There are currently 2447 foreign-trained doctors working in Finland.

Latest figures show that foreign-trained doctors are becoming much more common in the wealthier countries.

The number of doctors practising in Finland who have been educated abroad increased threefold from 2000-2007 and has continued to rise, according to the Organization for Economic Cooperation and Development (OECD) health data report 2009. The only other OECD country with a comparable net gain was Ireland. There are currently 2447 foreign-trained doctors working here.The number of doctors of other nationalities has risen from 390 to 618 over the past five years. 30 per cent of foreign doctors are Russian speakers, while 20 per cent come from Estonia.

Markku Viitamäki from the Finnish Medical Association believes two factors have accounted for the rise. “First of all, doctors working in Finland are well paid compared with some other countries, which accounts for the large number of Russian speakers. Secondly, the increase has been constant since we joined the EU thanks to European rules on free movement. Thus, since Estonia and Poland joined the European Union we have seen increases from those countries as well.” According to FMA figures, doctors from about 60 countries are working in Finland at the moment.

The numbers are not the result of policy as such, suggests Viitamäki. “It’s the same in other countries with a generally high standard of living. We don’t have many Irish or British doctors here.” Around 15 per cent of all posts at Finnish health centres are vacant, and psychiatrists are in particularly short supply.

Physicians from non-EU countries face more stringent tests before receiving a licence to practise. Courses are held at Tampere University to provide extra education on administration, legislation and clinical medicine, as well as practical training. Doctors from within the EU, on the other hand, do not even have to take a language test before being licensed, although ‘health care professionals should possess the language skills required for the performance of their duties,’ according to the National Authority for Medicolegal Affairs. Perhaps unsurprisingly, the language issue has the greatest potential to cause difficulties for those who do not have a good grasp of Finnish. “Many doctors get stressed about learning Finnish well enough to work,” says Viitamäki, “it partly depends on the speciality of the doctor. An anaesthetist might only speak to other professionals who speak English, while a general practitioner will need to use Finnish on a much more regular basis.”

Depending on where the doctor has trained, there can be significant differences between a practitioner’s work in Finland and their home country. One doctor from London, John Shaw, is soon to begin work at the district of Raseborg’s general hospital, west of Helsinki. “I trained and worked at St. George’s in London, where we had 440,000 outpatient visits and operations each year,” he says, “while here at Västra Nylands Hospital there is something like 46,000.” Shaw faces more language challenges than some other immigrants. Since Raseborg is an area with a high proportion of Swedish speakers, he has to learn the necessary vocabulary in both Swedish and Finnish.

“I’ve taken some Finnish and some Swedish courses, but it can lead to some difficult situations. In the hospital I would say that around 80 per cent of the patients and nurses speak Swedish as their mother tongue, but the doctors tend to speak Finnish amongst themselves and notes are usually in the patient’s language,” he explains. “On the other hand, diagnoses are in Latin which is actually extremely helpful for a doctor. Also, the notes are typed up so you don’t have to interpret terrible handwriting like in the UK.” At one point during a two-week practicum at the hospital, Shaw was treating a Swedish-speaking patient with one Finnish and one Estonian doctor. “Four languages at once!” he laughs, “I don’t know what the patient thought of all that.”

In practice, although some Finns may feel uncomfortable with being treated by a doctor who does not speak perfect Finnish, in practice it seldom a big problem, says Viitamäki of the FMA. “There are many examples of Russian and Estonian doctors working in the countryside, who have been working in the health sector here a long time and have excellent relationships with their patients. As another example, in bigger cities these days there are now more doctors with Arabic as their native language. Of course, we also have more residents who might speak Arabic, so they are also able to receive treatment in their first language,” he says.

Nick Barlow - HT