hajra_magyarok said:
Hi All -
I'm currently a medical student in the US. I've always considered moving to Hungary after medical school, but I know nothing about its current medical system.
Is anybody here familiar with the Hungarian medical system?
Could anybody explain to me what the steps that one needs to take in order to become an attending in Hungary are? Take cardiology, gastroenterology or other internal medicine subspecialties as examples. I know people attend medical school after high school for 6 years to receive the MD equivalent. What happens afterwards?
Thanks a lot!
PM me in Hungarian if that's easier.
Are you serious? (If so, I might suggest a psych consult.)
It must have been a very long time since you've been here.
To answer your question, what happens after someone graduates from here is that they almost literally become slaves to the powers-that-be (more on that later).
Post-graduate trainees must complete two years of a rotating internship (confusingly called residency) before starting three years of basic specialty training (gyakornok). At the end of this, one is eligible for the specialty (szakorvosi) exam in internal medicine. To get subspecialty training, you'll need several additional years (I'll ask tomorrow as to how many) before becoming eligible to sit for the subspecialty examination.
Ok, that's no big deal, right? A little different than the U.S., but nothing drastic.
Here come the kickers.
1) Salary. The starting "resident" makes on the order of 85.000 Hungarian Forint per month (at current exchange rates that equals roughly US$450). This only increases by about 10.000 Forint
after the first specialty exam. In some cases the residents may actually make slightly more as they get a small housing stipend on the order of 15.000 Forint, which of course, they lose once they've passed their exam. For the sake of comparison, the
average Hungarian salary is around 100.000 forint per month officially; unofficially it exceeds this, often by a large percentage as many private labor contracts are paid 'under the table' allowing the employer to escape higher social charges and the employee to dodge taxes.
2) Hierarchy. The system is feudal. Think of the worst hierarchal structure in U.S. medicine and multiply it by a factor of about 10. Junior doctors are literally little more than slaves. They perform all the scutwork and get none of the glory or the hálapénz "gratitude money" (e.g. bribes, tips) Worse, promotion is often based on connections and not on merit.
3) A desperately underfinanced system. The Hungarian government in its infinite wisdom spends something on the order of 3.5% of GDP on healthcare. For comparison's sake, the Western European average is about 7-8% of GDP at a much higher total GDP. (The US spends something like 13-14% of GDP, Canada a little less, Germany about 10-11%.) So, the system rations healthcare. For instance, if you are over 75 and not well connected and unwilling/unable to pay bribes, you will find that your treatment will not much exceed supportive care.
With these factors, it is not surprising that young Hungarian physicians are fleeing the country. Now that their diplomas and specialty examinations are accepted all over the continent, they are leaving en masse. Even older physicians are getting in on the game, as they find that they can routinely work abroad (e.g. once a month) pulling a couple of shifts in Britain or Germany, where they'll be paid several times as much as they'll make back home in an entire month.
So, the state of Hungarian medicine at the moment is a mess. If you don't believe me, buy a cheap plane ticket and check it out for yourself.
Hajrá!
Miklos (feeling a little disillusioned after a tough day on the wards)
