Running Out of Doctors and Nurses

Russia is facing such an acute shortage of medical staff that some officials are considering importing specialists from Cuba. Journalists from the independent outlet Novaya Gazeta spoke with doctors on the ground and examined statistics to understand the scale of the crisis. Out of concern for their safety, none of the physicians who agreed to speak were named, and their hospitals were also kept anonymous. 

According to the Health Ministry, public hospitals are short about 29,000 doctors, 63,000 nurses, and mid-level medical workers. Rosstat data show that clinics in the Chukotka region are staffed at only 44% of their needs. In Kostroma, the rate is 56%; in Tver, 57%. 

Over the past 20 years, the number of hospitals in Russia has fallen by half. Chukotka — an area larger than France — now has only one hospital and 24 outpatient clinics. Neighboring Yakutia, spanning three million square kilometers, has just 52 clinics. In Arkhangelsk, the largest region in European Russia, 900,000 residents rely on 47 hospitals, almost all in the regional capital.

Hospital bed capacity has also plummeted. In Moscow, the number of beds per 10,000 residents has dropped from 90 to 44 in two decades — a trend repeated in Leningrad Oblast, Kaluga, Adygea, Dagestan, and elsewhere. Many regions have lost a third of their beds.

“The last 20 years have dismantled our health system. We’ll need to rebuild it from scratch,” said a professor at a Moscow medical university.

The shortage of medical staff is especially severe outside major cities. Moscow has 2.5 obstetrician-gynecologists per 10,000 residents; Buryatia has 1.5. There are no gastroenterologists in Chukotka, no oncologists in Kamchatka, no nephrologists in Kalmykia. Chukotka has three cardiologists for the entire region.

Nursing shortages are worse. “Even five years ago, we already felt it sharply. Now it’s a catastrophe,” said a chief physician in Leningrad Oblast. “One nurse here cares for more than 30 patients.”

The number of doctors nationwide has risen from 680,000 in 2016 to 759,000 in 2023. But many graduates do not specialize, and few remain in practice. In 2023, only 55% of medical school graduates went into the profession.

Training and certification for emergency or specialized work are expensive and difficult. Hospitals face frequent resignations. In Khabarovsk, 20 doctors and 15 nurses quit en masse. “It happens everywhere,” said one hospital director. “The work is brutal, the conditions are bad. Young staff come, do a few shifts, and leave.”

Doctors also report shortages of medicines and equipment. In Arkhangelsk, award-winning neurosurgeon Nikolai Serebrennikov keeps operating only because he repairs broken equipment himself and even holds patents for surgical tools. But last year, he was charged with financing extremism for donating the equivalent of a few dollars to Navanly’s anti-corruption fund. A conviction would bar him from both surgery and teaching.

Doctors face growing legal risks. In Moscow, pediatrician Nadezhda Buyanova, 67, was sentenced to five and a half years in prison over alleged comments about veterans of the war in Ukraine. “No doctor today can be sure they’ll be free tomorrow,” said an emergency physician. “We’re not afraid of being fired. We’re afraid of prison.”

According to the trade publication Medvestnik, criminal cases against doctors rose 25% in 2023, mostly for “causing death by negligence.”

The Labor Ministry estimated that 500,000 new staff will be needed by 2030 — 100,000 doctors and nurses each year. The Health Ministry plans to replace some doctors with paramedics starting in September, a move many physicians oppose.

Another proposal is to reintroduce the Soviet-era mandatory work placement system, requiring medical graduates to spend three years in public hospitals. Some senior doctors back the idea. “I’d support it,” said one hospital chief. “Even young doctors can be useful, and some may decide to stay.”