Three years in a Kharkiv hospital: why a young doctor decided to go to Germany

At the beginning of the Russian invasion, he travelled abroad with legitimate reasons, but soon returned home. But after three years of working as a doctor, he again decided to leave Ukraine and continue his practice in Germany. He told Socialportal about the main reason for his departure, whether other doctors will follow his example and whether he plans to return home.

Working during the war: shelling, patients from scratch and the "epidemic of loneliness"

The beginning of Maksim's medical practice coincided with the covid. In his 4th year, at the very beginning of the COVID-19 pandemic, he worked for six months as a nurse in the GP ward.

I know what kind of bread and labour it is," he says of the hard work of the nursing staff.

From 2023 to 2025, in the midst of a full-scale war, he worked as a doctor-intern in therapy in one of Kharkiv's cardiology hospitals. However, due to staff shortages, he was actually assigned to manage patients on his own.

I was trusted, I worked - and people recovered," Maksim recalls.

According to the doctor, the war significantly changed both the contingent and the condition of the patients he encountered. If at the beginning of hostilities hospitals received wounded people en masse, a year later the situation had changed: the majority of patients were lonely elderly people and migrants with neglected diseases who were left in the frontline territories without relatives. This "epidemic of loneliness", according to Maksim, can nullify even successful treatment.

As a doctor, it is very painful to see: a patient has received all the medicines, he got better, we discharged him - but he does not go to the family doctor for "Accessible medicines. And then such people die from stroke, from blood pressure, from heart failure, because they cannot continue to receive the required medicines, even when they are available for free. A person without family support will not survive," he states.

According to him, Kharkiv, where thousands of migrants have found shelter, lacks social service workers to provide these people with proper support.

We need to change the approach - we have a lot of people who can rely only on the state. It is very difficult for elderly pensioners to build new ties. Family ties have weakened, and people need support more than ever," Maxim believes.

According to him, now it would be possible to organise at least the delivery of medicines for lonely elderly people to the places of compact VPO residence. However, a full-fledged social support should include many more aspects.

In addition to worrying about the consequences of the war, medics in Ukraine also face a very real danger - over the past three years, at least 194 civilian medics have died because of Russian attacks. In Kharkiv itself, 30 kilometres from the Russian border, 44 out of 58 communal medical centres have been hit by shelling. Maksim saw the shelling himself while on duty.

The nearest bomb came 300 metres away from me. I saw the explosion through one house," he says of his everyday life in Kharkiv.

There were times when medical staff spent several days in the ward because of shelling and curfew.

It happens that there are only four days off in a month, and three of them I am on duty," Maxim admits.

The night shifts, which follow one after another, left almost no time for rest.

Sometimes you spend holidays at work: New Year, Easter. And it's fine if there is an opportunity to rest at night, but often patients, heavy patients arrive deep at night, - he recalls.

Formally, a doctor-intern must work 33 hours a week by law, but the reality of wartime dictates otherwise: medics take 4-5 duty shifts a month in excess of the norm. It was not uncommon for Maksim to be left to sort out documentation or write patient statements after a 24-hour shift. Despite the introduction of electronic systems, the doctor is still buried under a pile of papers. According to Maxim, it takes so much time to fill out documentation that "you don't lift your head" at appointments - there is almost no time left for the patient.

Despite the enormous fatigue, individual human stories sometimes gave strength to continue. Maxim tells about a case that particularly touched him. A 55-year-old military man was brought on duty straight from the zero position, having spent 35 days there:

He was received by my colleague, a doctor from my department, we were on duty together. He had been at the position for 35 days. He had not washed, he had not eaten normally, he said he had no one to change him. Our nurses cleaned him up, found him clean clothes. All evening the nurses of the ward groomed him. He cried and said: "God, what an attitude!".

I want to see my future children: why Maxim decided to leave

Despite all the daily heroism, two years of working at a front-line hospital gradually pushed the young doctor to decide to look for a future abroad.

Even before the war, the Ukrainian health care system suffered from a shortage of personnel, primarily at the level of nurses and therapists. Now the problem has become more acute: many specialists have left for the army or evacuated. Those left behind are forced to work for three. This has led the 26-year-old doctor to feel "on the verge of exhaustion and a nervous breakdown".

Also, he said, his moral strength was undermined by the inability to provide care at the appropriate level: often there were no medicines, equipment or conditions for treatment. For a young specialist, it is especially hard when a patient dies because of an objective lack of resources.

Many people think that doctors are bad if something happens. But people also die from complications that are very difficult to prevent - especially if the right instrumental and laboratory tests are not available. Not because the doctor didn't refer, but because they are not available in the hospital, or even in the city..., - the doctor notes.

For example, some hospitals in Kharkiv do not do CT scans at night, the laboratory may not work, there may be no blood supplies - if a patient had a stroke or internal bleeding in the "off hours", the doctor was powerless.

The third factor is salary and the ability to feed a family.

We are paid 23 thousand hryvnias, and after taxes it comes out to 17 with pennies. My salary as an intern was 15 thousand - it's ridiculous, it's not money," he says bitterly.

Even with the surcharge for the frontline zone, it is less than the average salary in the country.

I am 26 years old, my wife, who is already a doctor, is a little older. We don't understand how to have a child - because of the workload, low wages, martial law, chronic fatigue. I'm afraid that I won't be able to feed my family, and if I do, I won't see my child because I'm always at work," he says.

In such conditions, the idea of moving to a place where the labour of a medic is more highly valued and life is more stable became more and more attractive. However, the decision to leave was not easy for Maxim.

There is no hatred for my homeland. I love Ukraine. There is hatred for the processes, for the problems that will not be solved. There are no subjects in politics that express the interests of people of labour," the doctor stresses.

Problems of Ukrainian medicine through the eyes of a doctor

Maksym considers his experience as a reflection of the systemic problems of Ukrainian medicine. According to him, the root causes are chronic underfunding. However, there are also very specific issues.

For example, poor protection of doctors. According to Maksym, in case of an unfavourable outcome, the entire responsibility is often placed on the attending physician - regardless of the objective circumstances.

Every day, doctors are afraid that something will be blamed on them.... We don't feel any legal protection. If something happens, everything will be blamed on you, and I don't know of any cases where the trade union or the administration has paid for a doctor's lawyer - no, it's every man for himself," Maxim said.

This constant anxiety haunts the doctor from the first day of work and does not let go until retirement.

Maxim separately emphasises the problem of the attitude towards nurses and orderlies. It is they who bear the lion's share of patient care, work in three shifts, fulfil doctors' appointments, often for meagre money.

I don't understand how one can work for that money..... Nurses make 10 grand. I admire the nurses, especially those who have two or three children, who survive on these pennies," Maxim admits.

According to him, without their dedication, the system would collapse completely. However, neither the hospital management nor sometimes the patients themselves respect the labour of nurses.

Unfortunately, no one appreciates it - neither the administration nor the patients," the doctor said.

He has often stood up for nurses in front of disgruntled patients:

I explain to them: tomorrow there will be no one to treat you at all! We don't have enough staff.

Maxim reacts painfully when the problems of the industry are blamed on the "remnants of the USSR".

The Soviet Union collapsed 34 years ago. Those Soviet corrupt officials are either retired or dead. The current problems are entirely our own, national ones," Maxim says.

According to him, the current situation requires honest reflection and real reforms based on decent funding and respect for medical staff, rather than their continuous exploitation.