Lithuania's New Policy Requires Young Doctors to Work in Regions for Five Years
On Thursday, the Lithuanian parliament voted to introduce additional budget places in medical residency programs.
However, there is a catch.
The government covers the training costs, but upon enrollment, young doctors must sign a contract requiring them to work for five years in regions with a shortage of medical staff after completing their residency.
Young doctors are unhappy with this and plan to challenge the new regulation in the Constitutional Court.
“This measure is populist in nature,” said Laurynas Maciulevicius, chairman of the Lithuanian Young Doctors Association. The goal is to ensure access to medical care in regions lacking specialists, but he argues that “it does not address the fundamental question: why do doctors choose or, conversely, avoid working in these regions?”
According to social democrat Orinta Leipute, young doctors will still have the option to complete their residency without the obligation to work in regions for five years.
“It’s a matter of choice,” Leipute said in a press release. “If a young doctor does not want to study with subsequent obligations, they simply will not choose such places and will apply for existing positions that do not carry obligations.”
However, the chances of securing such a position are slim. Only 20 out of 385 budget places in residency across the country will not be tied to the five-year commitment in regions. Leipute stated that the number of budget places without obligations will remain at the current level. Young doctors can also opt for non-budget training.
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In Lithuania, there are more doctors per 10,000 residents than the average in the WHO European Region, surpassing Switzerland and only slightly trailing Germany. However, the overall number of doctors in European countries is declining due to an aging population and unattractive working conditions. Leipute estimates that by 2032, Lithuania will lack 269 general practitioners, 207 therapists, and 146 pediatricians.
Young doctors agree that regions need access to medical care, but they believe the core issue remains unresolved. “Regions need not doctors tied for five years, but a system where doctors want to stay,” Maciulevicius says, adding that no analysis of root causes, impact assessment, or clear justification for why the five-year commitment model would be the best measure has been presented.
Not a Panacea
According to social democrat Leipute, this measure is not a panacea but merely complements existing initiatives to attract doctors to regions, such as additional scholarships, relocation bonuses, or housing provisions.
“There is also consideration of how to make regional positions more attractive for older doctors who may no longer want to work in university clinics or large medical centers with particularly high workloads,” Leipute said.
Liberals have already criticized these changes, fearing a counterproductive effect. “The parliamentary majority has undermined the constitutional principle of personal self-determination,” said the chair of the Liberal Movement. “It is impossible to impose forced equality in healthcare; on the contrary, coercion will only push more doctors to leave and emigrate.”
As noted in a WHO report, several European countries have already implemented various strategies to address the shortage of medical staff in less attractive regions.
In Finland, authorities are trying to expand access to medical care by redistributing the geography of training locations for doctors, expanding nurses' powers, and offering incentives—higher salaries and more flexible working hours—to encourage doctors to settle in remote areas.
Latvia has taken a different approach. Medical universities prioritize applicants willing to work in rural areas after graduation. Doctors practicing in such regions may receive monthly bonuses, increased per capita payments, and additional financial support, including funding for professional development.
The new rules are set to take effect in 2027.
