“...Specialists of the Doctor at Work portal studied 1,400 vacancies for doctors and 420 resumes of doctors posted during 2011.

The purpose of the study was to obtain the following information:

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General characteristics of the proposed vacancies;

Demand for medical specialties by region;

Basic requirements of employers for candidates for vacancies;

the level of offered salaries depending on the region, medical specialty and type of employer (public or private clinic, pharmaceutical company, etc.);

Compliance with the proposed vacancies and the candidates’ resumes.

General characteristics of vacancies and demand for doctors by specialty

During 2011, 1,400 vacancies from 402 organizations located in 52 regions of Russia were posted on the doktornarabote.ru portal (an average of 2–4 vacancies per health care facility)...

To assess the characteristics of the demand for specialists depending on the region, vacancies posted by medical institutions in Moscow and St. Petersburg (16% of all vacancies), large regional centers - Yekaterinburg, Novosibirsk, Nizhny Novgorod, Omsk, Samara, Rostov-on-Don, Chelyabinsk (11%) and other regions (73%).

A comparative description of vacancies by specialty, depending on the region, is presented in Fig. 2.

Thus, all regions, without exception, are characterized by a large number of vacancies for primary care doctors. This is probably due to the discrepancy between the level of wages and the volume of work, the unsatisfactory organization of the work of the local service and the high workload on specialists, often due to the actually irregular working hours of doctors...

Employers' requirements for applicants

In addition to having a state diploma, 90% of state and municipal health care facilities require that the applicant have a valid specialist certificate...

91% of employers (including some private clinics) are ready to hire doctors without work experience or immediately after completing their internship or residency. In 4% of health care facilities, resumes are considered only if you have work experience from one to three years, 4.5% - from three to 10 years. Thus, we can conclude that it is quite easy for a young medical specialist to find a job, especially in the regions.

The highest requirements regarding work experience are imposed on candidates for the positions of chief physicians and their deputies, dentists and obstetricians-gynecologists. Without experience, the easiest way to get a job is for general practitioners, pediatricians, anesthesiologists and resuscitators, and surgeons.

Applicants are required to have a qualification category (second, first or highest) in a small number of institutions (only 1% of requests). These are private clinics (for vacancies of chief physicians or deputy chief physicians)…

Analysis of proposed salaries

The salary level of a medical specialist in Moscow and St. Petersburg directly depends on what kind of organization is looking for an employee: a state health care facility, a private clinic or a pharmaceutical company.

The chief physician of a private clinic in Moscow can earn from 60 thousand to 100 thousand rubles, a deputy chief physician -50-80 thousand rubles, a specialist doctor -40-65 thousand rubles. In a state medical institution, a deputy chief physician can claim a salary of 45–55 thousand rubles, and a specialist doctor – 11–50 thousand rubles.

The highest salaries in Moscow were recorded for chief doctors and their deputies (up to 100 thousand rubles), obstetrician-gynecologists (up to 60 thousand rubles), clinical laboratory diagnostic doctors (up to 65 thousand rubles), doctors- dentists (up to 55 thousand rubles), cosmetologists (up to 50 thousand rubles). Employers offered the lowest salaries to therapists, pediatricians and anesthesiologists-resuscitators (11–25 thousand rubles). As for medical representatives, their salary ranges from 30 to 60 thousand rubles. (with the possibility of career growth and further salary increases)…

In private clinics in regional centers there are vacancies for chief doctors and their deputies with salaries of 20–80 thousand rubles, and for specialist doctors – 17–60 thousand rubles. In government institutions, the level of offered salaries is lower - the chief physician and deputy chief physician can claim a salary of 20–50 thousand rubles, the head of a department – ​​25–35 thousand rubles, a specialist doctor – 7.5–30 thousand. rub. ...see Fig. 3, 4, 5

The relationship between applicants' expectations and employers' offers

...The most common people looking for work are therapists, dentists, surgeons, pediatricians, obstetricians-gynecologists, and anesthesiologists-resuscitators. In addition, there are many applicants for positions as medical representatives of pharmaceutical companies.

