State Duma Advances Controversial Bill Mandating State Service for Medical Graduates to Address Healthcare Workforce Shortage

On Tuesday, Russia’s State Duma, the lower house of parliament, approved a bill mandating that new medical graduates serve in state hospitals and clinics for a period of up to three years. This initiative aims to address the persistent shortages of medical staff within the public healthcare system.

The proposed legislation, which revives a concept from the Soviet era, stipulates that medical graduates must undergo a «mentorship» period in publicly funded clinics that are part of the mandatory health insurance scheme. The Russian Health Ministry will determine which graduates will be required to participate as well as the length of their mentorship placements.

Graduates who decline to participate in this mentorship program may face repercussions based on the funding of their education. Those whose tuition was subsidized in return for an obligation to serve in the public sector will be required to reimburse their educational institution and incur a penalty of 200%. Meanwhile, self-funded graduates and others could risk having their medical licenses temporarily revoked.

If this legislation receives approval from the Federation Council, the upper house, and is signed into law by President Vladimir Putin, it will take effect on March 1, 2026, applying to graduates from that year onward.

Vyacheslav Volodin, the speaker of the State Duma, highlighted the issues of overworked hospital staff and an excessive number of patients, which are straining Russia’s public health services and compromising care quality. He referenced estimates indicating a deficit of approximately 23,300 doctors and 63,600 mid-level healthcare workers as of early 2025.

The bill was passed unanimously after minor procedural adjustments, as reported by independent journalist Farida Rustamova. She noted that two lawmakers raised concerns that the mentorship requirement might deter young medical professionals from fulfilling their obligations, particularly in rural areas, due to the lack of housing and other supportive measures not addressed in the bill.

Historically, the Soviet healthcare system assigned newly graduated physicians to specific facilities for terms ranging from three to five years.