Prof. Filipiak: There is no shortage of doctors, there is a problem with their distribution. There is a shortage of nurses

There is no shortage of doctors in Poland – told PAP the director-rector of the Center for Postgraduate Medical Education, prof. Krzysztof J. Filipiak. He added that there is a shortage of nurses and medical caregivers, and some epidemiologists say that there will soon be a shortage of rehabilitators and physiotherapists.

PAP: A meeting of the Minister of Health, Jolanta Sobierańska-Grenda, with national consultants in the fields of medicine, medicine and dentistry, nursing and pharmacy, as well as those applicable in health care, took place at the CMKP. What direction are the changes in medical education going?

KJF: We want to make the programs of 86 medical and medical-dental specializations more realistic. We start this process in January 2026. We will then appoint teams of experts, separate for each field of medicine. The teams will have over a year to prepare new content for specialization programs. In the updated specialization programs we want to include, among others: AI medicine, interdisciplinary issues, i.e. care of elderly patients due to changing demographics.

Elements of “tactical medicine” that have so far been neglected in specialization training will also be important – aimed at external and internal threats, not only those of classic “battlefield medicine”. There is a separate ministerial team working in this area, whose recommendations will take into account the new programs.

The amended specialization education programs will enter into force in spring recruitment in 2028, so we will have over a year to prepare, edit, consult and approve them. This will be one of the largest reforms of medical specialization programs in recent decades.

Quality of medical education and specialization programs

KJF: Specialization managers and experts pointed out that the programs contain the number of procedures to be performed by doctors during specialization, but the entered amounts are not possible to implement due to staffing or technical reasons. There are simply not as many such procedures performed in accredited centers. Therefore, we want to reduce the number of these procedures and treatments required from a young doctor, but at the same time increase the degree of enforcement of this requirement.

PAP: Is there any concern about the decline in the quality of medical education?

KJF: We will achieve higher quality when a young doctor actually performs 100 procedures than when we require the unrealistic number of 500 to be performed. It is also important to make specialization programs practical. We will rely on gaining experience in performing them, and not on purely theoretical aspects. We are aware of the need to supervise the quality of training – CMKP even indicates paths on how to achieve this, implementing a pioneering model of orthopedic training in the country in one center, “Collegium Orthopedicum”, based on simulation rooms, a simulation operating theater, surgical robotics, cadaver rooms and practical exercises. Not all types of procedures can be performed in all accredited places, so new forms of training and new ideas for optimal training of doctors are needed. We would like to see such units as “Collegium Orthopedicum” also be established in other specializations.

PAP: What about artificial intelligence? Should doctors learn to use its tools as part of their specialization?

KJF: Knowledge of the ability to search knowledge bases and a critical approach to AI technology are needed by every doctor. We are thinking about introducing modules on new technologies for the use of AI in the education of certain specializations. Experts indicate three specializations that will benefit from artificial intelligence the fastest: imaging medicine, dermatology and pathology. When we design programs, especially in these three specializations, the emphasis will be on new medical technologies.

Medical staff and war

PAP: What will the preparation of medical staff for a war situation look like?

KJF: Elements of the so-called tactical medicine will appear in each of the 86 specialization program projects. We see that there is no classic war taking place on Ukrainian territory. Attacks on civilians, terrorist attacks, mass events in housing estates, and attacks on educational institutions very often occur. They also pose a direct threat to medics. Attacks are being carried out on hospitals, on medical teams, on teams of paramedics. Medical staff must be prepared for this.

As I indicated, the Minister of Health, Jolanta Sobierańska-Grenda, has just appointed a new team to develop proposals for changes in education standards preparing for the profession of doctor, dentist, pharmacist, nurse, midwife, laboratory diagnostician, physiotherapist and paramedic in the field of battlefield medicine. We are waiting for these recommendations. What will be new is that when CMKP starts working on updating specialization programs from January 2026, the teams working on these programs – in addition to a national consultant in a given field of medicine – will also include a consultant in the field of medicine related to the implementation of state tasks in the field of national defense in times of war and peace.

PAP: What are the prospects for coordinating the process of expanding competences and building understanding around it? These are changes that usually cause tension.

KJF: Integration of medical professions is one of the tasks of CMKP. Currently, the competences of various medical professions are not sufficiently used. Meanwhile, this is a factor that helps fill staff shortages. Staff shortages can be filled more efficiently by using one or the other group of employees.

It is true that the topic of expanding competences evokes great emotions. However, in a dynamically changing reality, changes and the need to adapt await every medical worker. I am a cardiologist by profession, this is my primary medical specialization, but in my office currently every second patient is over 70 years of age. So I'm slowly turning into a geriatrician. My competencies will change as the social structure changes. I will use geriatric knowledge more and more often than cardiology knowledge.

PAP: What other competencies does the system need most now?

KJF: The health care system is “alive”. Demographics, society and resources are changing. The greatest shortage in Poland is nurses, medical caregivers, health care system coordinators and so-called health educatorsi.e. a new profession that should emerge from the public health system. But the needs of the system may be different in two, three or four years. Some epidemiologists say that soon – mainly due to the demographic change in society – we will lack rehabilitators and physiotherapists.

PAP: Is there a map of health needs based on demographic forecasts that allows for planning? Do we only react when a problem arises?

KJF: Recent allocations of medical specialties were based to a greater extent on maps of health needs. The direction announced by the Ministry of Health also indicates that in the future, residencies will be closely related to location. These are announcements for now. We are waiting for their implementation.

Deficit medical specialties and the situation of child psychiatry

KJF: In recent years, child psychiatry has been quite popular among people choosing to specialize. Currently, 446 people are training in child and adolescent psychiatry. It is worth saying now that there is no shortage of doctors in Poland. However, we have problems with the distribution of doctors. There are many of them in academic centers, in large cities associated with clinical hospitals, and there are few of them in regional and district Poland. There are these gaps. Therefore, I would rather talk about the incorrect distribution of doctors than about their real shortage. Of course, we will not find a simple answer to the question about the target number of doctors in the system, because it depends, among others, on: from defining the responsibilities of doctors – in countries where a broad system of physician assistants has been introduced, the system needs fewer of them.

However, it is important to secure those specialties in which there were the greatest shortages: internal diseases and general surgery. Internal diseases are not chosen by graduates today, primarily because in Poland it is possible to obtain only one residency per specialization. Since it is possible to immediately specialize in cardiology, diabetology, nephrology, gastroenterology or pulmonology, young people often choose a narrow specialization instead of internal medicine. However, the Ministry of Health announces that it will be possible to choose a second residency for people who complete the first residency in internal diseases. In my opinion, such a simple move will make internal medicine as a specialization more attractive.

PAP: When will CMKP offer training in psychotherapy? Is the program ready?

KJF: The specialization program has already been prepared by a team of experts headed by a national consultant in the field of psychotherapy. The program was submitted to CMKP and in November 2025 it was submitted to the Ministry of Health. If approved, centers responsible for conducting specialization will have to be designated. After such a center applying to CMKP obtains accreditation, it will be possible to start specializing in psychotherapy. It is worth noting that obtaining the title of specialist is a procedure independent of the work ongoing in the Sejm on the Act on the profession of psychotherapist and the Act on the profession of psychologist.

Interview by Katarzyna Nocuń (PAP)

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