. That is also why many, like Dr. Teneva, continue to work even after they have reached retirement age. About one quarter of all practicing doctors in Bulgaria are over 60.
Dr. Shteryu Boyadziev worked at the children's ward with Dr. Teneva for years. Today he lives in Cambridge, England. There, the neonatologist - a doctor for newborns - earns ten times what he did in Asenovgrad. Yet, the pay was not the reason he left. "The relationship between doctors and patients has drastically deteriorated in Bulgaria. Many patients see doctors as corrupt people and greedy profiteers. There is no longer any trust. The country's media has also contributed to the phenomenon," says the 46-year-old. He goes on to lament the fact that Bulgarian doctors are often yelled at, even attacked, by angry patients who have no respect for the profession. He says it is an insufferable situation.
250 euros a month for assistant doctors
Neonatologists are a rarity in Bulgaria. According the Bulgarian Doctors' Association, there are only 42 such doctors in the country - and just 28 pediatric surgeons.
Unfortunately, betterment is nowhere in sight. Polls suggest that some 90 percent of young doctors plan on leaving the country as soon as they finish their practical training, if not before.
Dr. Boyadziev says, "Assistant doctors earn about 250 euros ($275) a month in Bulgaria. In contrast, they can start off at 3,000 euros ($3,300) or more in Germany." The neonatologist is upset with the poor working conditions and lack of funding at Bulgarian hospitals. He says the only tool that many Bulgarian doctors have at their disposal is a stethoscope.
The 50-year-old gynecologist Dr. Svetlana Molova can confirm that fact. She, too, worked in the Asenovgrad hospital for years. Three years ago, she moved to Germany.
'I only go to Bulgaria for vacation'
Dr. Molova lives in Nuremberg - in her own apartment. "I have been working in Germany for three years. During that time my husband and I were able to buy a car and take out a loan to buy a nice apartment in the city. That would have been impossible in Bulgaria," she says.
Back home, she worked in the hospital, as well as in her own private practice. Her husband taught computer sciences at Plovdiv University. "But we were still always short on money. We even had to take out a loan to pay for our son's wedding," she recalls. Today, Dr. Molova earns 70 euros ($77) an hour.
'Haven't really slept in years'
Back in the hospital in Asenovgrad, Dr. Teneva is examining a patient. Many more wait in the hallway. The pediatrician is tired. She, too, runs her own practice, besides working in the hospital. She has not had a day off in months. And she hasn't had a good night's sleep in years. "Somehow, you get used to it," she says.
But Dr. Teneva may yet be able to retire after all. A few weeks ago, she got word that two young colleagues will begin working as assistant doctors in her ward. Though the pediatrician fears that, "they will probably leave after their training is finished, too, like almost every other young doctor in Bulgaria." A dramatic development that greatly concerns many Bulgarians.