Reduction of Salaries and Staff Turnover Are Deepening the Crisis in russia’s Medicine

russia is experiencing a growing shortage of primary care doctors, ambulance workers, and mid-level medical personnel. Trade unions are reporting widespread overtime and low salaries.

The number of doctors under the Ministry of Healthcare has decreased from over 600,000 in 2000 to 549,000 in 2023. Only 63 % of them work directly with patients.

The situation is similar for nursing staff: in 2024, there were 1.18 million employees in state and municipal institutions, which is by 16 % fewer than in 2000. Real incomes have not grown over the last decade but have even declined in 40 regions. This leads to high staff turnover in both the public and private sectors.

More than two-thirds of doctors work more than one rate. A district therapist serves an average of 2,800 patients, compared to the norm of 1,700 – by 65 % more than the established workload. In emergency care, there is one doctor for every 16,000 people, instead of the standard 9,500. The shortage of staff  is especially acute in primary care, as well as in dentistry, urology, and gastroenterology.

About 80 % of ambulance crews are paramedics who can only provide first aid, while there is a shortage of doctor crews. The system has effectively given up  the standard of “one crew per 10,000 people and 20-minute availability”.