In Focus: Healthcare Professionals from Slovakia

19. Februar 2015

International Recruiting

Pan­orama of Bra­tis­lava. Source: http://commons.wikimedia.org

Pan­orama of Bra­tis­lava. Source: http://commons.wikimedia.org

There is an increa­sing num­ber of medi­cal staff from Middle and Eas­tern Europe com­ing to Ger­many with the goal to find a bet­ter life and job. But what are the incen­ti­ves that bring the health­care pro­fes­sio­nals from Middle and East Europe to Ger­many? And are there some chal­len­ges and hin­dran­ces which need to be con­side­red when recruit­ing medi­cal staff from these coun­tries? To ans­wer these ques­ti­ons, I deci­ded to take a close look at one small coun­try in the very heart of Europe, which is my home-country – Slo­va­kia.

Accord­ing to the sta­ti­s­tics appro­xi­mately 849 Slo­vak phy­si­ci­ans are cur­rently working in Ger­many. In the whole, the doc­tors from this small coun­try belong to the 10th most com­mon natio­na­lity among the for­eign phy­si­ci­ans working in Ger­many.1 This is not sur­pri­sing, as for the Slo­vak phy­si­ci­ans Ger­many is the second most popu­lar desti­na­tion when sear­ching for a work abroad, only in Czech Repu­blic you can find more Slo­vak doc­tors (pro­bably due to the lan­guage simi­la­rity).

Unem­ploy­ment

One fac­tor, which plays an important role, are the high unem­ploy­ment rates. With 12,6% of unem­ployed wit­hin the popu­la­tion is Slo­va­kia ran­ked above the EU-average, whe­reas in Ger­many only 5% of the popu­la­tion is unem­ployed (Sta­tus from Novem­ber 2014).2 Even though since the begin­ning of 2014 the num­ber of unem­ployed is gra­dually decli­ning in Slo­va­kia, it is still dif­fi­cult for the young gra­dua­tes and older unem­ployed inha­bi­tants for find a job.

Finan­cial Rea­sons

Fur­ther incen­ti­ves are the hig­her income oppor­tu­nities in Ger­many. Espe­cially young medi­cine gra­dua­tes are attrac­ted by hig­her sala­ries. Due to the recent enact­ment of the phy­si­ci­ans’ mini­mum wage in Slo­va­kia, the sala­ries increa­sed con­sider­a­bly in the last two years. Howe­ver, the over­all income is still very low com­pa­red with the one in Ger­many. There is a large dif­fe­rence espe­cially bet­ween the sala­ries of resi­dents without a spe­cia­liza­t­ion and medi­cal spe­cia­lists. In Ger­many the aver­age salary of a resi­dent amounts to 4.016 EUR, whe­reas it can range bet­ween 2.886 and 5.677 EUR. In Slo­va­kia the mini­mum salary of a resi­dent is 980 EUR, what is only one third of the salary ear­ned in Ger­many. The­re­fore, the Ger­man health­care labour mar­ket is par­ti­cu­larly appea­ling for the gra­dua­tes with little prac­tical expe­ri­ence.

The aver­age income of a medi­cal spe­cia­list in Ger­many is 5.104 EUR, whilst the actual income can vary bet­ween 3.381 and 9.729 EUR. In Slo­va­kia a medi­cal spe­cia­list earns on aver­age 2.150 EUR. Howe­ver, the income can in some cases amount even up to 6.000 EUR through pay­ment bonu­ses.
In the area of nur­sing the income dif­fe­ren­ces are even more appa­rent. The nur­sing staff in Ger­many earns on an aver­age 2.308 EUR, whilst the nur­ses in Slo­va­kia have an aver­age income of 1.022 EUR.

Working Con­di­ti­ons

Not only the income draws the Slo­va­kian phy­si­ci­ans and nur­sing staff to Ger­many, also bet­ter life and work qua­lity are deter­mi­ning fac­tors. Many Ger­man cli­nics and hos­pi­tals are with their mate­rial and finan­cial resour­ces, tech­ni­cal equip­ment and pro­fes­sio­nal exper­tise supe­rior to those in Slo­va­kia. More­o­ver, the cli­nics and hos­pi­tal in Ger­many offer their employees bet­ter career and trai­ning oppor­tu­nities.

Ulica_M.S.Trnavskeho_-_Trnava

The city Trnava. Source: http://commons.wikimedia.org

Edu­ca­tion Sys­tem

The edu­ca­tion of health­care staff in Slo­va­kia is com­pa­red to Ger­many highly aca­de­mic. The edu­ca­tion can takes place at two levels – at the secon­dary level in a health­care voca­tio­nal school and at the ter­tiary level in a col­lege or a uni­ver­sity.

