TIRANA, Oct. 27, 2022 – Justina Sinani, a fifth year general medicine student at Tirana’s public University of Medicine, expects to graduate next year, but says that she started her studies with the idea of leaving Albania after graduation.
She is still undecided about the specialization she will pursue, due to, as she says, the uncertainty about what is offered after specialization in Albania.
“That will be the moment when I will decide to stay here in my country or to leave. Most of my friends have started foreign language courses, with the intention of leaving,” Sinani said.
For years, studies in medicine and nursing have been seen by young people as an opportunity to turn their diploma into a “passport” to leave Albania.
In the last decade, according to the Federation of Albanian Doctors in Europe, more than 3,000 medical doctors have left Albania — with 1,500 of them landing in Germany.
They mainly complain about bad conditions in hospitals, lack of medicines and low wages in Albania as push factors.
The average gross salary of a doctor in Albania is about 110,000 leks or 950 euros. For comparison, the pre-tax average salary of a doctor in Germany is about 4,000 euros.
It’s a regional problem. Hundreds of doctors leave North Macedonia and Kosovo too, but Albania has the lowest rate of doctors per capita at this point.
The health authorities say that Albania, for now, does not suffer from absence of doctors and health personnel.
However, Prime Minister Edi Rama said on Oct. 18 that measures must be taken to address the problem. His proposal is to suspend the granting of degrees to young doctors until they perform mandatory civil service to “pay back” society for investing in them.
“We will not give you a doctor’s degree as soon as you finish school. You will go first to give back to your people what they have done for you, then you will also receive your diploma and go wherever you want, according to certain deadlines,” Rama said.
He later clarified that the degree will be blocked for three years. It is not yet clear when and how this measure will be implemented.
Rama said that doctors in many countries do not receive their diplomas immediately, but he did not specify which countries he was talking about.
“The Albanian people cannot pay for German doctors,” Rama said.
In Albania, specialization in medicine is largely self-financed. Payment by the state is made only for a number of specialists, which is determined by the Ministry of Health for the needs of the health system.
Even for general studies in medicine, students pay school fees themselves.
Rama said that he will ask the European Union to return the investment to Albania.
“They want to take [the doctors] to Germany, take them, but they have to return the investment. I mean that the European Union must find a way to return something… If we have opportunities for ourselves and for Europe, there is no problem. But, we cannot be in this passive position, this is madness”, said Rama, without explaining what he will specifically ask from the EU countries.
For the medical student, Sinani, the initiative is unfair.
“I do not agree at all. How can the diploma be stopped? I even think that if it is implemented, it will have a negative impact. Medicine requires several years of study, there are many expenses and in the end we are not awarded a diploma? I am for it to be decided with free will, to improve the conditions, the payments, but in no way should we be forced to stay by holding our diploma hostage,” Sinani told the Albanian Service of Radio Free Europe.
Arjon Kuçuku, another medical student in Tirana, describes this initiative as a “flagrant violation” of human rights and the university’s regulations.
“Personally, I have decided to stay in Albania, but this is my will. Not giving the diploma is not a solution. The best solution is improving the conditions in hospitals and increasing the salary, but a serious increase, not a funny one,” says Kuçuku, a third year medical student.
‘A violation of universal rights’
Ilir Allkja, a doctor who works in the emergency department of a private hospital in Tirana, said that not awarding diplomas to medical students would be a flagrant violation of universal rights.
“As far as I know, this does not happen anywhere,” Allkja said.
He adds that doctors should feel free to work in Albania.
“They should rely on their career, which should be as far away from politics as possible,” he added.
Allkja, according to media reports in Albania, was fired from his job at the Emergency Department of the main public Mother Teresa Hospital Center in Tirana two years ago, after he denounced the deficiencies in the health system in Albania, including the lack of masks, gloves, oxygen equipment, etc.
Head of association: Doctors need to have the freedom to decide themselves
An Albanian doctor in Germany, Aurora Meta Dollenberg, president of the Federation of Albanian Doctors in Europe, says that, at first glance, it seems unfair that Europe receives a ready-made product, while Albania is getting poorer every day from the younger generations. able to work in the health sector.
She appreciates the fact that the Albanian Government is worrying about the negative trend, but, on the other hand, she adds that strategies should be discussed very carefully.
“In Germany, the salaries are several times higher, the conditions are better, qualifications are offered without bureaucracy. So the Albanian state must invest in keeping young doctors in the country, competing with these states that are absorbing doctors and nurses,” Dollenberg said. “But the decision is up to the professionals to stay or go. No one can force them to stay and no one can prevent them from obtaining a diploma, which is provided for by law.”
She adds that with investments and concrete measures to improve conditions and increase salaries, young doctors can be kept in Albania.
That is the scenario that, according to her, “offers success.”
A ‘hasty proposal’
Civil society activist Adriatik Lapaj, who is also a lawyer, sees Rama’s proposal as hasty.
According to him, this will encourage young people in Albania to try to complete their medical studies abroad.
“You can’t tell the students: we don’t give you the diploma card. What has the state and the government given to those who were graying in school?” – asks Lapaj.
Kosovo is also facing an exodus of doctors for similar reasons.
According to the data of the Chamber of Doctors of Kosovo, 580 doctors left Kosovo in the period 2018-2021.Source: Radio Free Europe Albanian Service. Translated and adapted to English by Tirana Times.
