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Background There is an alarming shortage of medical personnel in Poland, which seriously affects the healthcare system and access to medical services. This study aims to identify possible actions aimed at mitigating and preventing staff shortages in Poland. Methods A qualitative study was conducted as semi-structured in-depth interviews with 15 key stakeholders of the Polish healthcare system. Interviews were conducted from April to July 2024 via the MS Teams platform. A directed content analysis of the interviews was conducted using NVivo software. Results Respondents indicated the need to develop and implement a long-term plan for the functioning of the healthcare system and medical personnel, which takes into account technological development, demographic and generational changes. Interprofessional cooperation, improved financing and working conditions, better management of available resources and attention to mental health, and implementation of activities aimed at preventing further employee outflow and burnout are necessary. It is also desirable to promote professions and educate from the youngest age - transparently showing and encouraging graduates to take up medical professions. Conclusions Possible actions to implement, aimed at reducing and preventing the shortage of medical staff in Poland, include preparing and implementing a long-term plan based on reliable data. The involvement of various entities should be enforced, taking into account management, financing and education. In addition, desirable actions concern the analysis of the needs of employees and the difficulties they face at work. Highlights Wide, long-term plan is vital for Polish healthcare workforce sustainability. Mental health support is critical to stop the outflow of health workers. Investing in education and promotion of health professions is needed. IT solutions and improved working conditions may reduce the workforce shortage.

Young doctors' choice of medical specialty is essential to maintaining a sufficient health workforce and developing a sustainable healthcare system. The choice of specialization is the result of numerous factors, including doctors' preferences, population needs, and the number of available residency slots. The aim of this article is to explore the factors taken into consideration by young Polish physicians in choosing their future specialty. We have conducted 30 structured interviews with randomly selected recent medical school graduates (17 female and 13 male). The study was conducted from December 2022 until February 2023 using online platforms. Data from in-depth interviews were coded using NVivo Release 1.6.1. Then thematic analysis was performed. Respondents indicated remuneration and career-associated factors as the main determinants, emphasizing that work-life balance, personal motivations, and the flexibility to choose the type of workplace (hospital vs. outpatient clinic) were even more important. Young doctors expect flexibility in working hours and better working conditions in future work, and these factors are important when choosing a medical specialty. Significant difficulties during the selection of medical specialty include limited residency slots in preferred specializations and lack of knowledge concerning the everyday aspects of work in a particular specialty. Factors and limitations influencing the choice of medical specialty should be taken into account by policymakers to address the shortages of doctors in deficit specialties. Knowledge about doctors' preferences regarding their medical specialty could support the development of targeted policies to increase the attractiveness of deficit specialties and reduce the uneven distribution of medical staff.

After the fall of communism, the healthcare systems of Central and Eastern European countries underwent enormous transformation, resulting in departure from publicly financed healthcare. This had significant adverse effects on equity in healthcare, which are still evident. In this paper, we analyzed the role of government and households in financing healthcare in eight countries (EU-8): Czechia, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia, and Slovenia. A desk research method was applied to collect quantitative data on healthcare expenditures and qualitative data on gaps in universal health coverage. A linear regression analysis was used to analyze a trend in health expenditure over the years 2000–2018. Our results indicate that a high reliance on out-of-pocket payments persists in many EU-8 countries, and only a few countries have shown a significant downward trend over time. The gaps in universal coverage in the EU-8 countries are due to explicit rationing (a limited benefit package, patient cost sharing) and implicit mechanisms (wait times). There is need to increase the role of public financing in CEE countries through budget prioritization, reducing patient co-payments for medical products and medicines, and extending the benefit package for these goods, as well as improving the quality of care.

The choice of medical specialty for future doctors is a multidimensional issue, associated with many factors. This study aimed to explore the factors influencing the specialty choices of doctors entering the Polish healthcare system. A nationwide cross-sectional survey was conducted from May until August 2023. The data was gathered via an online nationwide survey among recent medical school graduates. We explored respondents’ preferences regarding medical specialties (in two categories: surgical and non-surgical), and the factors that drive their choices. The U-Mann Whitney test was used to compare the distribution of 19 analysed factors, and the chi-squared test was used if a trend was not observed. 737 responses were collected, and 698 were included in the study. The respondents (60.5% female) preferred non-surgical specialties over surgical ones. The main factors influencing doctors’ choices were remuneration, the ability to maintain work-life balance, interest in the medical field, the ability to start a private practice, skills possessed, and doctor-patient interactions. Doctors pursuing a career in surgical fields are driven by slightly different factors than those who chose a non-surgical specialty. The youngest generation values a healthy work-life balance, and their non-professional life remains crucial.

