Abstract

Aim and objectives. Recruitment of physicians and nurses to work abroad calls to increase the supply of medical graduates, however, until now the professional mobility and age structure of health workers has not been studied or taken into account in Estonia while planning the quota for medical schools. The objective of this study was to estimate the number and age structure of the physician workforce in different scenarios, which take into account changes in the supply and professional mobility of physicians.

Materials and methods. Individual data on physicians, registered at the Health Board in April 2012, was linked to the list of 2007–2011 medical graduates from the Faculty of Medicine and to the 2012 list of postgraduate students in specialist medical training (residency) at the University of Tartu. This data was used to calculate agespecific annual probabilities to work as a physician in Estonia or to leave abroad, and to build a simple model for predicting the physician workforce in case of different scenarios.

Results. There were 4521 active physicians in Estonian health care in 2012 and 15% of them were aged 65 years or older. As compared to 1998, the total number of active physicians was the same, but the number of those under 65 years of age had decreased by 518. Annual probability of leaving Estonia decreased from 3% to 0.4% in parallel with increasing age. Until 2019 the number of physicians under 65 years of age will continue to decrease as there are less medical students studying than the number of working physicians in the age group of 59–64. In order to keep the number of physicians 3 per 1000 population (European average) by 2032, the mobility of physicians abroad should decrease by half, and the annual admission of medical students should be at least 200.

Conclusion. In order to keep the number of physicians in 2032 in Estonia at the level of 2012, it is necessary to increase the reserve of medical graduates as well as to decrease the professional mobility of physicians.