Romania suffering a massive healthcare exodus

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Romania facing mass exodus of healthcare workers
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Romania facing mass exodus of healthcare workers
Snow lies on roofs in the village Salistea de Sus, Romania, January 4, 2017. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Anuta Iuga, 65, one of doctor Gabriela Dromereschi's patients, poses for a portrait at home in Salistea de Sus, Transylvania region, Romania, January 4, 2017. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Bottles and glasses sit on a table at the home of Anuta Iuga, 65, one of doctor Gabriela Dromereschi's patients, in Salistea de Sus, Romania, January 4, 2017. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
A cart transports wood in Salistea de Sus in Romania, January 4, 2017. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
A mother holds her baby during a home visit from doctor Robert Ganea (not in the picture) in the village of Sacel in Romania, January 4, 2017. REUTERS/Andreea Campeanu THE IMAGES SHOULD ONLY BE USED TOGETHER WITH THE STORY - NO STAND-ALONE USES. EDITORIAL USE ONLY SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Doctor Andreea Kis, a family doctor, treats a patient at his home in the village of Tureni in Transylvania region, Romania, December 16, 2016. Kis moved with her husband and two children to Tureni, but many doctors in the countyside travel every day from the city to the villages where they work. REUTERS/Andreea Campeanu THE IMAGES SHOULD ONLY BE USED TOGETHER WITH THE STORY - NO STAND-ALONE USES. EDITORIAL USE ONLY SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
A mother holds her baby, during a home visit from doctor Andrada Ganea, in Bogdan Voda, in Maramures county, Romania, January 10, 2017. REUTERS/Andreea Campeanu THE IMAGES SHOULD ONLY BE USED TOGETHER WITH THE STORY - NO STAND-ALONE USES. EDITORIAL USE ONLY SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Patients are seen at doctor Andreea Kis's medical practice in Tureni village, Romania December 15, 2016. REUTERS/Andreea Campeanu THE IMAGES SHOULD ONLY BE USED TOGETHER WITH THE STORY - NO STAND-ALONE USES. EDITORIAL USE ONLY SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
A mother holds her newborn baby in the hospital in Viseul de Sus in the Transylvania region of Romania, January 5, 2017. REUTERS/Andreea Campeanu THE IMAGES SHOULD ONLY BE USED TOGETHER WITH THE STORY - NO STAND-ALONE USES. EDITORIAL USE ONLY SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Students study at the Medicine and Pharmacy University in Cluj-Napoca, Romania, December 8, 2016. There are currently over 6600 students at the Medicine and Pharmacy University in Cluj-Napoca, of which around 2260 are foreign. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Doctor Gabriela Dromereschi and her nurse Maria Iuga talk to a patient at their practice in Salistea de Sus in Romania, January 4, 2017. Dromereschi is one of two doctors in the town of about 5,000 people and has been working there since 1991. REUTERS/Andreea Campeanu THE IMAGES SHOULD ONLY BE USED TOGETHER WITH THE STORY - NO STAND-ALONE USES. EDITORIAL USE ONLY SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
A monument to doctors who worked in Sacel from 1938 to 2016 is seen next to the village practice, in Maramures county, Romania January 10, 2017. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Doctors who are part of the emergency rescue service bring a patient to the Emergency Unit in Cluj-Napoca, Romania, December 14, 2016. REUTERS/Andreea Campeanu THE IMAGES SHOULD ONLY BE USED TOGETHER WITH THE STORY - NO STAND-ALONE USES. EDITORIAL USE ONLY SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Doctor Gabriela Dromereschi does an ultrasound on a patient at her practice in Salistea de Sus, Romania January 4, 2017. REUTERS/Andreea Campeanu THE IMAGES SHOULD ONLY BE USED TOGETHER WITH THE STORY - NO STAND-ALONE USES. EDITORIAL USE ONLY SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
A doctor and a volunteer medical student who work for SMURD, part of the emergency rescue service, hug before the night shift at their office in Cluj-Napoca, Romania, December 14, 2016. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Women stand in front of the church during the Epiphany Mass, in Bogdan Voda, Romania January 6, 2017. Doctor Andrada Ganea works in this town as a family doctor, while her husband, doctor Robert Ganea, works in nearby villages. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Files are seen in a corridor at the hospital in Viseul de Sus in Romania, January 5, 2017. The hospital has only one doctor per speciality for most areas and when the doctor goes on leave, the hospital has to close that unit. After finishing their residency in the hospital many young doctors either leave to live abroad or go to larger medical centres. The management of the hospital managed to bring a Syrian and a Moldovan doctor to help fill positions. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
A nurse gestures at doctor Andreea Kis's medical practice of in the village of Tureni, Romania December 15, 2016. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Patients wait to be seen by doctor Gabriela Dromereschi, at her practice in the town of Salistea de Sus in Romania, January 4, 2017. REUTERS/Andreea Campeanu THE IMAGES SHOULD ONLY BE USED TOGETHER WITH THE STORY - NO STAND-ALONE USES. EDITORIAL USE ONLY SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES. TPX IMAGES OF THE DAY
Medical equipment is seen in the delivery room at the hospital in Borsa, Romania January 9, 2017. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Medicine is seen in a cabinet at the hospital in Borsa, Romania, January 9, 2017. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
A photo is seen on the fridge in a student dorm room at the University of Medicine and Pharmacy, in Hasdeu, Cluj-Napoca, Romania, January 14, 2017. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Women stand in front of a traditional wooden gate after the Epiphany Mass, in Bogdan Voda, Romania, January 6, 2017. Doctor Andrada Ganea works in the town as a family doctor, while her husband, doctor Robert Ganea, works in nearby villages. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES. TPX IMAGES OF THE DAY
A mother and her daughter are treated in the paediatric ward in the hospital in Borsa, Romania, on January 9, 2017. REUTERS/Andreea Campeanu THE IMAGES SHOULD ONLY BE USED TOGETHER WITH THE STORY - NO STAND-ALONE USES. EDITORIAL USE ONLY SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
A hallway is seen at a medicine student dorms in Cluj-Napoca, in Transylvania region of Romania, December 15, 2016. There are currently over 6600 students at the Medicine and Pharmacy University in Cluj-Napoca, of which around 2260 are foreign. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Medical staff work in the emergency ward (UPU) in Cluj-Napoca, Romania, December 10, 2016. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Sonia Papiu, 25, poses for a photo in her room in Cluj-Napoca, Romania, December 16, 2016. Sonia Papiu is a resident psychiatrist, and hopes to go to work in Germany. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Lacrima Dambu, a Romanian doctor who has been working in Germany for five years, holds her nephew in Cluj-Napoca, Romania January 19, 2017. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Dennis Ciui, 19, a dental student, looks at her phone as she celebrates a friend's birthday at a bar in Hasdeu, Cluj-Napoca, January 20, 2017. REUTERS/Andreea Campeanu SEARCH "CAMPEANU HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
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CLUJ, Romania, March 9 (Reuters) - Sonia Papiu started her first year of residency as a psychiatrist in the Romanian city of Cluj in January, but she plans to move abroad within the year, seeking better learning opportunities and hospital conditions.