There is a significant discrepancy between the “salary expectations” of applicants and the offers of employers. Thus, applicants for the positions of chief physicians expect a salary of 50–120 thousand rubles, applicants for the positions of deputy chief physician or heads of departments – 50–75 thousand rubles, and medical specialists – 20–60 thousand. rub. In most cases, offers do not correspond to this level, and the difference ranges from 28 thousand rubles. (for positions of deputy chief physician and heads of departments) up to 52 thousand rubles. (for the positions of chief physicians)…

It is precisely because of the discrepancy between the expectations of doctors and the salaries offered that there is a large number of resumes of doctors in the most scarce specialties (therapists, pediatricians, anesthesiologists, surgeons, obstetricians-gynecologists)…

Only the salary level offered to medical representatives meets the expectations of applicants (even slightly exceeds these expectations).

To summarize, we can draw the following conclusions.

The medical profession is in great demand... The most scarce specialists on the medical labor market in all regions of Russia are primary care specialists: therapists and pediatricians.

The level of personnel shortage in hospitals is such that most employers are ready to hire doctors without qualifications and work experience...

The main reason for the personnel shortage is a significant discrepancy between employers’ offers and the salary level expected by doctors...

The average salary level for doctors did not change significantly in 2011. The most in-demand specialists are general practitioners and pediatricians. Moreover, their work is the lowest paid.

Half of the specialists who compiled their resumes have more than a year of work experience, a quarter have two specialties, every twentieth have three specialties; every tenth specialist has a qualification category.

The only vacancy for which more than one candidate is applying is a medical representative. This is due to the compliance of the proposed salary level with the salary expectations of doctors.”

Russia's transition to a market path of development inevitably led to the emergence of unemployment, which is an integral feature of a market economy. In these conditions, we must study and apply the rich experience of foreign countries in reducing unemployment and mitigating its consequences, which shows that in the labor market a position of active employment is absolutely necessary, the main goal of which is to promote the speedy return of the unemployed to active work through such various measures such as assistance in finding employment, additional assistance in employment for persons with disabilities in the labor market, organization of public works and temporary employment, development of entrepreneurship and self-employment, vocational training and counseling.

The emphasis foreign countries place on active labor market programs and the reallocation of large shares of their resources to these programs (ranging from 0.4 percent of GDP in the United States and Canada to 2 percent in Sweden) is due to many reasons. Firstly, an active position not only and not so much supports the existence of those who have lost their jobs, but above all encourages the activity of every citizen aimed at finding a job, which, in turn, reduces his dependence on income support through social payments ( and, therefore, reduces the costs of the state budget), and also relieves tension in society associated with the severe mental state of the unemployed (even if they receive fairly high benefits). Secondly, an active position increases labor productivity in general and, in particular, contributes to the structural restructuring of the economy, thereby increasing the efficiency of the use of labor resources, since its main task is to quickly find the employee a workplace where his return will be the highest , that is, a workplace that will optimally suit his mental and physical abilities.

Based on the foregoing, it would be useful to review those measures of active employment in the labor market that are used in foreign countries, as well as a brief analysis of the extent to which it is possible to use similar measures in the Russian labor market. I would like to begin our consideration with the most obvious, but at the same time one of the most effective measures of assistance in employment, carried out by a specialized nationwide service. Its main task is to reduce the time it takes for the unemployed and workers to search for vacancies, as well as to reduce the discrepancy between workers and jobs. The employment service helps employers hire people who best suit their requirements, and workers find a place with better working conditions and/or higher wages.

Thus, the main responsibility of the employment office is to ensure that buyers and sellers of labor meet. An entrepreneur with a vacancy can send an application to the agency, indicating the nature of the work, the required qualifications, etc. An unemployed person or a person who wants to change his job has the right to ask for it at the office, for which he must fill out a registration form. Agency employees conduct the initial selection, matching requests and registration sheets. The employer is not obliged to hire the candidate found for him; an unemployed person can also refuse a job offered to him. In almost all states, employment services are free for both workers and entrepreneurs. The system for collecting and processing data is built on principles common to the entire country, and the information is classified and inaccessible even to the police.

