Health
Europe Faces Persistent Doctor Shortages Despite Rising Graduate Numbers
Doctor shortages continue to challenge healthcare systems across Europe, driven by an ageing workforce and a declining interest among graduates in general practice.
Every year, thousands of students complete their medical studies in Europe, yet the region still struggles to meet demand for healthcare professionals. In 2023, over 66,000 doctors graduated in the European Union, equivalent to roughly 15 graduates per 100,000 inhabitants, according to Eurostat. Numbers vary widely between countries, with Türkiye producing 13,720 graduates, Germany 10,186, and Italy 9,795. At the other end of the spectrum, only 31 doctors completed their studies in Montenegro, 52 in Iceland, and 144 in Estonia.
A significant share of graduates in countries such as Bulgaria, Romania, and Latvia are foreign nationals, many of whom leave the country after completing their studies. This has turned some nations into training hubs for doctors while widening regional disparities. Romania, however, has managed to reduce doctor migration over the past decade. According to the World Health Organization (WHO), the number of doctors leaving Romania fell from 1,500 in 2012 to 461 in 2021, thanks to improved pay, training, and working conditions.
“Health worker migration is a reality in our interconnected and globalised world, and we have the solutions to ensure it works for all parties. Countries can learn from each other’s experiences,” said Natasha Azzopardi-Muscat of WHO Europe. She added that failing to manage workforce movement fairly risks worsening health inequities and leaving fragile healthcare systems unable to cope.
Despite more graduates entering the system, shortages remain acute, particularly among general practitioners (GPs). While the overall number of doctors has grown in most countries, only about one in five in the EU work as GPs. Tiago Villanueva, a family physician and president of the European Union of General Practitioners/Family Physicians, told Euronews Health that graduates increasingly choose specialised fields, such as dermatology or ophthalmology, for better work-life balance and quality of life. He added that the solution lies in making general practice more visible and appealing, rather than simply increasing the number of medical graduates.
Europe’s doctor shortages are unevenly distributed. Austria has the highest ratio of practising doctors at 551 per 100,000 inhabitants, followed by Italy and Cyprus at 535, while Finland has the lowest at 288 per 100,000.
Ageing of the healthcare workforce adds further pressure. In 2023, nearly one-third of doctors in EU countries were over 55, according to OECD data. Countries with large shares of older doctors will need to train sufficient numbers of new professionals while encouraging those nearing retirement to continue working where possible.
With a projected shortage of 950,000 health workers by 2030, Europe faces a critical challenge in balancing rising graduate numbers with the need to retain talent and fill vital roles in general practice and other essential specialties.
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Uzbekistan to Launch Nationwide State Medical Insurance System in 2026
Uzbekistan will begin introducing a nationwide state medical insurance system from 2026, part of a broader overhaul of the country’s healthcare financing and service delivery. The reform will introduce digital referrals, a national health insurance fund, and a guaranteed package of essential medical services funded through the state budget. Officials say the changes aim to improve efficiency, expand access, and reduce informal payments.
“State health insurance is a social protection system designed to guarantee access to quality healthcare services,” said Zokhid Ermatov, executive director of the State Health Insurance Fund.
Discussions about state medical insurance in Uzbekistan began in 2017, but implementing such a system required years of preparation. The State Health Insurance Fund was formally established in December 2020, and pilot programmes launched in the Syrdarya region in 2021 tested new financing mechanisms, regulatory frameworks, and digital health systems. In November 2025, the Cabinet of Ministers approved regulations governing how medical care funded through the state budget will be provided in public and private medical institutions, with the rules set to come into force on January 1, 2026.
At the centre of the new model is stronger primary healthcare. Patients will first visit their assigned family clinic, where doctors provide consultations, prescribe tests, and determine whether specialist care is needed. If necessary, patients will receive an electronic referral to hospitals or specialists. Emergency and urgent care will remain available without referrals.
The reform introduces a patient-centred financing model, where healthcare providers are paid by the State Health Insurance Fund based on services delivered. Primary healthcare will be funded through capitation payments, while hospital treatment will follow case-based payments, a structure designed to improve efficiency and treatment outcomes.
A fully digital referral system will allow patients to choose hospitals from a list of institutions contracted with the State Health Insurance Fund using a government portal or mobile app. Referrals will remain valid for 60 days, and waiting lists and hospitalisations will be managed through a unified electronic health information system.
The insurance system guarantees essential healthcare services, including family doctor consultations, diagnostic tests, outpatient treatment, preventive screening, some medicines, hospital care, and certain rehabilitation services. Patients will not be charged additional fees for services included in the approved package.
Funding for the program will come primarily from the state budget, ensuring citizens do not pay direct insurance contributions. Priority access will be given to socially vulnerable groups, including children with disabilities, orphans, pensioners, pregnant women, unemployed citizens, and low-income families. The State Health Insurance Fund will allocate resources across regions to strengthen medical services and reduce inequalities.
International organisations have praised Uzbekistan’s approach, noting that general tax financing and universal coverage can improve financial protection and ensure predictable healthcare funding. Jessika Yin, Health Policy Adviser at the World Health Organization in Uzbekistan, said the reforms align with global trends toward universal health coverage.
If implemented successfully, Uzbekistan’s state medical insurance system could represent a major step toward universal healthcare, ensuring that people receive care without facing financial hardship.
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