The personnel Revolution: what will change for doctors and patients in 2026

The Russian Ministry of Health has prepared a draft order that could significantly change the system of medical and pharmaceutical specialties. The document proposes updating the list of positions in hospitals and polyclinics: from September 1, 2026, more than ten new areas may appear in the industry, and some of the usual specialties may disappear or change. The agency explains the initiative by the need to bring the regulatory framework in line with modern approaches to treatment and the requirements of evidence-based medicine. The current list of specialties is largely outdated and no longer reflects the real needs of the healthcare system. How innovations can affect the work of doctors and patients is described in the Izvestia article.

What will be added to the healthcare system

The Russian healthcare system is waiting for a large-scale update of the list of medical specialties. As follows from the draft order of the Ministry of Health, starting from September 1, 2026, more than ten new areas of training and work of specialists may officially appear in the country.

The document suggests expanding the list of professions that until now either existed only as narrow areas within other specialties, or did not have an official status in Russian medicine at all. In particular, the Ministry of Health proposes to include in the list medical biology, whose specialists will be engaged in laboratory diagnostics at the junction of biology and medicine, as well as medical physics — this area is associated with the maintenance of complex diagnostic and radiotherapy equipment.

Speech therapists and medical psychologists can receive a separate status. Nowadays, such specialists often work in the education system or in healthcare institutions without a clear definition of the profession in the medical nomenclature. The project also talks about the emergence of neuropsychology, a field related to the diagnosis and restoration of higher mental functions after brain damage.

Among the new specialties are embryology, related to reproductive technologies and artificial insemination procedures, as well as nutritionology, a field focused on developing personalized nutrition schemes and expanding the possibilities of nutritional care. In addition, the Ministry of Health proposes to officially separate medical massage into a separate specialty with its own educational standards.

A significant part of the changes concerns rehabilitation medicine. The list is planned to include physical rehabilitation, whose specialists help patients recover from injuries, operations and strokes, as well as ergorehabilitation aimed at restoring everyday skills and developing fine motor skills in people with disabilities. In addition, the project provides for the creation of a specialty "chemical expertise" for work in forensic and toxicological laboratories.

As noted in the document, updating the list should eliminate the accumulated contradictions between the actual practice of healthcare and the formal list of positions. Many specialists are already working in Russian clinics and laboratories, but their activities have not yet been fully reflected in the regulatory framework.

Which specialties are offered to be excluded

Along with the expansion of the list of medical areas, the Ministry of Health proposes to abandon a number of specialties that the department considers outdated, excessively narrow or duplicating the functions of other doctors.

In particular, the specialty of a diabetologist may disappear from the list. It is assumed that general endocrinologists will be involved in the management of patients with diabetes mellitus. A similar approach is proposed in other areas of medicine, where, according to the authors of the document, there has been an excessive fragmentation of professions. For example, the specialty of an ophthalmologist-prosthetist is planned to be abolished, transferring its functions to ophthalmologists and prosthetic engineers.

Positions related to the age division of patients may also be removed from the system. We are talking about city and district pediatricians, adolescent therapists and adolescent psychiatrists. The Ministry of Health believes that district pediatricians, internists, as well as child and adult psychiatrists will be able to provide medical care to children and adolescents without additional division by administrative or age principle.

The project also provides for the exclusion of some narrow-profile areas. For example, a separate specialty sexologist may no longer exist: it is assumed that the issues of sexology will remain in the competence of psychiatrists, urologists and other specialized specialists. A similar situation will be with prosthetic sign language specialists - their functions are proposed to be distributed between sign language specialists and prosthetic engineers.

In addition, the positions of zoologist and entomologist are planned to be removed from the list. The authors of the document point out that these areas relate primarily to biological science and should not be part of the structure of medical organizations. The changes will also affect secondary medical personnel: the position of a paramedic-narcologist may disappear from the nomenclature, while the functions of such specialists will remain with ambulance paramedics and nurses working in narcology.

The explanation to the draft order emphasizes that it is not a question of a complete abandonment of relevant functions or areas of assistance. They want to redistribute them among broader and more universal specialties. According to the developers of the document, this approach will simplify the human resources system of healthcare, reduce the shortage of specialists and get rid of excessive narrow specialization, which often complicated the organization of medical care.

New position in medicine

Since April 1, 2026, a new medical specialty has officially appeared in the Russian healthcare system — a doctor in the field of healthy longevity medicine. The corresponding position was introduced within the framework of the State Guarantees Program and became one of the first practical steps of the state to develop preventive medicine and increase the active life expectancy of the population.

The new specialists are not engaged in the treatment of existing diseases, but in the early detection of risk factors and the prevention of age-related health disorders. Their responsibilities include assessing the biological age of the patient, analyzing the causes of accelerated aging of the body, identifying the risks of diseases, as well as developing personalized recommendations on lifestyle, prevention, and further medical support. If necessary, specialized specialists will be involved in monitoring the patient.

The work of doctors in the field of healthy longevity medicine is organized in the Centers of Healthy Longevity Medicine, which are created on the basis of existing Health Centers. They work on the principle of comprehensive patient support.

The new specialty requires basic education in pediatrics or medical science, as well as training in therapy or general medical practice. In addition, such centers provide additional professional education programs for doctors in other fields who wish to specialize in aging prevention and health care.

The reaction of the professional community

The proposed changes have already caused an active discussion in the medical community. Practitioners, representatives of specialized associations and experts in the field of healthcare generally support the idea of updating the specialty system, but experts' opinions differ markedly on a number of points.

Supporters of the reform believe that the current nomenclature of medical professions has really needed to be reviewed for a long time. According to them, many areas of modern medicine actually exist and are actively developing, but at the same time they have remained outside the official system for years. This is especially true for medical physics, embryology, neuropsychology, ergorehabilitation and other interdisciplinary fields, without which it is impossible to imagine the work of large clinics and high-tech medical centers today.

Separately, experts pay attention to the development of rehabilitation medicine and a preventive approach. The emergence of new specialties related to recovery from injuries and strokes, as well as the introduction of a doctor in the field of healthy longevity medicine, is widely considered a reflection of the global trend towards preventive medicine and comprehensive patient support. According to some experts, the official establishment of such professions will create understandable standards of training and improve the quality of medical care.

At the same time, part of the medical community is cautious about the reform. The proposal to exclude a number of narrow-profile specialties caused the greatest controversy. Critics of the initiative fear that the abandonment of certain areas, such as sex pathology or adolescent psychiatry, may lead to a decrease in the availability of specialized care for patients. According to some doctors, combining functions within broader specialties does not always take into account the specifics of complex psychological and age-related conditions that require separate training and experience.

Concerns are also related to the staffing situation in healthcare. Some experts point out that expanding the responsibilities of doctors in related fields may increase the burden on already scarce specialties, primarily internists, psychiatrists, and endocrinologists. In addition, the transition to the new system will require a review of educational programs, accreditation standards, and additional training for existing specialists.

What will happen next

The draft order of the Ministry of Health is currently undergoing a public discussion stage. If the document is adopted without significant changes, the new list of medical and pharmaceutical specialties will enter into force on September 1, 2026.

The reform will require changes both from the medical education system and from the medical institutions themselves. Universities will have to develop new residency and retraining programs, and hospitals and polyclinics will have to review staff schedules and qualification requirements.

The Ministry of Health expects that updating the system will make medical care more modern, and it will be easier for patients to get help from specialists whose qualifications are officially fixed at the state level.