The experience of France is interesting, where employment agencies organize special circles for the unemployed, holding classes 2-3 times a week on the topic “How to look for a job”, where various options for upcoming negotiations with employers and other issues related to the rules of conduct when searching for a job are discussed. The activities of these circles are quite effective: they help 40 percent of those who attend them find a good place for themselves. Despite the fact that the efficiency of the public employment service is high, only a small proportion of vacancies are filled with its help, and these are predominantly jobs requiring low qualifications. Thus, in Sweden, only 35 percent of job seekers come into contact with an employment office. In France, 750 thousand people are employed through government agencies. per year, or 15 percent of the total labor requirement. Even in the United States, where there are 300 job banks covering the entire country, only 5 percent of people get jobs through a hiring assistance service. The fact is that a number of reasons complicate the functioning of agencies. Thus, entrepreneurs with lucrative vacancies and good employees rarely use their services, preferring to look for what they need through relatives and friends or through advertisements and direct contacts. It is estimated that the majority of workers (56 percent) get information about jobs from friends or family. Secondly, employers often do not advertise their vacancies for fear of revealing trade secrets. In this regard, in some countries they are legally required to do this (“Law on mandatory registration of vacancies” in Sweden). Thirdly, difficulties in evaluating both proposed work and workers not only reduce the success of the bureau, but also reduce their prestige. In many cases, private employment agencies are more promising. Finally, the national employment service is often seen as a place to find work for losers, and employers perceive the people sent to them by the agency as the worst part of the workforce. Another common government effort to improve labor market information is the publication of data on future demand for various occupations, which is especially valuable for students deciding which career path to pursue. However, these publications contain a lot of room for error: they provide national averages, while trends in local markets may vary; technological shifts that change the demand for labor are almost unpredictable; and many calculations do not take into account that this demand also depends on wages. As for the basic principles of the Russian employment service, they correspond to international practice. Like employment bureaus in foreign countries, Russian employment service agencies ensure the publication of statistical data and information materials about the supply and demand for labor and employment opportunities. The activities carried out by our employment agencies are undoubtedly useful for many people who are unemployed or seeking to find a new job. At the same time, to the difficulties experienced by employment services in foreign countries, which employment offices in Russia inevitably face, are also added difficulties specific to our country, such as the lack of reliable information systems, including the necessary equipment, software, and stable contacts with employers and workers. In these conditions, it is necessary to significantly increase the scope of labor intermediation using, for example, means such as multifunctional labor exchanges dealing with various professional groups of workers from workers in broad specialties to intellectual workers; various job fairs based on territorial-industrial, social-professional, production-seasonal and other criteria, depending on the situation on the labor market; specialized exchanges designed for specific categories of the population. Currently, the media - press, radio, television - can also play a significant role: it is necessary to issue special bulletins about vacancies, newspapers for those who are looking for a job, booklets that help to answer tests correctly, questionnaires, the filling of which usually accompanies the employment procedure, and instructions for those who are afraid of losing or have already lost their place, containing rules of behavior in the labor market. Vocational training and retraining programs, as many scientists recognize, are the main direction of an active employment position in the labor market, since employment prospects, especially in the context of structural adjustment, are strictly linked to the development of human resources: good education and qualifications reliably protect workers from unemployment. Thus, the share of those temporarily unemployed in the United States among those employed primarily in mental labor is 2-3 times lower than for manual workers, and among those with higher qualifications, the unemployment rate is 4-7 times lower than for others. A similar picture can be seen in Eastern European countries: although unemployment was initially concentrated among skilled workers, the highest levels of unemployment now occur among unskilled workers.

These programs are developed and adopted at the legislative level or implemented through the joint participation of the state and entrepreneurs in organizing professional training and retraining of personnel. They are aimed primarily at people who have lost their jobs due to the fact that their previous profession is outdated, at those who can no longer work in their specialty due to illness, at young people who have not received the necessary vocational education, at women -housewives who decide to return to the labor market. Typically, candidates for training are looked for by the state employment service. She also arranges studies and provides scholarships. Vocational training can take place in special centers or as part of continuing education programs at the enterprise. In the centers, education is structured in such a way as to provide people with a wide range of professions. Its high efficiency is guaranteed by the use of individual plans that take into account the abilities and knowledge of each student, the modular principle of constructing educational programs and modern workshop equipment, including computers. Leading specialists from universities and industrial firms are involved in developing training courses. Faculty are paid at the same level as employees of their class in the private sector. The total duration of training varies from several weeks to 3 years, depending on the degree of complexity of the profession and the individual preparation and capabilities of the student. Such centers can be either public or private.

Any country forms its labor market and its system of labor relations, taking into account the characteristics of the national economy, social traditions and a number of different factors.

