How I became Forbes Russia’s source on contract medical training, and what the research found
Three weeks ago, a Forbes Russia reporter reached out with questions about how Russian regions compete for doctors. The piece ran on July 29: Forbes Russia article.
Here’s why they came to me.
I’ve been running projects for a while now, at least by the standard of my own life: the last four years. Back when I was preparing for the OGE (Russia’s Basic State Exam, taken after 9th grade in the country’s 11-year school system), I published reviews of exam-prep services: a review of Maximum Education’s free intensive math course, a review of Examer’s free multi-subject course, and a review of the «Homework» service from the Prosveshchenie publishing house.
Then came school projects. Two I’m especially proud of: «An Introduction to Project Work for High Schoolers» and the opening piece for a case study on defoamers for Moscow’s Pre-Professional Olympiad for Schoolchildren, where I had a few days to learn the basics of oil drilling, drilling fluids, and the chemistry of silicone defoamers just to pick a case to work on.
I took university admissions seriously. In Russia, there’s no other way into a good school.
A quick primer for anyone whose age or location puts them outside the usual concerns of Russian applicants. Contract training (целевое обучение) means free medical school at a Russian university in exchange for a mandatory service period (отработка), usually three years in primary care: a regular outpatient clinic, working as a general practitioner or pediatrician. I covered the whole system in a separate guide: «How Russia Trains Contract Doctors».
Paid tuition in Russia climbs every year. A year of paid study at a Moscow university now costs roughly what an average Moscow worker outside an office job earns annually; in the regions, it runs about a year’s income for the same kind of worker there. State-funded seats are scarce, and there are really only two ways in: win the All-Russian School Olympiad, where practically every student in the country competes and around 5,000 make it to the finals across all subjects, or score at the very top on your graduation exams. Applicants to medical school take the Unified State Exam (EGE) in chemistry, biology, and Russian, and the cutoff at good universities runs past 300: three exams worth 100 points each, plus extra points for individual achievements. In recent years, Olympiad winners have taken every single state-funded seat in dentistry and general medicine at Moscow’s top universities. In 2024 there weren’t even enough seats for all the Olympiad winners; parents complained all the way up to the president, and everyone got in. Regular top students, meaning anyone scoring above 270, an excellent result by any measure, got nothing. So if you’re not a prodigy and can’t afford tutors for every subject, contract training is really your only option, and it comes with its own brutal competition, especially for wealthy regions and good hospitals.
Regions compete for doctors because a young specialist always has an out: move to a big city, or go into private practice, where the pay is better. The same limited pool of specialists just circulates between employers, and rural public healthcare is usually the first to lose out. The government added meaningful top-ups for anyone willing to work in towns under 50,000 people, but that still isn’t enough, so regions run their own incentive programs on top of it. That’s where the settling-in bonuses (подъёмные) of 1–4 million rubles (~$10,000–$40,000) come from, along with free land plots and housing vouchers.
I was applying to medical school myself, and I needed to understand the terms regions were offering contract students (целевики) across the country. My first choice was studying in Moscow or St. Petersburg with a service period in Moscow or the Moscow region. But in 2025, Moscow wasn’t signing any contract-training agreements at all: the only way to study at a Moscow university through the contract-training track was through a sponsoring region (заказчик). I wrote to the health ministries of the regions I was interested in and asked the questions I actually wanted answered, and, honestly, writing those questions turned out to be a project of its own. Make them too detailed and ask too many, and nobody answers («we don’t have time for every little question»). Keep them too simple, and you get a form response like «all the information you need is on our website.» Once I had answers and realized how much was still missing, I decided to write to the remaining regions too and pull together whatever I could find. That’s how «Navigator for Contract Students» was born: individual articles for every major Russian region, covering base salary, the Zemsky Doctor payment, housing, contract terms, and what happens if you break the contract early, among other things.
Later, to spare applicants the agony of choosing, I wrote comparative reviews for all eight of Russia’s federal districts. I split the larger ones into parts for readability, Central into three and Volga into two, for eleven pieces in total: Central (Near Moscow), Central (Black Earth Region), Central (Periphery), North-Western, Southern, North Caucasian, Volga (Republics and Perm Krai), Volga (Oblasts), Ural, Siberian, and Far Eastern. In every review, I tried to find something worth knowing about the region itself, something worth the move beyond the paycheck. A doctor’s life is mostly work, sure, but they’re probably owed a couple of days off every few years.
Nothing in Russia comes close to my project’s scope, not from the government, not from education consultants, not from any private individual. That’s likely why the Forbes reporter found me when she sat down to write her story.
The Questions She Sent Me
→ Do these recruitment and incentive programs actually work, or do they just mask the staffing shortage?
→ Which region would you personally move to, judging purely by money and benefits (top 5)?
→ Which regions surprised you most, in both directions?
→ Are there regions where the terms look generous on paper but work against the doctor in practice?
→ Which 2–3 regions would you recommend watching over the next few months?
→ Which regional ministries answered substantively, and which stayed quiet?
→ Among your peers, which regions have a good reputation, and which do people avoid?
It took me two evenings to answer what she’d sent, and I added answers to a few more questions I thought deserved to be asked:
The Questions I Added Myself
→ How much does a contract-track graduate actually take home, in rubles, down to the last kopeck, rather than the «base unit × multiplier» formula that never gets published as an actual figure?
