"We Can Stop Healthcare System Collapse, But We're Not Wanted Even During Pandemic"

November 20, 2020 - Petra has been waiting for her internship for a year now. She often meets Maja at the employment Bureau, who has been hoping for an internship for two years. Besides her, Petra sees hundreds of other colleagues who were once just like her, the best students of their generations. Despite the endless stories about there being a shortage of medical staff, these same healthcare workers are not being seen as essential to start work, even during the pandemic.

After graduating, they are required to complete a one-year internship, after which they receive a license with which they can be employed. It all seems fine, but internship places hardly open up, and when they do, they lack or some other set up has already been previously arranged.

"The internship can be cancelled," says Petra B., a medical laboratory diagnostician. "As it's a professional study, as part of the study, we're obliged to do a professional internship, that's over 500 hours in different types of laboratories." As such, during school alone, they get acquainted with the job and gain experience working in the laboratory.

Some of the bachelors in physiotherapy, occupational therapy, medical laboratory diagnostics, radiological technology, or sanitary engineering wait for an internship for up to two years, which means they have spent that period browsing on hospital and employment Bureau websites, just waiting for a vacancy. After graduation, many of them exercise their student rights and work for three months in shops, cafes, restaurants, and other places unrelated to their profession. When those three months pass, they're simply sentenced to sit and twiddle their thumbs at home. To get the right to an internship, they mustn't be employed outside of their profession, and it is mandatory to register yourself on the Croatian Employment Service's (CES) unemployment register.

The problem with internships is not only in regard to gaining experience, but that it isn't even possible - it's obligatory to do it, but hospitals aren't obliged to announce a tender and hire an intern. That is, no one guarantees them a time period in which they must wait, and when they can get started with work; months and even years can pass, leading to yet another burning problem - labour shortages.

Not everyone agrees with the abolition of internships, despite the many issues with it. Bachelor of Radiological Technology, Ana K., with all the hours of professional practice she now has under her belt, doesn't feel ready to enter the labour market with such responsibility. She believes that internships are a good experience and an excellent opportunity to learn and improve one's knowledge and skills.

"But, if it's obligatory, then it should be ensured that every person who finishes school automatically gets a place in a hospital and does that internship, and not just do it as it is done now - there are too few places for the number of graduates," says Ana. K., who, as an alternative, proposes shortening the length of service to give as many healthcare professionals as possible the opportunity.

The problem of obtaining an internship has existed for many years in Croatia. Still, as the demand for healthcare workers increases during the pandemic and even retirees are being called upon, bachelors are also waiting for a call, but it hasn't yet arrived. On the contrary, this year, the internship measure was completely suspended until the autumn when the quotas for healthcare professionals were adopted. The total quota for healthcare professionals is 170 employees, including 99 employees in hospitals, 50 employees in health centres, and 21 employees in the Institute of Public Health.

The CES recorded 1277 new unemployed people in the healthcare sector this year. If we take into account that the Medical Polytechnic in Zagreb alone enrolls about seven hundred students every year, it means that a similar number of them are waiting for an internship every single year, in addition to those who graduated in previous years and still haven't received an internship. In addition to Zagreb, health studies also exist in Varazdin, Osijek, Rijeka, Split, Bjelovar and Karlovac.

Physiotherapist Maja B., who has been waiting for her internship for two years now, is especially saddened that her profession is not considered useful even during the time of the pandemic. However, this situation prompted them to raise their voices so that the Ministry of Health could hear them.

"After numerous appearances in the media, interviews and sending letters to the Ministry, they finally remembered us and started with their 'mobilisation' and invited us to work in the Zagreb Arena, which is open as an additional capacity to receive those who are unwell,'' says Maja, who thinks it would be great if that work was recognised as an internship, regardless of its duration. "We help the state, save the healthcare system from collapsing, the state saves on salaries because they'd pay us for maybe 3-4 months, not for a year, and we'd be recognised for our experience much earlier than we would normally. It would be good for us, and also good for them,'' concludes Maja, although she is aware of the fact that this is difficult to achieve.

Although the Republic of Croatia is a member of the European Union, it hasn't abolished internships after college like other member states have. As a reminder, students have to do over 500 hours of practical work during their studies - not only at the faculty but also throughout hospital wards, nursing homes, laboratories, and in various other conditions. However, there is no internship for doctors of medicine and bachelors of nursing in the Republic of Croatia. The study of nursing is part of the Medical Polytechnic of Zagreb, as well as the previously listed fields that are required to complete an internship and earn a license. They are exempted from the internship due to their fifth year of high school, during which they acquire the necessary practical knowledge to start working.

Dissatisfied that the internship as an obligation was not secured, they launched a petition to cancel the internship, which has so far collected over 5,000 signatures. In addition to bachelors, the petition seeks to include scholars who have completed their education and are waiting to be registered at the CES, as well as the upcoming generations of students who have yet to complete their education.

When Petra's friends heard that she had enrolled in the field of healthcare, the reaction was more or less the same: "Good for you, you'll at least have a job." That was one of the reasons for her enrollment in this faculty. The same is true for most of her colleagues. "However, I didn't think that we still wouldn't be desirable even during a pandemic,'' concludes Petra B.

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