There are models of labor relations that go beyond national boundaries and cover a number of countries.

1. European (continental) model, it is often called social democratic. Its characteristic features:

· High level of legal protection for the employee.

· Strict labor law standards aimed at preserving jobs.

· Strong trade unions, the presence of institutions of workers' representation.

· Industry tariff regulation

High legal minimum wage

· Relatively small differentiation of wages. This model is more used by European countries. It provides a high level of social security.

· Supporting weakly competitive workers through subsidies to firms.

· Support for employment in socially important sectors of the economy

· Creation of special jobs within the framework of the state employment promotion program.

· Carrying out a “solidarity policy” in wages to achieve equal pay for equal work, regardless of the financial condition of certain companies;

· Supporting less profitable firms and curbing the profits of more efficient firms, leading to equalization of wage levels in them;

· Payment of unemployment benefits is subject to the simultaneous retraining of a person for his subsequent employment.

2. Anglo-Saxon model (USA, Canada, UK, Australia, New Zealand). It is characterized by the following features:

· Greater similarity between labor and civil rights.

· Decentralization of legislation on employment and assistance to the unemployed.

· Freedom of the employer regarding hiring and firing.

· Collective bargaining regulation is mainly at the firm level, rather than at the industry and region level.

· Weak distribution of in-house personnel training.

· Very high territorial and intercompany labor mobility, especially in the USA.

· Higher wage differentiation.

This model has many advantages: jobs are created more dynamically; the unemployment rate is lower; higher rates of economic growth.

Japanese model. Its properties:

· For a significant part of workers, there is a system of labor relations that is based on the principles of “lifetime employment”, in which the employment of a permanent employee in the company is guaranteed until he reaches the age of 55-60 years.

· Salaries and social benefits depend on how long a person has been working for the company.

· As a result of long-term relationships, the potential of women is identified and used as effectively as possible, so their price discrimination is minimal.

· There is an effective system for selecting personnel for investment in human capital and promotion.

· Intra-company patriotism, which allows the use of motivation methods that are not applicable in other countries.

· An increase in wages by 10-20% due to the occurrence of significant events in the employee’s life.

· If it is necessary to reduce production, personnel, as a rule, are not fired, but some workers are transferred to other enterprises or their working hours are reduced.

· The difference in wages is not great: the least qualified worker receives only 4 times less than a highly qualified worker.

· The unemployment rate is low, within 2-3%.

· Regulation of labor relations mainly occurs at the enterprise level, where there are various trade union organizations operating at the corporate level.

Currently, the situation on the labor market in Japan has changed: international competition has intensified and the degree of risk in business has increased.

And the latest Chinese model of labor relations. It is characterized by:

· Strict regulation of labor relations in the public sector.

· Complete lack of legal regulation in the private sector.

· Low labor costs, allowing us to achieve success in price competition in foreign markets.

· Labor surplus in many areas of the country

· The hard work of the population, whose morality has been shaped over centuries under the influence of Confucianism.

· Availability of free economic zones that help attract foreign investment and advanced technologies.

A distinctive feature of the Russian labor market is that a significant part of employers and self-employed people, as well as a silent part of hired workers, operate in shadow economic activity.

The shadow economy is an unaccounted economic activity that includes:

· Legal economic activity, not taken into account by official statistics and not subject to taxation

· Illegal, deliberately hidden economic activity.

According to various expert estimates, the cost of products and services produced in the informal sector of the economy in the 90s ranged from 20 to 50% of GDP.

Such a wide spread of shadow economic activity is explained by high costs, including those associated with the costs of opening a legal business, running it, protecting property rights in an ineffective state, and paying taxes. The informal economy accounts for a significant portion of the country's labor force. It employs over 25 million people, i.e. more than 30% of the country's economically active population.

Informal employment has its advantages: it helps to ease social tensions associated with unemployment, low income from legal activities and uncertainty of future income, and contributes to the growth of production of goods and services in demand by society.

In the informal sector, three main types of employment can be distinguished according to the degree of legal formalization of the employment relationship:

1. Quasi-formal hiring (a contract is concluded, but rather for appearances, for inspection authorities; it does not protect the employee, does not give him illegal status, nor the benefits and guarantees provided for under the Labor Code of the Russian Federation)

2. Informal hiring based on oral agreement (especially common in street and market trade, in the field of personal services, when hiring immigrants).

