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Bulgaria’s healthcare system is grappling with a severe shortage of medical professionals, a report from the Bulgarian Council for Economic Analyses has highlighted, causing concern over the country’s healthcare system, as waiting lists grow and hospitals close.

This comes as the World Health Organization estimates that the global shortage of medical professionals is projected to reach 15 million by 2030, with the deficit becoming increasingly pronounced in the European Union.

Uneven distribution

In Bulgaria, while the overall number of physicians per 100 thousand population in 2021 is above the European median, specific shortages persist. 

Notably, the country faces a deficit of around 1,000 general practitioners, over 460 psychiatrists, and a staggering shortage of approximately 16,900 nurses, and the capital Sofia needs more than 2,500 nurses.

The distribution of healthcare professionals in Bulgaria is uneven, with certain regions experiencing a more acute shortage than others, according to a report by the European Commission in 2018.

In some areas, the number exceeds European benchmarks, while others, including the cities of Blagoevgrad, Kardzhali, and Haskovo, face the most significant shortages.

The shortage is most severe among nurses, with only one nurse for every doctor, failing to meet the recommended ratio of two nurses per doctor.

Why is there a shortage?

The shortage of medical professionals in Bulgaria can be attributed to various factors. Overtime, low wages, and a lack of recognition emerge as key contributors to the nursing shortage.

The Bulgarian education system, although partially compensating for the outflow of doctors and nurses, fails to meet the needs defined by existing shortages. Germany alone has “imported” some 50,000 doctors from abroad. The United Nations estimates that Bulgaria will lose 23% of its remaining population by 2050.

This exodus of medical professionals poses a significant challenge to the government. The competition among countries to attract and retain medical professionals further exacerbates the problem.

The authors of the studies suggest several policy actions to address the shortage, including prioritising the training of medical professionals, retaining them within Bulgaria (including foreign trainees), attracting back Bulgarian professionals working abroad, and improving working conditions and career development opportunities.

What effect is this having on people?

The consequences of the shortage are already evident in various regions of Bulgaria. Municipal hospitals, such as a facility in Kavarna, face critical staff deficiencies, with only one clinical laboratory assistant and zero midwives for a population exceeding 11,000.

Larger medical facilities, such as the Multispecialty Hospital for Active Treatment in the city of Lovech, are forced to suspend departments, including Obstetrics and Gynaecology, due to a lack of doctors.

The closure of vital departments has resulted in the redirection of patients and a strain on neighbouring facilities in Lovech’s neighbouring cities of Troyan and Pleven.

The difficult financial situation compounds the personnel problem, further hindering the ability of healthcare institutions to attract and retain medical professionals.