Without even finishing her studies, Shpresa from Pristina has secured five job offers - in Germany and Switzerland.
After June, when she completes her nursing studies at one of the private colleges in Kosovo, she will be licensed and then begin her journey abroad.
The employers from whom she has received offers are only waiting for her confirmation, as well as the date when she will start work.
"In seven or eight months I will be there," says Shpresa, whose real identity is known to the editorial staff of Radio Free Europe, reports A2.
The salaries offered, according to her, are much higher than the maximum salary of around 840 euros gross that a nurse can receive in Kosovo.
"It's mostly between 3,600 and 3,800 euros [gross] per person. From that, the taxes withheld by the state are deducted, and around 2,600 to 2,700 euros [net] remain," Shpresa emphasizes.
But it's not just the salary that motivates him to move outside of Kosovo.
She doesn't want to face the bad experiences that, according to her, her colleagues have gone through during job competitions.
"Unfortunately, things in Kosovo are based on acquaintances [nepotism]. I don't know anyone. So, for me, it's more important to go to foreign countries than to stay in Kosovo. There, your college degree is recognized, they welcome you just like a nurse, and there you don't need to look at who your mother is, father is, or who you know," said Shpresa.
She is not the only one targeting European Union countries.
The trend of healthcare personnel leaving Kosovo for Western countries, which has been noted for several years, is continuing, say the Federation of Healthcare Unions of Kosovo.
If this trend is not curbed, according to the president of this federation, Tevide Imeri, the country risks being left without doctors and nurses of various profiles.
"It is strange and absurd that Kosovo is producing health workers, as if they were 'food' to export. Private and public [educational] institutions are producing cadres to sell," Imeri emphasizes.
According to data from the Federation, but also from the Kosovo Medical Chamber, from 2018 to now, around 850 doctors have left the country, most of whom have fled to Western countries for employment reasons.
For the same reasons, according to them, over 300 nurses leave Kosovo each year, to work mainly in Germany, but also in other European countries.
A study by the Institute for Advanced Studies - GAP, in Pristina, published in October last year, which compares employment in Germany and Kosovo, as well as sectors and salaries according to purchasing power, shows that during the years 2019 to 2023, a total of 9,416 Kosovo citizens were employed in the health sector in Germany.
Meanwhile, during the same period, the same sector in Kosovo employed 14,786 people.
The President of the Kosovo Chamber of Physicians, Pleurat Sejdiu, tells Radio Free Europe that during the period 2018-2022 alone, around 700 doctors have received a certificate of professional cleanliness from the Chamber.
This certificate, according to him, is necessary for employment, especially in Germany. The trend of doctors leaving Kosovo, he says, has continued in the years that followed until today.
"In the current year, there are 31 [doctors who have left], so far. It is estimated that about 90 percent of those who have received certificates have left. We have about 850 doctors who have left Kosovo. In general, if we calculate with those who graduate from the Faculty of Medicine in Pristina, Tirana and Tetovo, we have approximately six lost generations," says Sejdiu.
The public healthcare system in Kosovo is mainly supplied with medical staff who graduate from three universities: those of Pristina, Tirana, and Tetovo.
They should be cadres who renew the medical campus of Kosovo's public health system.
Data from the Kosovo Chamber of Physicians, according to Sejdiu, show that last year, around 180 doctors from these three universities entered the Kosovo labor market.
Also, in 2024, about 220 doctors left the public health sector, of which 111 left the country, 92 retired, and 15 doctors of working age died.
"It means we are in the red every year," says Sejdiu.
However, he adds that, on average, around 500 doctors remain unemployed in Kosovo during a year.
Unemployment, according to him, is the number one reason why doctors leave for employment abroad.
The new generations of doctors, as he says, "are more ambitious about learning knowledge," and are not satisfied with the quality of specializations offered in Kosovo.
In the specialization phase, the salary of young doctors is around 700 euros gross, says Sejdiu, adding that this is discouraging for them.
"The common denominator of all of this is the lack of prospects for them in the healthcare system in Kosovo," Sejdiu emphasizes.
A large number of nurses have left Kosovo to find employment in Western countries, confirms Imeri from the Federation of Health Trade Unions of Kosovo.
"In 2023, 713 [nurses] received documentation to leave," says Imeri, adding that the trend of nurses leaving continues.
"It is estimated that almost one nurse per day leaves for Germany, which amounts to more than 300 within a year," she emphasizes.
Imeri also supports Shpresa's claims of nepotism during employment in the public healthcare system in Kosovo.
"This is very true. The point is that [nepotism] is so well covered with papers [documents] that it is impossible to detect it. It happens that a nurse is waiting 12-13 years [for employment]... People are tired of waiting, or begging politics to hire them," Imeri emphasizes.
The Kosovo Ministry of Health has not responded to Radio Free Europe's question about whether it has a plan or strategy to curb the exodus of health workers for employment abroad, as well as to prevent the alleged causes of this exodus.
What are the consequences?
The Kosovo Chamber of Physicians and the Federation of Health Trade Unions of Kosovo consider that the country's governing authorities should create a long-term strategy, which would curb the trend of healthcare personnel leaving the country.
On the contrary, as Sejdiu says, the departure of doctors who are in the specialization phase initially leaves primary medicine, or Family Medicine Centers, without staff.
"Especially in medium and small municipalities, there are a number of health centers that are closed because they do not have doctors. This is the first wave. The second wave means that regional hospitals have only just begun to be hit, where there is no renewal [with doctors]. The third wave will hit the University Clinical Center of Kosovo (UCCK), but a little later," Sejdiu emphasizes.
He adds that most doctors of various profiles are concentrated at UCCK, in Pristina.
This approach, he claims, demonstrates the lack of an employment strategy by the Ministry of Health, which should distribute staff proportionally across other regions of Kosovo.
Imeri also expresses the opinion that, if the trend of healthcare personnel leaving the country is not curbed, primary medicine will take the biggest hit.
"The coordinators with whom I am in constant contact say that by 2030 there will be no family doctors left," says Imeri.
She adds that it is imperative that the competent governing authorities create sustainable health policies and strategies that eliminate the causes of health personnel leaving the country.
If this does not happen, according to her, the future of the public health sector is completely uncertain.
"In some way, an uncertainty is created, which is why even I, at this age [50 years old], would often think about leaving... maybe taking the children and leaving. If I were to create a job, I would sign today and leave," Imeri concludes.
Meanwhile, Shpresa believes that everyone should continue their career and future in the country where they were born, raised, and developed.
"Unfortunately, if the conditions are the same [in Kosovo], then my career and my life continue in Germany or Switzerland. The moment things go well in Kosovo – and I hope they do – I will definitely be here to give my maximum to contribute to my country, to my homeland and to my beloved people."/ REL (A2 Televizion)
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