1. Human Resource Planning: Lithuanian Physicians in the Process of Accession Zilvinas Padaiga Vice-Rector Kaunas University of Medicine Lithuania 6 th European Health Forum Gastein 1 st - 4 th October 2003 "Health and wealth - social and economic dimensions of health"

2. Based on: 1. Survey of WHO Liaison Officers of 8 accession countries (BUL, HUN, LVA, LTU, POL, ROM, SLO, SLK) – training, licensing, employment and planning of HHR; 2. Survey of physicians and residents in LTU re potential migration to EU and other countries after accession; 3. Prognosis of number of physicians until the year 2015 in LTU; 4. Survey of experts re recommended number of physicians in LTU during the next decade – Delphi study; 5. WHO HFA DB, National License Registry, Sickness Fund DB, National Health Information Center DB, Universities.

3. Number of physicians per 10,000 population, 1990 - 2000 SOURCE: WHO. (2000). Health For All Data Base (Statistical Data Base). Copenhagen: World Health Organization Regional Office for Europe

4. Number of graduated physicians per 100,000 population, 1990 - 2000 SOURCE: WHO. (2000). Health For All Data Base (Statistical Data Base). Copenhagen: World Health Organization Regional Office for Europe

5. Messages: From 8 accession countries surveyed: Intake of students planned on demand - 4 countries Experience in planning HHR -limited Unemployment of physicians -no (exc. BUL) From WHO and EU: Recommendations for or coordination of planning HHR -absent

6. Percentage of physicians and medical residents intending to go abroad, Lithuania, 2002

7. Reasons for leaving (physicians and residents): Higher salary->70% Higher quality of life ->50% Better possibilities for carrier ->40% Countries of interest: Residents - Nordic (Denmark, Norway, Sweden); UK; Germany. Physicians – Germany; UK; Nordic (Norway, Sweden, Denmark).

10. Britain to train thousands more health staff Last Updated: 2003-02-17 10:00:43 -0400 (Reuters Health) By Richard Woodman LONDON (Reuters) - Thousands more training places are to be funded for nurses, midwives and other health workers in a bid to tackle staff shortages in the National Health Service, ministers announced on Monday. Health Minister John Hutton said more than £3.4 billion would be spent over the next year supporting the learning and development of healthcare staff, an increase of more than 12%. By 2005/06, the budget would be £4.1 billion a year, 36% more than now. This includes £1.99 billion on training for nurses, allied health professionals and healthcare scientists; £746 million for training undergraduate medical and dental students and £1.37 billion for doctors and dentists on specialist training.

11. Risk factors for intention to move abroad, physicians Risk factorOR95% CI Male1.080.58-2.01 Age (years)0.940.91-0.96 Life in the city1.050.65-1.70 Knowledge of English1.600.96-2.67 Married / cohabiting1.120.58-2.15 Visit abroad for professional reasons 1.180.67-2.07 Having friends abroad3.221.91-5.42

12. Risk factors for intention to move abroad, residents Risk factorOR95% CI Male1.210.68-2.15 Age (years)0.970.87-1.09 Life in the city2.040.88-4.71 Knowledge of English1.900.83-4.36 Married / cohabiting1.590.33-1.06 Visit abroad for professional reasons 3.291.73-6.27 Having friends abroad1.340.76-2.34

13. Planning of LTU physicians number until 2015 based on assumptions: Annual population growth: -0.06% Annual drop out due to retirement: 1.92% Annual mortality rate: 1.08% Drop out due to other reasons: 1% Drop out from studies: 17% Average duration of studies: 9 years Recommended number of physicians per 10,000 population: 33.5

14. Projected number of physicians per 10,000 pop. (without administrators) till 2015

15. So what? Is there any sense to plan HHR on the national level without cooperation with other countries? Who will take the initiative? Who should be involved – universities, research, professional associations, MoH, MoE, MoF? Accession might have substantial impact on numbers of physicians as well as other HHR if no cooperation will be started.