Would lowering the threshold in universities bring in more family doctors?
Estonia lacks family doctors, especially outside Tallinn and Tartu. Dr. Peeter Mardna, the leading inspector of the supervision department of the Health Board (Terviseamet), thinks the situation would be solved if local governments would send people to study somewhere else if their examination results were under the threshold to get into the Faculty of Medicine in a university.
There is currently a shortage of almost 60 family doctors in Estonia and most of the vacancies are outside Tallinn and Tartu.
Peeter Mardna, a member of the supervisory board of East Tallinn Central Hospital, said local governments should make agreements with young students before their medical studies.
He said: "The local government should pay the student for their scholarship. In addition to that, they should sign an agreement that when they discontinue their studies, they have to pay back the support money they got from the scholarship. The contractual obligation should last for three to five years."
Mardna admits that in order to make it easier for young people in rural areas to compete with students at elite schools, the threshold of the medical faculty for municipal scholarship holders should be lowered.
He added: "As the threshold is very high, the students from elite schools have set higher life goals for themselves and do not want to become a family doctor."
In order to apply for a medical degree, the average score of exams must be over 90. According to Mardna, the threshold for family doctors is ten points lower.
Le Vallikivi, the head of the family doctors' association, thinks that this is not a good solution. She said: "What do you mean by lowering the threshold? Does that mean we should make a group of foolish people who will become family doctors? It sounds like that to me. I am sceptical about that as we should not bring down young people's future initiative to become who they want to be."
Ruth Kalda, professor of family medicine at the University of Tartu, also said it is not necessary to lower the threshold because students at ordinary schools are still able to exceed it.
Kalda said: "It is again some kind of prejudice of people who from are critical areas and they do not seem to be able to apply. There are still young people who do not come from Tallinn and Tartu and want to study medicine. They are from Ida-Viru, Pärnu and South Estonia counties. We can see that they are not going back."
Kalda is also sceptical about local governments funding scholarships.
She added: "There has been a discussion before that local government should support and find additional financial help for family doctors. But we found that there are not that many local governments who can afford that."
Mardna said that they should and obligation to maintain a list of family doctors.
Mardna said: "It is the biggest mistake they can make. No one is required by law to ensure that a family doctor has to work somewhere. Otherwise, this system cannot work unless someone has an obligation to provide family doctor care in a certain area."
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Editor: Katriin Eikin Sein