She will not be alone.

"I don't think any of my colleagues are planning to stay," she said. "I think I could learn more abroad. You have higher responsibilities as a resident there."

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In the Romanian system, doctors go through six years of medical school and then three to five years as a hospital resident, treating patients while working under the supervision of senior staff.

Finding a job abroad will be easy. Cluj, one of Romania's largest cities and a university and business hub, hosts several agencies recruiting for western European hospitals.

Romania has bled out tens of thousands of doctors, nurses, dentists and pharmacists since joining the European Union a decade ago, lured abroad by what the country lacks: significantly higher pay, modern infrastructure and functional healthcare systems. France, Germany and Britain are among the most popular destinations.

The consequences are dire. Romania is one of the EU states with the fewest doctors. Nearly a third of hospital positions are vacant and the health ministry estimates one in four Romanians has insufficient access to essential healthcare.

"Medical staff leaving Romania at an almost massive pace deepens the problems of the healthcare system," former health minister Vlad Voiculescu has said. "Entire hospitals are facing a major personnel deficit and entire towns don't have a family physician."

This despite the fact that Romania is a leading EU state when it comes to the number of medical graduates. But the system - ridden with corruption, inefficiencies and politicized management - has been unable to motivate them to stay.

The shortages are even starker in rural areas.

"Because we have one doctor per section for most specialties, when a doctor goes on holiday we need to close down the section," said Cristian Vlad, the hospital manager in Viseul de Sus, a small town near the Ukrainian border.

Vlad said three hospitals in the region shared one anesthetist until last year, when his hospital brought in another from neighboring Moldova.

"I live in hope that our resident doctors will change their mind and stay in smaller hospitals, too," Vlad said.

More from inside Romania:

TURNING POINT

Romania is taking steps to address the issues. Pay has risen significantly, although it still does not measure up to western standards. The net average monthly wage for the healthcare system stood at 2,609 lei ($606) at the end of 2016, nearly double what it was three years ago.

In 2016, the health ministry created a multi-year plan for the medical profession, including a simpler recruitment process, education reform, better promotion opportunities, and subsidies for physicians willing to move to remote villages.

The strategy has yet to be approved by the two-month-old cabinet of Social Democrat Prime Minister Sorin Grindeanu.

"Measures to improve healthcare are in place, but the system suffers from inefficiencies, limited accessibility and corruption," the European Commission said last month.

Yet not all doctors shy away from remote areas. From the village of Tureni, Andreea Kis has been serving as a family doctor for five villages for nearly five years.

"I chose to be a family doctor because this is compatible with family life," said Kis, a mother of two. "People in the villages preserve their humanity better."

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