"The military doctor earns between 4 and 19% present little than the worst paid civilian doctor," says Gen. Broni Grzegorz Gielerak. manager of the Military Medical Institute – PIB points to staff shortages and systemic barriers that discourage doctors from serving. As he says, all of this translates into medical safety for armed forces and more broadly – the safety of the state.
Grzegorz Gielerak: "Of the 1506 medical posts provided for in the structures of the army, 888 are filled, which represents 59% of the full-time position – 618 doctors are missing". photograph by WIM-PIB
In fresh weeks, much attention has been paid to public debate regarding the hard wellness situation. To what degree does this “fall” – as any experts and politicians say – of the wellness strategy in Poland affect what is happening within military medicine?
Gen. defends Grzegorz Gielerak: The financial situation of the wellness strategy straight translates into conditions the functioning of military medicinal productsbecause their activities are financed entirely by a public payer. In this respect, we are no different from civilian entities – the problems of the full strategy are besides affecting the military. However, it is optimistic that we no longer have the National wellness Fund's queue strategy in place to defend medical soldiers since 2023. Activities Military Medical Institute - State investigation Institute The soldier remains a precedence patient, so there is no substantive justification for refusing to give him or her assistance.
You amazed me due to the fact that today, in the context of the wellness system, it is hard to think positively.
In general, I am inclined to justice that the glass is more half full than empty. However, this does not mean that I do not see problems requiring intervention. An example are fresh situations in military hospitals in Szczecin and Lublin, due to the time limit being exceeded, admissions to orthopaedic surgery units have been limited. If specified barriers besides include soldiers, this leads to a real narrowing of the scope of their medical care. This is an unacceptable situation, weakening assurance in military wellness services and requiring systemic correction. Military hospitals should constitute a state crisis detachment as institutions capable of acting even erstwhile another elements of the wellness strategy are paralyzed.
The "Military Doctor" training, organized by the Military Medical Rescue Center, serves to improve the field of combat medicine, preparing future military doctors to save lives in utmost combat conditions. photograph by WCKMed
According to a study published in late 2025 by WIM-PIB, problems in military wellness care are serious. The paper created under your direction is very bitter. You indicate, among others, staff deficits and deficiency of motivation for the service of military doctors.
The study cites information from our investigation and analysis. The situation is serious. Of the 1506 medical posts provided for in the structures of the army, 888 are filled, which accounts for 59% of the staff position – 618 doctors are missing. Equally crucial remains the medical safety factor. The North Atlantic Alliance recommends a 100 soldiers per doctor. In full implementation of the current staff standard – which we do not meet anyway – this rate would be 140 soldiers per doctor in Poland. In fact, with the current condition of the staff, the proportion reaches 260 to one. The figures should so be worrying. We have the largest land army in Europe and are striving to further increase its numbers. Without decisive action, the staff crisis will deepen – and in a strategy as complex as the military wellness service, operating on an equally demanding wellness market, all negligence triggers the snowball effect: 1 vacant occupation means a greater burden on the others, a higher hazard of burning and subsequent departures, and these discourage further candidates – and so on.
Which specialists are missing most in the army?
Like the full wellness system, the military wellness service is struggling with a shortage of specialists. Young doctors are reluctant to choose specializations requiring many years of intensive training – this applies to both treatment areas specified as surgery and orthopaedics, as well as anesthesia, interns, infectious diseases and intensive therapy – i.e. specialities of crucial importance for the protection of medical forces and in the event of emergencies. A separate, equally worrying problem is intellectual and psychiatric care: we have only 13 psychiatrists in active service.
Does this mean that we don't train adequate military doctors, or just besides many leave the service?
That's the root of the problem. We conducted 2 independent surveys – among military doctors and students Military and Medical College of the Medical University of Lodz. The results of both studies lead to a common conclusion: the primary problem of military wellness services is not education or training of doctors, but keeping them in service. Initiatives aimed at expanding training limits will not translate straight into eliminating the causes of staff shortages. However, the factors identified by respondents are crucial: a predictable career path, a warrant of access to specialisation, real professional and technological improvement opportunities and appropriate relations with supervisors.
Gen. defends prof. dr hab. n. med. Grzegorz Gielerak
They say if you don't know what's going on, it's most likely about money. Doctors in the military make besides small money?
The staff crisis cannot be reduced to pay alone, as only 13% of respondents indicate the level of pay as a precedence problem. Nevertheless, today, a military doctor earns between 4 and 19% little than the worst paid civilian doctor. It sounds as if the strategy of all month, along with the payment of the salary, asks the military medics: “I pay you below the marketplace minimum and I limit your professional improvement – what else do I gotta do to convince you to leave the army?” Let me give you an example. In WIM-PIB we conduct many investigation and investigation projects financed from external funds, where military and civilian teams work. And imagine: the same project, the same work, and the military expert is paid worse just due to the fact that that's what the hotel regulations are. What signal are we sending these people? erstwhile a doctor in a uniform sees that his civilian counterpart is more gratified for the identical work, he does not calculate the difference in gold, but feels a deficiency of designation for his competences and engagement, which naturally creates a sense of injustice and undermines loyalty to the army.
