There are districts in almost all of Bulgaria without pediatric gastroenterologists and nephrologists. According to data from the National Health Information System, only 39 people in the country have acquired these specialties. They practice mainly in large cities such as Sofia, Plovdiv, Varna, Burgas, Stara Zagora and Pleven, reports BNT.
Families from all over Bulgaria travel for consultation and treatment in the only pediatric gastroenterology and nephrology clinics in the specialized pediatric hospital in Sofia. Dr. Kirova and Dr. Bozadzhieva are among the few residents in them.
Dr. Spasiya Kirova, pediatric gastroenterology resident, SBALDB “Prof. Ivan Mitev“: “The specialty is difficult. It is difficult, not everyone would like to take a risk. We are very busy. There are children from all over the country. The capacity of the department is almost always full.“
Dr. Liliya Bozadzhieva, pediatrician, specialist in pediatric nephrology, SBALDB “Prof. Ivan Mitev“: “It concerns quite rare cases with life-threatening conditions. I suppose this is part of the lack of desire among most people. The fact that they are severe cases rather gives me motivation to learn more.“
The Pediatric Association says that a problem for Bulgaria is the uneven distribution of pediatric specialists.
Assoc. Prof. Yordanka Uzunova, head of the pediatric clinic at UMBAL “Lozenets“, secretary of the BPA: “The fact that there will be many specialists does not mean that the diagnostic and treatment process in childhood will improve. The narrow specialist should deal with some serious illness. And the fact that a child has a stomach ache, this problem should be solved by the pediatrician.“
The solution to the problem depends on the state.
Assoc. Prof. Yordanka Uzunova, head of the children's clinic at the University Hospital “Lozenets“, secretary of the Bulgarian Association of Pediatricians: “There should be a policy, where, in what place to distribute, in what places the narrower specialties should be. To prepare people, to stimulate them to go there.“
Dr. Spasiya Kirova, specialist in pediatric gastroenterology, SBALDB “Prof. Ivan Mitev“: “There should be a patient flow, good medical care as conditions and a training base. Specialists to train them, and a base in which they can work afterwards. Pay is another topic.“
The Ministry of Health says that to overcome the territorial imbalance, each year they allocate places for state-funded postgraduate students in specialties with a shortage of personnel.