More and more eastern European doctors are heading west as government economic austerity measures eat into their pay and conditions deteriorate, leaving behind understaffed health systems in crisis.
From Bulgaria, Hungary and Romania, growing numbers of physicians, surgeons, anaesthetists and other specialists are packing up for countries like Britain, Germany and Sweden.
"There are no prospects for me in Hungary," said surgeon Csaba Andok, who is in his fifties. "I am leaving for Germany where my work is appreciated," he told AFP.
Last year 1,111 physicians applied to the Hungarian government for a certificate allowing them to work abroad, up 25 percent from 2009, according to the ministry of national resources.
|Doctors and nurses are seen here marched through central Warsaw, adding their voices to nationwide protests in Poland to demand pay hikes and more public spending on health services|
This may represent just a fraction of the country's 30,000 practising doctors but, in a worrying trend for the future, it involves many of the 800 new graduates a year.
"Discontent is widespread among doctors, primarily due to deteriorating salary conditions," Andok said.
Their caseloads have increased over the past year for the same pay, which at 550-740 euros ($780-1,050) a month is comparable to that of a waiter in a trendy cafe.
"Work is carried out by a very limited staff and the shortage of personnel makes daily pressure unbearable," Andok said.
The economic crisis that hit Hungary in 2008 led the government to impose stiff austerity measures including a sales tax hike, the scrapping of 13th-month annual bonuses and reduced heating subsidies.
The picture is no rosier in Romania where medical professionals have seen their salaries cut by at least 13 percent since the government introduced cost-cutting measures last July.
The number of doctors wanting to leave the country almost doubled in 2010 to 2,779 from the previous year, according to official figures.
In neighbouring Bulgaria, nurses are leaving at the rate of 1,200 per year, the association of medical professionals estimates.
They earn about 400-500 leva (205-255 euros, $290-360) a month, several times less the average pay for a nurse in Britain.
The exodus is hammering the healthcare system in the EU's poorest member state, which the health ministry says has around half the 60,000 nurses the association of medical professionals says it needs to function properly.
The Bulgarian emergency and anaesthesia services are particularly hurt by the departure of hundreds of doctors a year, according to union officials.
Small hospitals meanwhile lack basic equipment and material, some even asking patients to bring along their own sheets.
In Estonia the complaints that push professionals to consider emigration are less about salaries than about standards and disheartening bureaucracy.
"The current health system in Estonia is a lot like it was during the Soviet era, with bureaucrats deciding how and for what funds are given," said doctor Ivo Kolts, who also teaches anatomy at Tartu University.
"Estonian hospitals are often interested in making useless analyses and computer screenings because the state pays for such studies, regardless of whether a patient needs them or not," he told AFP.
"The quality of treatment is often not the priority."
Desperate Hungarian doctors say they are considering resorting to the drastic tactics of their Czech colleagues, around 3,000 of whom handed in their resignations en masse in December.
The action prompted the government to agree to several pay rises until 2013.
Hungary's centre-right government led by Prime Minister Viktor Orban says it is working to improve work conditions for healthcare employees, but the details remain vague.
In the meantime retired doctors are being called back into service to fill vacant posts, particularly in the countryside.
The governments in Bulgaria and Romania have not said how they plan to stop the haemorrhaging.
Poland has managed to stem a similar outflow of medical staff since 2005 by increasing salaries and investing in training, with some professionals now choosing to return.