Shortage of Emergency Medicine Specialists: Only 129 Doctors in Bulgaria Have “Emergency Medicine” Qualification

There is a shortage of emergency medicine specialists in Bulgaria. According to data from the Ministry of Health, there are 129 doctors with this specialty in the country.

In the emergency medical centres nationwide, there are nearly 1,390 posts, of which 378 remain vacant. The greatest shortage of doctors in emergency care is in Sofia, Varna and Pleven. Hospitals’ emergency departments are also facing staffing problems.

Dr. Ventsislava Markova works in the intensive care unit of the hospital in Pernik. She also assists in the emergency department because she has specialised in emergency medicine.

Dr. Ventsislava Markova, ICU, MBAL “Rakhila Angelova”, Pernik:

“Things are seen in a different way. The patients who need us are most often in a very serious condition. We have to respond immediately – on the spot.”

She worked in an ambulance for six years but gave it up due to low pay and difficult working conditions.

Dr. Ventsislava Markova, ICU, MBAL “Rakhila Angelova”, Pernik:

“People think that emergency medics who travel in ambulances are just ordinary taxis and are used only as porters and transport. This essentially makes the job meaningless.”

Few of the doctors working in ambulances have specialised in emergency medicine.

Dr. Ventsislava Markova, ICU, “Rakhila Angelova” general hospital, Pernik:

“It is a problem because there are cases where exactly these skills are required – the ones taught during emergency medicine training. To resuscitate a patient, to restore cardiac activity, to intubate them.”

Both ambulance teams and hospital emergency departments can be staffed by doctors without a specialisation in emergency medicine, the Ministry of Health explains. It states that paramedics and medical assistants graduating in the country could help cover the shortage in emergency centres. However, there is high staff turnover in both ambulance services and emergency departments.

Dr. Krasimir Dzhinzov, Director of the National Cardiology Hospital: “Ideally, every emergency department should have an anaesthesiologist-resuscitation specialist or an emergency medicine specialist approved by the Ministry of Health. There are not enough specialists because it is a very intensive specialty.”

Simeon Ivanov graduated as a doctor last year. For the past few months he has been working in the emergency department of the National Cardiology Hospital, but does not want to specialise in emergency medicine.

Dr. Simeon Ivanov, Emergency Department, NCH:

“The responsibility we carry is very high, including criminal liability. And this is perhaps a major reason why the specialty is not attractive.”

The state prioritises funding for training positions in emergency medicine, the Ministry of Health says. It also notes that specialties with low salaries are those facing the greatest shortage of staff.