EUROHEALTH

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Enhancing the health workforce
actual outflow, or confirm how long, if
at all, the health professional settles to
work in the destination country. Data also
include foreign nationals who obtain their
medical degree in Hungary, but does not
distinguish outflow of domestic medical
doctors in their case. Table 2 shows the
number of applications received by ENKK
from 2011 to 2014.
Semmelweis University Health Services
Management Training Centre (HSMTC)
has also played a key role in assessing
mobility of the health workforce in
Hungary. Back in 2003, the Centre and
the Association of Hungarian Resident
Doctors (doctors in postgraduate
specialization training) initiated a survey
for resident doctors. The annual survey
studied the potential and motivations for
residential doctors to migrate. 5 Based
on these surveys migration potential
was high, between 60% and 70%, with
around 10% (average rate) taking active
steps to realize this intention among
respondents. 5 The analysis also identified
a potential “marginal migration decision
threshold point” for remuneration.
According to the analysis, medical
doctors “would not consider migration
and not take on a second job and/or accept
informal payment” if salaries for resident
doctors in their first two years, nonspecialists
and specialists were increased
to 200,000 HUF (€645 Euro); 300,000
HUF (€970); and 450,000 HUF (€1450),
per month, respectively.
Migration as a top policy priority
Despite these available data, by 2010, no
comprehensive retention strategy had
been implemented. This changed when the
State Secretariat for Healthcare declared
that the international mobility of doctors,
Table 3: Annual number of Markusovszky
scholarships between 2011 and 2013
Number of granted
Year
scholarships
2011 584
2012 486
2013 547
Total 1614
Source: Ref 6
especially outflow among new graduates, 11
is a top priority of the country’s health
policy agenda. This political commitment
resulted in concrete efforts to address
the issue in a comprehensive way.
One of the interventions implemented
to secure the health workforce was a
scholarship programme.
The scholarship programme
and implementation
The programme was introduced in 2011
with a scholarship for resident doctors.
In 2012 and 2013, two additional
scholarships were introduced (see Box 1).
These three scholarships are only available
for resident doctors entering postgraduate
training to obtain their first specialization
or who have at least one year remaining
prior to completing their ongoing first
specialization training * . As compensation,
the recipients must provide the equivalent
number of years of service in a specified
health care setting (settings vary
depending on scholarship) after obtaining
the specialization, typically amounting to
five years of service. All three scholarships
award doctors a tax-free net sum for the
period of their postgraduate specialist
training, in addition to their monthly
salary. The marginal migration decision
threshold point served to determine the
monetary value of these scholarships.
Based on a recorded decrease in the
number of applications for verification
certificates to work abroad by new
graduates, the scholarships have been
important in retaining newly graduated
doctors – the main target group. 6
The entire process (application,
contracting, payment, monitoring) is
coordinated and managed by ENKK.
Announcements of recipients and rules are
available on the ENKK website. 12
Results
Since the introduction of this programme
applications have exceeded the amount
of awards that the government was able
to fund, indicating great interest among
the target group. The total number of
* Specialists who enter a new postgraduate resident training
program to obtain a second or third specialization are not
eligible to apply for the scholarship.
Box 1: Scholarships #
1. Markusovszky Lajos Scholarship
Program
Introduced in 2011, this scholarship is
available to all resident doctors who
are enrolled in their first specialization
training, regardless of speciality. The
scholarship stipulates that graduates
must work in the public health care
system upon completion of the
specialty training. The monthly net sum
of this scholarship is 100,000 HUF
(approx. €320).
2. Méhes Károly Scholarship Program
Introduced in 2012, this scholarship is
available to paediatric resident doctors.
Upon completion of the specialization
training, graduates are appointed to a
service post in underserved areas in
primary care* practices that have been
left vacant for a prolonged period. The
monthly net sum of this scholarship
is 200,000 HUF (approx. €640).
3. Gábor Aurél Scholarship Program
Introduced in 2013, this scholarship
responds to acute shortages in
emergency medicine. The Gábor Aurél
Scholarship is available to emergency
medicine resident doctors. Recipients
must work at a Hungarian Ambulance
Service assigned post upon completion
of the specialization. The monthly net
sum of it is 200,000 HUF (approx. €640).
Note:
#
Resident doctors can apply for more than one
scholarship, but they can only accept one scholarship.
* Primary care for children is characteristically provided
by paediatrician specialists in Hungary.
scholarships granted for the Markusovszky
scholarship alone has increased three fold
since its introduction (see Table 3).
The number of resident doctors applying
for postgraduate specialist training is
also monitored annually, together with
the number of graduating doctors. These
data allow further observations. Since
doctors, who apply for the aforementioned
scholarship programmes, have to enter
postgraduate specialization training, they
also have to apply for a postgraduate
Eurohealth — Vol.22 | No.2 | 2016