Author: Emilia Milcheva
"We are the cheapest labor force in hospitals - our working hours should be from 7.30 to 14.30, but it is never observed, we stay until 17-18-19 hours. The schedule is two night shifts, two day shifts, plus two weekends a month. We also examine offices three times a week, usually about thirty people come to each office. None of the overtime is paid, I get 2,300 leva clean and a little more - if they decide to give us for the office."
And a decent salary?
This is the life of a third-year resident in a private hospital in the capital - one of those who insist that the state take care of clear regulations, decent pay and decent treatment of young doctors. In other hospitals, residents receive even only half of this money - 1,100-1,200 leva, elsewhere at most 2,500 leva, and so on for 4 or 5 years (in some surgical specialties), as long as the training lasts. When these years are added to the 6-year study, it turns out that young doctors actually start earning a decade after completing their training - in the best case scenario.
“However, they tell you that you should be grateful for this opportunity… But they don't provide you with additional paid leave, for example, if you work with X-rays. We are exposed to more radiation than is permissible and no one asks us. If we don't take care of ourselves not to get in, no one will tell you”, says another colleague of his, who is at a state hospital.
How many young doctors are specializing? For example, last year the state order was for 357 places, for 2025 - the places are 361.
The unpaid work that is kept quiet
Before they get this opportunity - each of them, like the other residents, has gone through the so-called stage of “volunteer” - a euphemism for the unpaid work that is expected of candidates for a medical specialty. This period can last 6 months, but for some it lasts for three years. There is no regulation. If the hospital likes you, if you find connections, this drudgery can be shortened, but woe to you if you are not so lucky. The hospitals do not talk about this topic, these facts are also avoided by the leadership of the Bulgarian Medical Union (BLS).
How do young doctors support themselves during this time? Some have families that manage to support them financially, others work in two places. For example, a dentist wants to specialize in maxillofacial surgery. For more than a year, he has been doing "voluntary" work, alternating between the private clinic and his office. Other candidates for a specialty - or those who have acquired one, while the owner collects the proceeds, work in the clinic like him.
The monster "tripartite contract" is the other vice of the system, in which there are no regulations. These are cases in which hospitals do not pay a penny to young doctors who are training for a specialty, and a third party (relatives/private center/small hospital) provides him with some remuneration - but may not pay him at all.
Some residents live in a student dormitory, which is not guaranteed throughout the entire period of training, others rent an apartment, which for Sofia means a minimum of 1,000 leva monthly expenses. In some places, however, hospitals offer to pay for the costs of accommodation, to provide municipal housing and/or paid leave. For example, for 2024 The highest salaries for residents were offered by the Pavlikeni General Hospital - 2,776.14 leva with provided transportation and accommodation, and by the Dr. Treiman Hospital - Veliko Tarnovo - 2,740 leva plus free municipal housing.
"They deprive us of sleep, I won't talk about social life"
A regulation requires that the salary of a young doctor be 2.5 times the minimum wage (MW), which means 2,692.5 leva for this year, but this indicator is not respected - there are pay slips with three times smaller amounts. Medical students and residents are demanding at least 3.5 times the minimum wage and payment for night work in the amount of 0.5% of the MW or 5 leva per hour, because now it is less than a leva per hour. And on weekends, only nurses and interns are on duty in many hospitals.
For comparison, MPs receive an additional 2,124 leva when they are members of committees. “I love my job and everything I do, but they deprive us of purely human needs such as normal sleep and nutrition, not to mention a social life”, says one of the interns, whom Deutsche Welle spoke to.
The Medical Students' Association in Sofia is proposing that, through an amendment to the Law on Medical Institutions, it be written that the basic monthly salary of a doctor without a specialty, as well as a master's degree in pharmacy without a specialty, will be no less than 150% of the average gross salary in the country over the past 12 months.
The meager pay of young doctors and their problems contrast with the hundreds of thousands of annual salaries received by directors of state and private hospitals. That is why a large part of them choose to go abroad, and in Bulgarian healthcare, doctors in the age group 55-64 prevail - according to national statistics, they are 9375, or 31.1%. Young doctors under 35 are 5781, or 19.2%.
Will their turn come?
But even if some solution to salaries is found, the problem of how to support them in social and domestic terms remains, as well as the mechanism by which places for residents are filled. For specialties such as dermatology and obstetrics and gynecology, for example, there are legends about five-figure sums given under the table in order to accept certain young doctors as residents. During the protests, proposals were heard from young doctors to return to competitions, but the topic died down.
By the end of July, legislative changes must be adopted that guarantee “decent pay” in the sector, promised Deputy Prime Minister Atanas Zafirov. But the reality in the ruling coalition is more reminiscent of a false council: the diagnosis is clear, there is no treatment. The largest parliamentary group - GERB-SDF, which so willingly raised the salaries of security officers from the Ministry of Interior, DANS and DATO by over 50%, is evading the young doctors. Where will the money come from, asked Prof. Kostadin Angelov, who does not agree with the proposed regulations because they are reminiscent of a “planned economy”. “It will be the doctors' turn too - when Bulgarians start vacationing in Bulgaria and their fees will be used to pay salaries for everyone”, is the painkiller “prescription” of GERB leader Borisov (whose sister is a pediatrician).
There is public support for doctors
However, public support for the increase in salaries in the Ministry of Internal Affairs was almost within the statistical error - 3.7%, while over 85% of Bulgarians support the protests of the doctors. Toshko Yordanov from “There is such a people” says that if young doctors do not want to treat, they would bring in foreigners for 500 dollars, but instead it would be much better if they brought in police officers.