Lithuanian Parliament Approves New Residency Incentives for Rural Doctors Amid Opposition

On Thursday, Lithuania’s parliament approved the addition of new state‑funded medical residency slots.

But there is a catch.

The state pays, but the junior doctor, upon admission, signs a contract committing to work for five years in a region that is facing a lack of health care professionals after their residency.

The junior doctors are not impressed and plan to take the case to the Constitutional Court.

According to Laurynas Maciulevičius, president of the Lithuanian Junior Doctors Association, the policy is populist. Although it seeks to improve health‑care access in underserved areas, it fails to address why physicians choose — or refrain from choosing — to work in regional settings, he said.

Social Democrat Orinta Leiputė, a key architect of the reform, notes that junior doctors may opt to complete residency without the five‑year service obligation in rural areas.

Leiputė explained in a press release that this creates an option for doctors who prefer not to undertake obligatory training; they can instead apply for existing positions that lack such commitments.

Nevertheless, opportunities for such positions are limited.

Only 20 of the 385 state‑funded residency slots will be exempt from the five‑year regional requirement, and Leiputė confirmed that this figure remains unchanged; junior doctors may also pursue non‑state‑funded positions.

Lithuania boasts a higher doctor‑to‑population ratio than the WHO European average — ranking above Switzerland and just below Germany — but the overall number of physicians is declining across Europe due to ageing populations and unappealing working conditions.

Leiputė warns that Lithuania will face shortages of 269 family physicians, 207 internists and 146 pediatricians by 2032, and the challenge of eradicating rural medical deserts is shared by most European nations.

Although junior doctors acknowledge the need for improved regional health‑care access, the fundamental problem persists. Maciulevičius stresses that regions require a system that encourages doctors to remain, rather than merely assigning them for five years, and notes the absence of any analysis or justification for the five‑year obligation model.

Not a silver bullet

Social Democrat Leiputė argues that the measure is not a panacea but rather complements existing initiatives — such as extra scholarships, relocation grants and housing support — to attract doctors to the regions.

Leiputė adds that efforts are also being considered to make regional posts more appealing to older physicians who may prefer reduced workloads compared with university hospitals or large medical centres.

Liberal parties have criticised the reform, warning that it undermines individual freedom of self‑determination and that coercive measures could drive more doctors to leave and emigrate, according to the Liberal Movement’s chair in a press release.

Various European countries have implemented distinct strategies to tackle health‑care workforce shortages in underserved regions, as reported by the WHO.

In Finland, authorities aim to enhance access by redistributing medical training places geographically, expanding nursing roles, and providing incentives such as higher salaries and flexible working conditions to attract doctors to remote areas.

Latvia, by contrast, prioritises applicants who commit to rural practice after graduation, and offers doctors in underserved areas monthly bonuses, higher capitation payments and additional financial support for professional development.

The new regulations are slated to commence in 2027.

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