The shortage of family doctors in Estonia is worsening by year, and even now, around a quarter of all working family doctors have already reached retirement age. Which is why the state expanded admissions for medical residency programs in family medicine from 35 to 40.

"As of today, we've apparently accepted 30 family doctors — leaving us short ten," said Ruth Kalda, director of TÜ's Institute of Family Medicine and Public Health. "Surely that's an important number, but of course we won't fulfill our needs."

Several other specialties likewise had to organize a round of followup admissions for their residency programs, but the situation with family doctors is currently most critical.

"The [additional] residency spots weren't filled," said Kersti Esnar, director of the Ministry of Social Affairs' Health System Development Department. "On the one hand, we're creating opportunities, but on the other, there aren't as many {med school] graduates either. And not all of them are prepared to immediately continue with a residency the same year. The root issues go back to how many high school graduates are continuing in higher education."

The medical school program at TÜ has 180 state-financed spots. This September, however, just 169 students will be entering med school, and according to Dean of the Faculty of Medicine Margus Lember, this is because admissions criteria were updated.

Previously, prospective students could apply to med school based on the results of their Estonian language and math state exams. This year, however, requirements were expanded to also include chemistry and physics state exam results, an Estonian language test as well as an interview aimed at assessing candidates' motivation for applying to the program.

"Motivation is important," Lember said. "Over the years, we've seen that it's prestigious to be accepted to med school. Everyone accepted may have very good exam results, but that motivation, that desire to become a doctor, that we've never assessed before. And some 15-18 students have always voluntarily dropped out by November; they'd made the wrong choice. We're hoping that those accepted under the current system are more motivated and better."

While the university didn't manage to fill all 180 spots in its med school program this fall, the dean believes they will going forward.

"There's a huge need for doctors in Estonia, and in the coming years we'll be conducting a thorough audit and med school will likely need to be expanded," Lember said. "Although this is a complex issue — of the number of doctors, their residencies, their choice of jobs following residency. This is a complex issue for the state, not just for the university."

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