Enab Baladi – Yamen Moghrabi

The medical sector in the regime-held areas is witnessing an increasing migration of doctors to various countries, mostly Germany, for financial and moral reasons.

The regime has not publicly concealed its dissatisfaction with the emigration of doctors several times, despite its recognition of the low wages paid by workers in the medical sector.

Darem Tabbaa, the regime’s Minister of Education, raised controversy in an interview on the Syrian Educational channel in August 2022 when he asked, “Which is better, studying medicine for 12 years and then immigrating to Germany and treating Germans, or studying for two years and entering the labor market and earning two million pounds?”

State media, or those close to the Syrian regime, frequently talk about the migration of Syrian doctors in various specialties, with the exception of plastic surgery.

On May 23, the semi-governmental newspaper al-Watan said that the medical staff lost 30% of the anesthesiologists, part of this percentage due to travel, and 70% of the doctors are close to retirement.

A second report, published by al-Watan on June 21, indicated a shortage of doctors in As-Suwayda governorate in southern Syria.

Material and moral reasons for emigration

Damascus-based doctor Ismail, pseudonym, told Enab Baladi that “resident doctors” go exclusively to European countries, specifically to Germany for several reasons, including the absence of good financial returns and long working hours, and that “there is a big difference between obtaining approximately $11 (in Syria) and 3,000 euros in Germany.

This low salary is not sufficient for transportation between the places of residence and work and one cup of coffee during a shift, Ismail added, referring to the long working hours, which reach 36 hours during shifts.

The study of human medicine in Syria is divided into two phases. The first includes university study, which may extend for six years (depending on the specialization), including a first preparatory year, and then five academic years.

As for the second stage, which is the specialization stage, it takes the same period and is also related to specialization, according to the Syrian Commission for Medical Specialties.

The Global Economy website, which is specialized in studying the country’s economic prospects in 2022, indicated that Syria leads the Arab countries in the emigration of talents abroad.

The ophthalmologist’s reasons, Sarah, are not different from Ismail’s reasons for wanting to emigrate from Syria to Germany.

Sarah, 29, a pseudonym for the doctor, who hails from the coastal city of Latakia, told Enab Baladi that she wants a financial return equivalent to her work, describing the reality of government hospitals as “bad.”

The work of many government hospitals in the areas of the Syrian regime is currently based on “resident doctors” or study students, with very low salaries that do not exceed $10, in addition to the moral impact, according to Sarah.

“Dozens of cases during which I felt helpless in front of patients due to the absence of the necessary medical equipment. We deal with the diagnosis based on our knowledge, studies, and self-diagnosis, not the necessary examinations,” Sarah added to Enab Baladi.

And she continued that she is making twice the effort required of her by linking the symptoms to each other in order to reach the correct diagnosis and reducing the expensive analyzes and images that are required from patients.

In addition, the difficulty of opening private clinics or laboratory analysis centers makes travel a more likely option for Dr. Ismail, who indicated that cosmetic specialties may be the only ones whose doctors do not have to travel.

Sarah points out that the purpose of travel determines the doctor’s destination. If the goal is only to collect money, return to Syria, and open a private clinic, then the doctor usually goes to one of the Arab Gulf states or Erbil in Iraq or Somalia.

Why Germany?

In 2022, the German Federal Statistical Office announced that 19,100 Syrians obtained German nationality after meeting the linguistic and civil conditions, according to Reuters.

Germany is one of the countries most Syrians have sought refuge in in recent years after former German Chancellor Angela Merkel decided to open the door to Syrian asylum seekers in 2015.

Syrians in Germany entered the medical sector among the 57,000 foreign doctors working in the country.

The official medical magazine Ärzteblatt said that Syrian doctors ranked first in the number of foreign doctors in Germany in 2022.

The Ärzteblatt report stated, “A large percentage of our fellow doctors come from other countries,” including statistics showing the presence of 5,339 Syrian doctors.

One of the main reasons why Germany is a preferred destination for Syrian doctors from inside Syria is the clarity of the steps required to reach it, according to Ismail.

He added that despite the long period of time, the clear steps and criteria make it easier.

Both Ismail and Sarah submitted their travel applications to the German embassy and were asked to pass the language exams (at least the third level) and attest the university degree, grade transcripts, and a document from the Criminal Security Department stating that they have a clean criminal record.

Applicants are also required, according to Ismail, to obtain a paper that qualifies them to apply for certificate modification exams, a house rental contract, a language examination, and a guarantee amount that ranges from 12,000 to 16,000 euros.

Sarah said that traveling to Germany has become a “lifestyle” for dozens of doctors in Latakia, who have already started learning the German language, and they exchange experiences, information, and common questions among themselves.

Usually, Syrian doctors provide a language examination in Lebanon or Jordan due to the absence of any recognized body in Syria.

The German Integration and Immigration Annual Report System previously classified Syrian doctors as “the strongest medical group among foreign nationals.”

According to the report, one out of every six employees (16.5%) in the health and care profession has an immigrant background, and experts predict that this proportion will increase in an aging German society.

The data shows that doctors also fill in gaps where Germans are missing, preferring to work in clinics, in small towns, and in the countryside within the five eastern federal states.