→ What does an applicant actually see on the «Work in Russia» portal (trudvsem.ru) at the moment they need to decide on a contract-training agreement? Very little: a listing often amounts to one line, something like «compensation per Russian federal law,» with no figure attached.
→ Are all the openings even visible to applicants, and do they have a real choice? The best openings in the system often aren’t visible at all.
→ How does the dormitory question get resolved for applicants from other cities? You have to accept a placement before the university itself knows how many dorm beds will free up by September 1. Renting privately in Moscow costs roughly half the price of tuition, on top of it.
→ Is it true that contract seats are simultaneously underfilled and crowding out strong applicants? In 2025, contract seats filled at a little over 40% nationally, while at Sechenov University’s General Medicine program, 810 of 1,020 state-funded seats went to contract students, another 204 went to various privileged categories, and only six were left for open competition.
→ How real is Tatarstan’s move to recruit foreign doctors? Since July 2026, the republic has paid 1.15 million rubles (~$11,500) to relocating specialists, including foreign nationals with a residence permit, but not to its own contract students, who remain bound by their obligations.
→ Will Belarusian doctors keep being a source of staff for Russia? Starting in 2026, Belarusian medical schools have effectively eliminated paid full-time study, replacing it with a mandatory multi-year service period at home after graduation. Those graduates simply won’t be coming to Russia anymore, and the shortage here will only widen.
→ What does it actually cost to study in Moscow, and what can the same money buy abroad? Sechenov’s top program, with housing, runs 10–13 million rubles (~$100,000–$130,000) over six years. Medical education in Germany costs about the same or less, housing, food, and everything else included, but comes with a European degree and no service obligation.
→ Is it true that the economics run in reverse for nurses? A nurse reaches stable income years earlier than a doctor, without the risk of missing an ordinatura (Russia’s residency placement) slot, which for a doctor can mean a lifetime tied to a primary-care patient panel.
→ How does military deferment fit into this system? Neither the service period nor the new mentorship requirement grants any deferment at all, and that shapes how young men in medicine plan their lives.
→ How does maternity leave count toward the service period? The law pauses the obligation during pregnancy until the woman is actually employed, but counts maternity leave fully toward the term once she’s already working for her sponsoring region.
→ Was there any public reaction to the new mentorship law? The draft collected more than 2,500 downvotes on the public consultation portal, and nearly all the comments were negative.
All told, it came to twenty pages. I sent it over on July 12. It took the reporter a couple of weeks to write the piece: Forbes’ rules require a journalist to independently verify every figure before publication rather than simply quote a source. Varvara Kolesnikova did exactly that: she checked official salaries, statistics, and the court cases I’d mentioned. Everything held up. I wasn’t particularly worried, honestly, I’d done the work properly. Not everything made it into the final piece, of course; Forbes has its own rules on content and length. But the article turned out well, and it was my first time working with journalists.
If you want to dig deeper into what’s actually happening in Russian medical education right now, look at two documents: Federal Law No. 424-FZ on mandatory mentorship for young doctors (March 2026) and Government Decree No. 555 on penalties for breaking a contract-training agreement early. Together they paint a far more accurate picture than any regional press release.
Since I’m writing this for an international audience: I genuinely don’t understand why universities in Russia’s neighboring countries still don’t target advertising at Russian applicants. Right now, Russian applicants go through one of the harshest selection processes anywhere, especially for state-funded seats. The ones who make it through, or who miss the cutoff by only a little, tend to be extraordinarily capable and motivated, the kind of people who could study anywhere. A lot of them go into medicine because they genuinely want to treat people, not for the money the way it’s stereotyped in the US, and with decent training they’d make excellent doctors. The data I’ve collected for my own articles is fairly unambiguous on this: good doctors are in demand in nearly every country right now. So why aren’t you recruiting the best of the best? If I were dean of some Semmelweis somewhere (I genuinely like that school), I’d teach students for free, in exchange for 10% of their future salary, for life. Over the long run, that Semmelweis would end up richer than Harvard. This offer stands, by the way: get in touch, I’m ready to sign that contract.
I’m personally willing to publish solid write-ups of foreign university offers for applicants from Russia and Belarus on my site. I usually research and write these myself. But if your university has a new program worth knowing about, especially one aimed at Russians, send me the details and I’ll publish it. By «solid,» I mean articles with real numbers: tuition and housing costs, specific support programs (scholarships, discounts, fee waivers), admission and language requirements, the odds of staying to work in the country after graduation, and actual salaries in the field.
Please pass this along to anyone you know on an admissions committee. My email is egor@kugno.ru, and I check it several times a week.
If this level of thoroughness interests you on adjacent topics: the site has more than fifty articles on relocation and careers abroad for doctors and nurses from Russia. The section on Europe’s leading economies alone covers 16 countries across 32 articles, there’s a separate guide to Directive 2005/36/EC and the «three-year rule» for doctors without an EU degree, a series specifically on diploma recognition for nurses by country (the economics there, incidentally, work out better and faster than for doctors), and a whole body of country-specific guides to medical education abroad for graduates of Russian schools.
This year, and probably next year too, I’ll mostly be writing about pharmaceutical regulatory affairs across the EAEU and Russia, so there’s more coming on LinkedIn.