Background: Due to the significant staff shortages, emigration of health professionals is one of the key challenges for many healthcare systems. Objective: The aim of this article is to explore the estimated trends and directions of emigration among Polish health professionals. Methods: The emigration phenomenon of Polish health professionals is still under-researched and the number of studies in this field is limited. Thus, the authors have triangulated data using two methods: a data analysis of five national registers maintained by chambers of professionals (doctors, nurses, midwives, physiotherapists, pharmacists, and laboratory diagnosticians), and data analysis from the Regulated Profession Database in The EU Single Market. Results: According to the data from national registers, between 7–9% of practicing doctors and nurses have applied for certificates, which confirm their right to practice their profession in other European countries (most often the United Kingdom, Germany, Sweden, Spain, and Ireland). The relatively high number of such certificates applied for by physiotherapists is also worrying. Emigration among pharmacists and laboratory diagnosticians is rather marginal. Conclusions: Urgent implementation of an effective mechanism for monitoring emigration trends is necessary. Furthermore, it is not possible to retain qualified professionals without systemic improvement of working conditions within the Polish healthcare system.

Background The expansion of medical schools is one of the proposed solutions to shortages in health workforces. Poland has been struggling with limited human resources in healthcare for years. The aim of the study was to provide an analysis of the current situation of medical education in Poland and to describe the impact of the government’s ongoing measures to provide a new influx of doctors. Methods A retrospective, cross-sectional study presents a descriptive and comparative analysis of official governmental documents, showing the latest legal amendments, changes in admission limits, and geographical distribution of Higher Educational Institutions (HEIs) for the period of 2013–2023. We referenced the current number of physicians in each voivodship and used a dynamic index to analyse the changes in quotas. We performed statistical tests where needed, considering a p -value < 0.05 to be statistically significant. Results The latest legislative changes enabled occupational HEIs to offer MD programmes. The mean distance between the two nearest HEIs decreased between 2013 and 2023. Total admission limits increased by 92.3%, reaching 10,289 available spots in 2023. The dynamic index was higher for quotas in private HEIs than in public institutions. The index was comparable, regardless of the teaching language. The number of students positively correlated with the number of physicians working in each voivodship. Conclusions This study highlights the uncontrolled expansion of medical education in Poland, driven by workforce demands but lacking a long-term strategy. Legislative inconsistencies hinder regulation, while new medical schools in rural areas may improve regional healthcare if properly planned. Recent policy changes emphasize the need for a national strategy based on demographic data and healthcare needs. Strengthening accreditation and quality control is crucial for sustainable medical education reform.

Healthcare workers are representatives of occupations that are most exposed to high levels of stress in the work environment. These characteristics of work increase the probability of suffering from mental disorders. One aspect of mental disorder prevention in the workplace is the role of healthcare managers as those people who are responsible for minimizing the negative impact of work-related stress factors. Their role can be performed by creating effective initiatives supporting workers' mental health. The need to support the implementation of such initiatives has been highlighted by the COVID-19 pandemic. The aim of the review is to summarize available types of managerial interventions in the field of mental health protection of medical staff, considering the assessment of their prevalence, determinants of effectiveness, and limitations from the perspective of healthcare managers. The article was prepared based on the literature review method and covered publications from original research in English and Polish, published until June 2023 in the following databases: PubMed, Google Scholar, and PsycINFO. In addition to the original research, the review also includes documents developed by international health organizations. The determinants of effective managerial interventions that can be used for the needs of managers and decision-makers in the field of mental health management in the workplace have been presented. The greatest widespread of mental health initiatives concerned the pandemic period, but now the key systemic task should be to maintain the frequency of impacts outside the pandemic period, due to the constant nature of stressors. The determinants of their effectiveness include, among others: incorporating elements of psychological knowledge into the process of educating managers, involving healthcare specialists in the development of programs, and examining the needs of the staff each time at the stage preceding interventions. Med Pr Work Health Saf. 2024;75(1):57-67