3. Self-employment is carried out in Russia mainly in the informal sector of the economy.

One of the features of the Russian labor market is the massive spread of secondary employment - voluntary (permanent or temporary) paid labor activity carried out in free time from the main job.

The shadow economy has its disadvantages: over 25 million people are employed in the informal economy, i.e. this is more than 30% of the country's economically active population. But there are also advantages: it eases social tensions associated with unemployment, low income from legal activities, and promotes the growth of production of goods and services in demand by society.

The Russian healthcare labor market in the context of its accession to the WTO

Globalization is often perceived as a threat, as something that may be good for “others” and to which “we” are forced to adapt. At the same time, there are a number of convincing facts indicating that globalization is a unique chance for the whole world. However, Russia still has to adapt to it. This article briefly describes the results of our study of the potential of “globalization” for one of the sectors of the Russian economy, namely healthcare, since it is the most important factor in shaping the health of the population, and therefore one of the priority areas of the country’s development.

The study addresses a little-studied issue, namely possible changes in the labor market in the healthcare industry as a result of Russia’s accession to the WTO, which is very important, since globalization (and the WTO is its leading institution) of the service sector will lead to significant changes in this industry.

Changes that may occur in the labor market of this industry, due to Russia’s accession to the WTO, are associated , first of all, with private sector development. Based on the analysis of foreign experience, we can conclude that competition in the market for expensive medical services, which are no longer available to a wide range of citizens, may become more intense. At the same time, against the background of the expansion of the sphere of paid services, the quality of free ones may decrease, including because many paid services are provided within the framework of state budgetary institutions. There is a risk that further development of the private sector in medicine will lead to an increase in the cost of health care and, as a consequence, to BSC growth(demand provoked by supply). Accession to the WTO may generally lead to a deeper “demarcation” of the healthcare system along the commercial – non-commercial principle.

Problem part-time jobs in healthcare will “gain momentum”. As the experience of foreign countries shows, additional part-time work in the private sector has begun to spread in the health care systems of those countries that have undergone rapid liberalization of medical practice. An important feature of the private sector is that it pays more attention to issues of efficiency and management of resources, in general, and labor, in particular, than government organizations do, in this sense, the emergence of the private sector in medicine will lead to more efficient use and management of medical staff.

Russian medical institutions and pharmaceutical companies (treatment, diagnostic, advisory, preventive medical services and pharmacology), after the WTO requirements are fully reflected in federal legislation, may face growing competition with foreign medical institutions in the domestic Russian market of medical services. In order for domestic companies in the field of medicine to become competitive in the world market, and for the healthcare sector to fulfill its primary function - protecting the health of the nation, large-scale investments and a consistent healthcare development program are needed. The main object of concern should be the labor market. Only a clear state policy in this area of ​​healthcare will help smooth out the possible negative consequences of joining the WTO and increase the positive ones. At the same time, when specifically assessing the impact of Russia’s accession to the WTO on the labor market in healthcare, it is necessary to consider this issue from the point of view of the four WTO Agreements - GATS, TRIPS, TBT and SPS, which are based on the idea of ​​liberalization and it is necessary to be prepared for its consequences.

The main positive opportunities for the development of the labor market in healthcare will be: the development of cross-border provision of medical services, the development of telemedicine, the development of the international market for medical educational services, etc.

Among the negative consequences is the increase in “brain drain” of medical personnel. Due to the existence of the BSC, the employment situation in regional labor markets in healthcare may worsen. Since the employment of doctors depends on the average per capita GRP in the region, we can talk about the possible deepening of regional differentiation of healthcare labor markets.

After Russia's accession to the WTO, healthcare will become one of the developing sectors of the service sector, giving doctors the opportunity to receive competitive wages and choose a certain model of labor behavior.

The study concludes that Russian society has every reason to be concerned about the impact that WTO accession will have on the country’s ability to implement national health care policies in the interests of the population and, accordingly, its impact on the development of the labor market in this industry. This is also important because there is no alternative to the international systems of trade and services formed within the WTO. Therefore, it is very important to know well the “rules of the WTO game”, the rights and obligations of the state, industry, medical personnel, and of course citizens, including an assessment of not only opportunities, but also risks. This implies an urgent need for information support for the process of integrating the healthcare system into this new format.

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