At the col­le­ges and uni­ver­si­ties in Slo­va­kia not only phy­si­ci­ans receive their trai­ning and edu­ca­tion, but also nur­ses and carers, mid­wi­fes, phar­macists, phy­sio­the­ra­pists and nutri­tion con­sul­tants. For many of these pro­fes­si­ons a qua­li­fi­ca­tion can be obtai­ned only by com­ple­ting an under­gra­duate or a post­gra­duate pro­gram in a col­lege or a uni­ver­sity. As a result voca­tio­nal trai­ning in Slo­va­kia con­sists of much lar­ger theo­re­ti­cal part com­pa­red with the one in Ger­many. A dis­ad­van­tage of this edu­ca­tion sys­tem is lack of spe­cia­liza­t­ion. Through the nur­sing under­gra­duate or post­gra­duate pro­gram a gene­ral qua­li­fi­ca­tion as a nurse is obtai­ned. In order to acquire a spe­cia­liza­t­ion, e.g. as a ger­iatric or a paed­iatric nurse, an addi­tio­nal qua­li­fi­ca­tion is necessary.

In order to obtain a qua­li­fi­ca­tion as a phy­si­cian a diploma from a six-year post­gra­duate pro­gram of medi­cine is necessary, the same rule app­lies when stu­dy­ing den­tis­try. At the end of the stu­dies state exami­na­ti­ons and dis­pu­ta­ti­ons take place. Due to the adjust­ments towards Bolo­gna pro­cess the medi­cal stu­dies in Slo­va­kia are in the con­tent and struc­tu­rally simi­lar to those in Ger­many and are ack­now­led­ged in all EU-countries. After the com­ple­ting the stu­dies most of the gra­dua­tes strive for a post­gra­duate trai­ning as a medi­cal spe­cia­list. Simi­larly as in Ger­many, the post­gra­duate trai­ning so-called resi­dency takes place in an aut­ho­ri­zed health­care insti­tu­tion and con­sists of a prac­tical and a theo­re­ti­cal part. The resi­dency lasts usually from three up to five years depen­ding on the area of spe­cia­liza­t­ion.

Health­care voca­tio­nal schools are insti­tu­ti­ons of the secon­dary level, which also pro­vide health­care edu­ca­tion. The stu­dents acquire here a dou­ble qua­li­fi­ca­tion, on one side a gene­ral edu­ca­tion and on other side a voca­tio­nal trai­ning stron­gly groun­ded in the prac­tical expe­ri­ence. The edu­ca­tion in a health­care voca­tio­nal school lasts usually four years. Mainly the qua­li­fi­ca­tion for auxi­l­i­ary pro­fes­si­ons are acqui­red here, e.g. health­care assis­tants, nutri­tio­nists, den­tal assis­tants, but also pro­fes­si­ons which do not require a large theo­re­ti­cal know­ledge, e.g. phar­maceuti­cal lab assis­tants, ortho­pa­e­dic tech­ni­ci­ans, mas­seurs or sani­ta­ri­ans. After gra­dua­ting from the health­care voca­tio­nal school an addi­tio­nal qua­li­fi­ca­tion is pos­si­ble.

Lan­guage Com­pe­tence

Ger­man has been esta­blis­hed as a for­eign lan­guage for many years in Slo­va­kia. Accord­ing to the Euro­ba­ro­me­ter sur­vey 28% of the popu­la­tion is able to speak Ger­man on a flu­ent level.3 Espe­cially, the young gene­ra­tion is able speak good Ger­man, in par­ti­cu­lar stu­dents, people with hig­her edu­ca­tion and citi­zens of lar­ger cities. Ger­man is usually taught as the first or second for­eign lan­guage in the pri­mary school and in the secon­dary grammar school, while the stu­dent in the secon­dary grammar school can choose, which for­eign lan­gua­ges they want to learn. It is also pos­si­ble to gra­duate in Ger­man as a for­eign lan­guage, which is equi­va­lent to the lan­guage level B1. More­o­ver, there are also bilin­gual secon­dary grammar schools in Slo­va­kia, at which the clas­ses are taught ent­i­rely or par­ti­ally in Ger­man and when gra­dua­ting the school-leaving exami­na­tion is com­ple­ted in Ger­man lan­guage. Simi­larly, in some col­le­ges and uni­ver­si­ties the lec­tu­res and semi­nars are taught com­ple­tely in Ger­man. Even though, the medi­cine and health­care pro­grams cur­rently do not pro­vide this pos­si­bi­lity, the stu­dents can still choose cour­ses of dif­fe­rent Ger­man levels or medi­cal Ger­man as an elec­tive sub­ject or even write the degree the­sis in Ger­man lan­guage.

Con­clu­sion

The Slo­vak health­care staff is due to their good pro­fes­sio­nal qua­li­fi­ca­tion and lan­guage skills attrac­tive for the Ger­man labour mar­ket. Since the eco­no­mic and working con­di­ti­ons in Ger­many are bet­ter than in the Slo­va­kia, the health­care pro­fes­sio­nals are par­ti­cu­larly ent­i­ced to move to Ger­many and stay there even over the long term. A simi­lar situa­tion pre­vails also in many other Middle and East Euro­pean coun­tries. In this way the health­care pro­fes­sio­nals from these coun­tries offer the pos­si­bi­lity to fill in the per­son­nel gaps and improve the cur­rent situa­tion in health­care in Ger­many.

Sour­ces

  1. http://de.statista.com/infografik/1764/auslaendische-aerzte-in-deutschland/
  2. http://de.statista.com/statistik/daten/studie/160142/umfrage/arbeitslosenquote-in-den-eu-laendern/
  3. http://ec.europa.eu/public_opinion/archives/ebs/ebs_243_sum_de.pdf
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