The phenomenon of professional migrations in the healthcare sector may exacerbate the problem of health workforce shortages. The scale of migration of medical personnel in Poland is estimated mainly on the certificates issued by the regional chambers confirming qualifications that grant the legal right to practice in other EU countries. Migrations concern also physiotherapists, who are the third largest group of health professionals. However, the problem of this phenomenon has not been assessed, and there is a lack of research in this area. The aim of the study was to compare the intention of migration among practicing physiotherapists and students in the last two years of master’s studies in physiotherapy, as well as to identify the factors affecting their intentions to migrate. The study covered practicing physiotherapists and students in the last two years of master’s studies in the field of physiotherapy in Poland. A total of 236 respondents took part in the study, including 119 physiotherapists and 117 students of physiotherapy. The tool used for the study was an online questionnaire. The scale of the intention to migrate was estimated at 45.3% among students and 47.1% in the group of practicing physiotherapists. The most frequently indicated destination countries for the migration of physiotherapy students and practicing physiotherapists were Germany, Norway, Switzerland, France and the United Kingdom. In both studied groups, the pull factors with the greatest impact on the intention to migrate were the possibility of obtaining higher earnings and working in better infrastructural conditions. In turn, the most important push factors turned out to be the low prestige of the profession in Poland, limited prospects for professional advancement and the stressful work environment. The respondents most often indicated separation from loved ones and poor command of foreign languages as significant barriers to professional migration. Both students of physiotherapy and practicing physiotherapists show great interest in the intention of professional migration, and the decisive determinant is economic factors.

Abstract The healthcare sector faces a critical shortage of healthcare workers, creating significant challenges in healthcare delivery. The use of Information Technology (IT) solutions in healthcare presents potential remedies to reduce the negative consequences of this problem. The purpose of this study was to identify IT solutions implemented to mitigate the effects of medical shortages and improve administrative processes and care access. The study used a systematic approach integrating desk research, national expert consultations and comparative analysis to examine IT solutions in healthcare systems. Five European countries were selected for the in-depth analysis: Poland, the Netherlands, Spain, Finland, and Croatia. The impact on administrative processes, care access, and the functioning of healthcare systems was assessed. The study identified a variety of regulatory frameworks, common implementation strategies and the institutions responsible for these activities. All compared countries used telemedicine, e-prescriptions and various types of health applications. It was found that the most frequently used IT solutions were electronic health record (EHR) and e-prescription systems. However, IT training, its organization, financing and mandatory nature differed in individual countries. In addition, common barriers were identified across all countries, such as financial constraints and interoperability issues. Integrating IT solutions offers opportunities to address health workforce shortages and enhance healthcare efficiency. Tailored strategies and collaborative efforts are essential to address financial constraints and interoperability issues. Implementing best practices identified in this study can improve administrative processes and care access. Future research should prioritize longitudinal impact assessments and explore new technologies to optimize healthcare IT solutions.

Introduction: University hospitals constitute a unique group of health care organizations which traditionally link three functions: (1) providing highly specialized services, (2) teaching activities, and (3) conducting research. Objectives: To assess the level of carrier satisfaction among physicians working in three university hospitals in Poland (1); to assess whether the physicians have the intention to migrate and what the main reasons for migration are (2); and to identify the actions that might be taken at the hospital level to mitigate physicians’ intentions to migrate (3). Methods: Cross-sectional study with both quantitative and qualitative components. In the quantitative part, an online questionnaire was distributed among physicians working in three university hospitals. A total number of 396 questionnaires were analyzed. In the qualitative part, in-depth interviews with six hospital managers were conducted and analyzed using thematic analysis. Results: On a scale from one “very dissatisfied” to six “very satisfied”, the mean career satisfaction of physicians was 4.0 (SD = 0.74). The item with the lowest mean concerned salary level (2.8, SD = 1.41). In the sample, 34% of physicians declared intentions to migrate from Poland. The main reasons for the intention to migrate were: Better working conditions abroad, higher earnings, the ability to maintain better work-life balance, better training opportunities abroad, and problems due to a stressful current workplace. Hospital managers considered the actions that can be taken at the hospital level to mitigate physicians’ migration to be specific to those focused on the working environment. Conclusions: Career development opportunities and features related to the working environment are the main factors influencing physicians’ satisfaction and migration intentions that can be modified at the university hospital level.