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- A wedge is a wedge: medical schools are experiencing difficulties with target enrollment
A wedge is a wedge: medical schools are experiencing difficulties with target enrollment
According to Izvestia, in the 2024-2025 admission campaign, regional medical universities have experienced a serious problem with the closure of target quotas for training. In some cases, the shortage of target students is more than 20%. At the same time, if in the general competition solid A's in all exams do not guarantee admission even to a regional university, a target place can be taken by a straight A student who will eventually fail to cope with his studies. Against this background, the Ministry of Health is going to put target students in the same conditions as other students, introducing a system of mandatory work for all those who have studied for budget money.
What is the situation with target enrollment in medical schools?
According to the data analyzed by Izvestia on the admission of applicants to regional medical universities in 2024, the target places remain a way to enter with very low scores. Moreover, many universities have a significant under-enrollment under this quota.
For example, the Perm Medical University planned to enroll 285 target students in "medical business", but only 222 were enrolled. Only 88 target students were enrolled in pediatrics instead of 135. To enter the specialty "medical business" on target enrollment was enough 133 points. This sum is formed from the results of three USE exams. The applicant scored 42 points in chemistry, 45 in biology and 46 in Russian language. These are triples. And the minimum score for the main set is 231.
The situation is similar in other universities. So, in Rostov State Medical University out of 410 places in the direction "medical business" 323 are allocated under the target quota, but enrolled on it were only 246. The lowest score with which a target applicant managed to enter the university was 140. At the same time, the general competition took only 18 people, and here the lowest passing score - 263. In "pediatrics" similar indicators: 246 out of 259 target places are occupied, and the lowest score - 125. In general competition, 56 people were admitted, and the applicant who "jumped in the last carriage" scored 254 points.
At the Far Eastern State Medical University, 537 people applied for 75 general places, but managed to enter with a score of 217. At the same time, the target admission was understaffed: Khabarovsk Krai planned to train 115 future doctors, but 103 were enrolled. And the lowest score at admission was only 125.
In Krasnoyarsk State Medical University the under-enrollment of target students is quite small - 225 out of 235 planned for "medical business" were enrolled. But even here we can see a huge difference in the quality of applicants by the general competition and target quota: the lower passing score is 255 and 125 points.
Figures on enrollment of students in Smolensk State Medical University are indicative: for "pediatrics" enrollment in the general competition was more than in the target one, 84 people against 53. But the lowest passing score in the competitive main enrollment - 174, and the target quota - 131.
Average passing scores of applicants for the main and target enrollment seriously differ in the Ryazan State Medical University named after academician I.P. Pavlov, and in most other regional medical universities. It is much easier to enter the target quota. This does not mean that there are no capable students among the target students. For example, according to the quota of Khabarovsk region in the Far Eastern Medical University, 21 target students scored more than 200 points. But another 27 scored less than 160.
How many target students reach polyclinics
The Ministry of Health has staked in solving the personnel issue on target recruitment: in 2024, 76% of all places in the areas of "medical business" and "pediatrics" in universities were allocated for the target quota. At the same time, in October 2024, the speaker of the State Duma Vyacheslav Volodin said that only 34% of target students "return to hospitals to work, went into the profession".
He did not specify where this figure was taken from, but his data is partially confirmed by a study published in 2023 by researchers from the Kaliningrad and St. Petersburg Universities. According to their data, medical schools graduate about 70-74% of total enrollment, and of all graduates, up to 30% eventually do not go to work in practical healthcare.
Irina Abankina, a professor at the Institute of Education of the National Research University Higher School of Economics, still considers the numbers of target enrollment in Russia to be quite high, but she admits that the number of target students expelled in the first and second years is also high.
- Guys there are obviously weaker. Many of them do not master educational programs, their training is not enough," she told Izvestia.
At the same time, as Deputy Health Minister Tatyana Semyonova said last year, the health care system in 2023 lacked 29,000 doctors and 63,000 average medical workers.
We would like to add that for a long time target training in the country was only nominally effective, but in recent years, students are more and more often demanding compensation for refusal of the contract. For example, recently a former student of the Chita State Medical Academy was fined Br415.4 thousand for non-fulfillment of obligations under the contract of target training - she was supposed to go to work after training at the Bauntovskaya CRB, but she dropped out of her own accord.
Will the time off from enrollment in medical schools discourage students from enrolling in medical schools?
Meanwhile, the media recently reported on the intention of the Ministry of Health to introduce a system of compulsory work for graduates of medical universities and colleges. It is stated that all students, now studying at the expense of the budget, will have to work for two or three years in a public or private clinic, which is included in the system of compulsory medical insurance. Graduates will be given the opportunity to choose their own region and clinic, but if they do not get employed within a year after graduation, they will have to compensate the budget for the training in a twofold amount.
At the same time, it is proposed to increase the penalty for students who refuse to fulfill the terms of the target training contract. Now they have to pay the full tuition fee.
Badma Bashankaev, the first deputy chairman of the State Duma Committee on Health Protection, considers this approach to be completely fair.
- "If the employment system is extended to all graduates who graduated from higher education institutions on a budgetary basis, it will give an additional incentive to the development of the system of targeted training and will make it possible to achieve more significant results," he told Izvestia. - Targeted students are initially aware of the place of their future work and working conditions at the enrollment stage.
The Trade Union of Healthcare Workers of the Russian Federation opposed such a measure. Its chairman, Anatoly Domnikov, said that it would discriminate against medical students compared to everyone else.
-This idea will simply scare away applicants," he told Izvestia. - It would be better to find a way to oblige all target students to work off the money spent on their education. The personnel issue should be regulated by salaries - if they are not high, we will never solve the problem.
He added that school graduates who are not confident in their own abilities often go to study under the target quota. And compulsory training may also reduce the quality of those applicants who are ready to enter the main enrollment.
Alexei Kurinniy, deputy chairman of the State Duma Committee on Health Protection, told Izvestia that if mandatory distribution is introduced, targeted training will lose its meaning altogether. He called for the target training program to be brought up to date, but "not to change abruptly the long-established conditions for everyone". Sergei Mironov, the leader of the Duma faction "Just Russia - For Truth," said that the introduction of compulsory distribution work should be linked to an increase in salaries and social benefits for doctors, preventing young specialists from working "in difficult conditions, and even for a penniless salary.
Other experts, however, agree with the Ministry of Health's initiative. Irina Abankina notes that the practice of working to confirm qualifications after graduating from medical schools - in fact, working as interns - is practiced in many countries. She is sure that this measure will not scare away applicants, especially those who are going to connect their future life with medicine. At the same time, she believes that young specialists should still be helped to find a job: some form of distribution is needed.
Maria Evdokimova, an ENT doctor and co-founder of the My Clinic medical center, also emphasizes that she sees nothing wrong with students working in the OMC system immediately after graduation.
- The system of target-oriented recruitment, as it seems to me, has much more disadvantages ," said the interviewee of Izvestia. - The admission of graduates with very low scores to the target places does not help our health care system to improve. If we talk about working out the training of those who study on the budget, while high scorers will study on the budget, this is a great idea. Medical schools should initially enroll the strongest graduates.
Larisa Popovich, Director of the Institute of Health Economics at the National Research University Higher School of Economics, believes that the Ministry of Health does not aim to eliminate the imbalance between target students and those who enter the main enrollment with this initiative.
- Themain goal is to solve the problem of staff shortage," she believes. - The idea of compulsory work after graduation for budget money has been floating around for a long time. Some people think that it will scare away applicants, but, in my opinion, students who receive education for budget money in order not to work in the industry in the future are generally not needed.
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