Mandatory three-year work experience may become a prerequisite for periodic accreditation of medical school graduates

The bill is at the public discussion stage; it has not yet been submitted to the State Duma. The Ministry of Health proposes to amend Article 69 No. 323-FZ of November 21, 2011 "On the Fundamentals of Health Protection of Citizens in the Russian Federation" and several articles No. 273-FZ of December 29, 2012 "On Education in the Russian Federation". If the document is adopted, it will enter into force on March 1, 2026.

Changes to 323-FZ

In the explanatory note, the regulator noted that retaining specialists in the healthcare system is one of the most important tasks. According to the Ministry of Health, 35% of graduates who completed their studies at medical universities and 40% of graduates of medical colleges who studied at the expense of the budget do not work in state clinics. Thus, they do not participate in the implementation of citizens' rights to receive free medical care.

In this regard, the department proposed to establish for such graduates a mandatory three-year work experience in the state health care system under the guidance of mentors. The activity can be carried out in any state medical institutions of the graduate's choice, if certain conditions are not specified in the contract for targeted training.

"It is extremely important for a medical worker to gain practical work experience that meets state quality standards immediately after graduation. A mentoring system has been implemented in all key areas of public healthcare, and highly qualified specialists work in the industry who will provide the young specialist with the necessary support in the first three years of independent professional activity, and will help him consolidate and improve the practical skills he has acquired," the explanatory note says.

After passing the primary or primary specialized (in the case of residency graduates) accreditation and completing the mentoring program, young doctors will be allowed to undergo periodic accreditation. If these conditions are violated, then, according to the bill, the specialist will not be allowed to undergo periodic accreditation until the total period of his/her work under the mentor's supervision reaches three years.

In May 2025, the Russian Ministry of Health presented a draft law that would introduce mandatory work for state-funded students of medical universities for up to three years. The regulator then noted that the proposed system had fundamental differences from the "Soviet model of distribution" and targeted training. The draft has now been removed.

Changes to 273-FZ

The new document proposes to make a number of adjustments to the law "On Education in the Russian Federation". Thus, the Ministry of Health intends to receive the authority to issue a conclusion on the maximum value of admission control figures established for medical universities or colleges. The decision, as the authors of the initiative believe, is necessary to strengthen measures to eliminate the personnel shortage and imbalance in the industry.

According to the data for 2023, which the regulator provides in the explanatory note, the current personnel shortage (29 thousand doctors and 63 thousand mid-level medical workers) does not allow the healthcare system's personnel needs to be fully met without increasing the effectiveness of targeted training. The Ministry of Health believes that at the moment, at the level of subjects and medical organizations, it is difficult to plan for eliminating the personnel need due to the possibility of changing the customer of targeted training under specialty programs to another customer of targeted training upon admission for further training under residency programs.

In this case, if a student fails to fulfill his/her obligations under the contract for targeted training, the amount of the fine, equal to the amount of federal budget expenditures, does not cover the costs of training the necessary medical or pharmaceutical worker. In this regard, it has been proposed to introduce a fine of double the amount. Previously, it was proposed to establish an increased fine of triple the amount.

The Ministry of Health presented the procedure for calculating the amount of compensation for training and the fine. The current, one-time fine, the department believes, is not actually a penalty, but an interest-free educational loan.

"The current model of fines is not tied to indexed financial indicators (for example, the minimum wage) and does not depend on the inflation rate. Currently, there is a negative practice when applicants, entering the first year, apply for targeted training, knowing full well that they will not fulfill their employment obligations, planning to return the funds in the amount spent on their education over six years without interest," the explanatory note says.

In order to "faithfully fulfill the terms of the contract on targeted training by graduates," the Ministry of Health proposes to approve other measures. Thus, it is proposed to grant the student the right to be exempt from fulfilling obligations under the contract on targeted training when concluding the next contract on targeted training with the same customer. Similar provisions were also presented in the draft law , published in May 2025.

Another innovation may be the establishment of priority rights for applicants planning to enter into a targeted training agreement when entering into secondary vocational education programs.