It's sad in the back: there has been a shortage of rheumatologists in Russia for five years

An acute shortage of rheumatologists has been observed in Russia for the past five years, said Alexander Lila, chief freelance rheumatologist at the Ministry of Health, speaking at a round table in the State Duma. According to him, the need for such specialists is only half closed in the country. There is a shortage of personnel in almost all regions of the country, experts confirmed to Izvestia. In Russia, more than 20 million people live with rheumatic diseases, and almost one in two of them has a disability. How they propose to solve the problem is described in the Izvestia article.

Why are there not enough rheumatologists?

As of February 2026, there are 1.5 thousand rheumatologists working in Russia, which is only half of the required number of doctors of this profile. This was stated by Alexander Lila, chief freelance rheumatologist at the Ministry of Health, Director of the V.A. Nasonova Scientific Research Institute of Rheumatology.

"For example, there is only one rheumatologist working in Kamchatka for the entire region," he said during the State Duma round table "The main vectors of the strategy for combating rheumatic diseases."

The expert stressed that all medicines necessary for effective treatment of rheumatic diseases are available in Russia, but new technologies require a high level of education of doctors. However, in 2025, the Russian Medical Academy of Continuing Professional Education in Moscow, according to him, graduated only two rheumatology residents.

— This happens because this is targeted training, and the regions do not apply on time, — says Alexander Lila.

The shortage of doctors of this profile has been observed in almost all regions of Russia for about five years, Polina Pchelnikova, president of the Russian Rheumatology Association Nadezhda, confirmed to Izvestia.

— Because of this, the diagnosis period is extended. There is a so—called "window of opportunity" — this is the first 12 weeks, when the patient must be diagnosed and treated in order to have the most positive prognosis," the expert noted. "Otherwise, events may occur that significantly affect disability and premature death.

The lack of specialized specialists leads to the fact that patients cannot adjust their treatment in time. Waiting times for consultations and hospitalization now average three months, although the legal norm is 14 working days.

"We do not have a systematic program in our country to preserve and increase the number of rheumatologists," Polina Pchelnikova complained. — The assistance is only of a local nature. If support measures are taken in a particular subject and institute, then young rheumatologists appear there. The rest of the regions remain at a disadvantage.

Izvestia sent a request to the Ministry of Health with a request to tell how the number of doctors in this field has changed over the past three years and in which regions there is a shortage of rheumatologists in 2026.

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What is the situation in the regions

In 2025, the Moscow Regional Scientific Research Clinical Institute named after M.F. Vladimirsky graduated ten rheumatologists, said Dmitry Karateev, professor of the Department of Therapy at the Faculty of Advanced Medical Training, chief freelance rheumatologist at the Moscow Region Ministry of Health.

— It's not much, but I hope that the growth will continue, — said the doctor during the round table of the State Duma. — About 200 thousand rheumatic patients are registered in the Moscow region per year, of which 30 thousand people suffer from severe forms of diseases.

He noted that in 2017, biological therapy (modern genetically engineered drugs. — Ed.) there were 500 patients, now there are 2.5 thousand.

— Despite the multiple growth, we are not yet reaching the target parameters for the provision of biological drugs. There is a big difference not only between regions, but also between municipalities of the same region. First of all, it depends on the personnel issue.

The shortage of staff seriously complicates the work, Evgeny Trofimov, head of the Department of Therapy and Rheumatology named after E.E. Eichwald, scientific secretary of the I.I. Mechnikov Northwestern State Medical University, agreed.

— The theses that rheumatologists should be trained in a larger volume are absolutely correct. At our department in St. Petersburg, we graduate 10-15 rheumatologists annually, this is a residency plus professional retraining cycles. The admission control figures are obtained as a result of the applications that the regions give us. We are ready to increase the number of interns we graduate by two to three times. We have all the capacities and the clinical base for this," Evgeny Trofimov assured.

The creation of an appropriate national program will help to draw attention to the field of rheumatology, says Tatyana Dubinina, Chief rheumatologist of the Central Federal District, Head of the Laboratory of Medical and Social Problems in Rheumatology at the Nasonova Federal State Medical Research Institute.

— To cope with the personnel shortage, it is necessary to increase interest in the specialty of rheumatology, to make sure that future medical students know about it, — she said. — Now we have ten times more cardiologists than rheumatologists, 20 times more neurologists, and 15 times more oncologists. The population still confuses a rheumatologist with an intensive care specialist.

Tatiana Dubinina complained that patients with back pain, which may be a manifestation of Ankylosing spondylitis (a chronic disease of the spine and joints. — Ed.), come to the doctor only 15 months after the first symptoms appear.

"They don't even consider a rheumatologist as a specialist who could help them," the doctor complained.

Rheumatology centers are most often located in large cities, so sometimes a patient needs to travel 300 kilometers or more to see his doctor, Tatiana Dubinina noted.

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How many people in Russia have rheumatic diseases

Rheumatic diseases affect tendons, muscles, and other tissues of the musculoskeletal system. There are about 200 types of such pathologies, among them rheumatic arthritis, gout and systemic lupus erythematosus.

In particular, women of childbearing age are most often affected by systemic lupus erythematosus, Alexander Lila said. He also said that the average age of rheumatology patients in Russia is 48 years.

There are more than 20 million patients with similar diseases in the country, and one in two of them has a disability, Ruslan Dreval, a member of the Russian Ministry of Health's specialized commission on Rheumatology and director of the Center for Social Economics, said at the round table.

— Rheumatic diseases are in the third or fourth place in terms of contribution to a patient's disability both in Russia and around the world, - said the specialist. — Studies show that they are often accompanied by cardiovascular diseases (from which they increase mortality by 50%), cancer and diabetes. However, we have a large arsenal of biological drugs available in our country, the treatment of which shows good results," Ruslan Dreval pointed out.

The expert is sure that the statistics of the Ministry of Health on the number of such patients differ from the real state of affairs in the regions — there is no federal register of rheumatological diseases in Russia.

— If we do not know the exact number of patients, their profile and needs, it is very difficult to plan financing, — Ruslan Dreval stated. — This is a serious barrier. Unfortunately, today we cannot say that we fulfill all the true needs of our patients. In addition, the subjects are not able to provide full coverage of needs from regional budgets. It's no secret that patients are forced to sign up for waiting lists.

Polina Pchelnikova added that in the regions, the main freelance rheumatologists maintain their patient registers on their own initiative.

"Employees of private clinics should also be given the opportunity to enter their data so that the register is complete," she said at the State Duma round table.

Alexander Lila suggested launching a program to combat rheumatic diseases throughout the country. In his opinion, the first step could be the creation of a federal registry. The participants of the round table are going to send a corresponding appeal to the Ministry of Health.