Dr Rita Lénárd, an internal specialist, wrote about the difficulties and injustice that resident doctors have to face in Hungary. Her article that appeared on wmn.hu is meant to be a wakeup call, to appreciate those doctors who would stay in Hungary and give them the opportunity to learn.
After the unsettling news about Hungarian hospitals being gravely indebted, here is another problem that our healthcare system faces: the bad treatment of resident doctors. They are the young specialist candidates who have already graduated and should take the place of senior doctors in a few years. To do that, however,
they need practice. Instead, they are treated like servants.
They have already studied for 18 years, but their knowledge is mostly theoretical. That is why they should work side by side with more experienced specialists.
Dr Rita Lénárd recalls in her article the shocking experience she had 39 years ago when she applied for her first job in a hospital. She was a 24-year-old summa cum laude graduate full of excitement. At the job interview, they immediately rejected her, only because she was a woman.
The only question they asked was if she could cook or not, and then they said:
“How do you dare to think you could do such a difficult job? You are a woman, go have children and cook for your family…”
She obviously left the place outraged, but this example was only one of many disappointments – for her and other resident doctors.
What is actually a resident doctor?
In the past century, they were called doctors with servant’s licence
(referring to medical students’ hospital passes). After graduation, they still had to study to specialise before they could practice on their own. These young professionals lived in the hospital and could be called in at any time.
For their work they only got board and lodging, but no salary.
When Dr Rita Lénárd started her job, they were no longer called servants but assistant doctors, but the arrangement and the place at the bottom of the hierarchy did not change with the name. They worked 260-280 hours a month, obliged to be on duty 12-14 times.
They were not appreciated at all. She remembers the embarrassing time when she tried to sit with other colleagues in the cafeteria. They just looked at her and told her that she had not deserved it yet to sit with them. That was when she vowed to be different once she would be in their position.
What is the situation today?
Well, unfortunately, it is not much better nowadays than it was in Dr Lénárd’s time, despite us living the days of permanent lack of doctors.
The purpose of having resident doctors is that they learn the ins and outs of the field from a senior.
Nevertheless, the doctors’ society has, according to Dr Lénárd, a confirmed, anachronistic, feudal hierarchy, in which they regard residents as orderlies, or servants. They are not treated as partners and are constantly looked down on, getting tasks beneath their skills.
What the doctor is most disappointed about is that almost everyone in her age group has experienced this treatment yet now that they could, they do little to change it.
One problem might be that until our healthcare system remains infected by gratuity money the more experienced doctors have no interest in letting their younger counterparts work and learn – because they would not get the gratuity money from the patient then.
Thus there is no mentor-apprentice relationship, and older doctors keep their knowledge to themselves.
It is actually not the bad salary that makes so many young professionals leave Hungary. Hungarian doctors move abroad because the gratuity money, the feudal hierarchy and the bad working conditions leave them no opportunity to learn and develop here.
Yet, there would be many, who would stay and bear all this for they occupation.
Making it more difficult
And what happens to them? To those who are willing to stay?
Well, they can apply for scholarships if they try – bear in mind, they are already graduated, full-time doctors, and they would get scholarships. But that amount is not enough to start their lives, to pay the student debts and so on.
To make matters worse, the headcount restrictions affect resident doctors as well. This means that they have fewer places available and it is more difficult to get those: they have to apply for the job, and if they get it, they still need to sign a letter of intent and forward that to the National Healthcare Services Centre (ÁEEK). After that could they sign a contract with the ÁEEK but this last step did not happen.
So right now the young doctors are up in the air, with no certain job or salary.
Some resident doctors are still waiting, others are packing already…
The problem, according to Dr Lénárd, is that there is an entire generation of doctors missing: the 35-50-year-old doctors at the peak of their career, who should teach the residents, are already long gone, they left the country and the older generation will be retired in a few years.
All in all, the administrative issues that are holding up the resident doctors right now, send the same message that the old doctors told Dr Rita Lénárd in her time: you are not worthy of our attention…