Strong. But if money isn't everything, where else do military doctors see problems?
The majority points to an excessive burden on administrative and logistical tasks and a deficiency of prospects for professional development. A military doctor has a statutory right to specialize 27 hours a week, while a civilian practitioner has 38 hours. As a result, it is much more hard to get specialization during military service and takes on average 2 to 3 years longer than in civilian service. In addition, there is limited availability of specialization sites, long distances between individuals and medicinal agents, and a differentiated approach of the commanders to train their physicians.
Those who, after all, have completed their specialization must besides face real difficulties. It's up to the commander's will that they can practice in a close hospital. The dependence of professional improvement on arbitrary decisions is powerfully demotivating and, most importantly, is contrary to the interests of the armed forces, which should depend on maintaining the service of the best specialists. The consequences of these barriers are seen in the self-assessment of the environment: 38% of medical officers consider their own preparation for action on the battlefield insufficient. So we are talking not only about the staff crisis, but besides about competence.
Are you saying that it's not adequate that doctors aren't enough, that they're inactive underprepared?
Everything we are talking about translates straight into medical safety for the armed forces and public security. The function of military wellness services is not only to care for soldiers, but besides to prepare the civilian wellness strategy for action in times of crisis and war. However, in order to be able to fulfil this role, it must function smoothly and its staff should have appropriate competences. At this point, however, there is simply a fundamental problem, frequently overlooked in discussions focused exclusively on staffing – about 72% of military doctors have no specialization.
We invest tremendous resources in weapons, make defence capabilities, allocate crucial amounts of money to train and prepare a professional army. Let us so take equally decisive action so that the people in whom we have invested time and money have the medical support they deserve.
My attention was besides drawn to another data. According to the report, only 41% of respondents from the Military and Medical College declare their willingness to proceed their service, 28% are undecided, and until 31% decided to leave the army. How is it possible that so many people want to resign before taking the first position?
I will admit that this was besides a surprise for the authors of the report. What is symptomatic, the percent of people declaring their intention to leave the army is higher among students of the last year than among those starting school. This means that motivation fades as studies proceed – the closer to the end of education, the more people do not want to tie their future to the uniform. delight note: we are not talking about people who have been disappointed by the regular reality of service in the unit, excess administrative or logistical responsibilities. But if students, even before entering the reality of the service, think about leaving it, let us not ask what is incorrect with them – let us ask what makes specified a decision seem reasonable in our system.
They're gonna make little money than their fellow civilians, pursuit after the field, spend years specializing. possibly we shouldn't be surprised.
That is why we should do everything we can to improve the terms of service of military doctors and halt them leaving the army.
The Ministry of Defence has decided to reactivate Military Medical Academy in Łódźand in Krakow was created Medical Army Command. What another changes are you talking about?
The appointment of the Medical Army Command is an crucial signal of direction of change and a essential organisational decision. At the same time, the current position in the strategy and the scope of competence indicate the request for further evolution. In the long term, this structure should service as the leading entity in managing the full spectrum of military medicine.
The comfort of the service of military doctors would besides greatly improve their relief from non-medical tasks which they are presently burdened with in units. In this way, they would have regained rather a bit of time for apprenticeships and professional improvement. It is besides worth considering the implementation of the incentive system, which would reward the taking of key specializations from the point of view of military needs. The proposed allowances would not only compensate for the existing wage gap between the civilian and military systems, but would besides encourage medical practitioners to make professional improvement in precedence directions for the army.
Grzegorz Gielerak: "In WIM-PIB we conduct many technological and investigation projects financed from external resources, where military and civilian teams work"
In addition, the first specialised training should be carried out by doctors in leading military hospitals, operating at that time in a variable working condition [it is to make an adequate number of posts for soldiers who are in the course of cyclical training; the staff in this case may be variable]. The proposed solution will let them to hold mobilization allowances in the parent units and periodically participate in the exercises together with their medical safety teams. As a result, they will not lose contact with the reality of the service, will supply ongoing medical support for operational activities and – crucially – systematically make the competences essential for modern military operations. This activity should be complemented by training and certification to operate in specialised emergency medical consequence teams and field hospitals.
Turn over the table. Were these ideas discussed in the Department of Military wellness Service?
I'm not proposing a revolution, I'm just checking to see if the strategy on which we are based is inactive on unchangeable foundations. The conferences organized by WIM-PIB are always attended by representatives of the Military wellness Service Department. Furthermore, most of the proposals contained in the study are studies that have been submitted to the Department successively over the last 2 years pending their analysis and further action. It is hard to recognise cooperation as a real dialog to date, even though the vast majority of our initiatives have not been answered in substance.
Times change, troops change, doctors besides change. The organizational culture of the army requires constant improvement – it should not stay rooted in the erstwhile era, while the fresh generation has completely different expectations. erstwhile hiring young doctors in WIM-PIB, I don't hear questions about earnings – I hear questions about how their professional improvement will look in the next 5 to 10 years. This position should besides be the key to military medicine. Let us plan careers for 25 years of service, make a strategy of improvement and benefits utilizing the opportunities offered by NATO membership – only in this way will we attract to the army and keep top-class specialists in it.
