The perspective of anesthesiologists who moved to Sweden

You accepted the job, learned the language, and your belongings are in a new accommodation in a distant country. Our candidates Kristina and Patricija explained to us in more detail what you can expect, what will await you and how the life of an anesthesiologist goes after moving to Sweden.

Kristina

Kristina thought about moving for a long time and, like many candidates in our area, she was first interested in new opportunities in Germany and Austria. These countries are often chosen by candidates who want to have a connection with their homeland, but Kristina was not satisfied.

“I have to admit that my first choice was Germany or Austria. Partly because of the relative proximity to Croatia, partly because in my environment, those are the countries that come to mind first when thinking about working abroad. But I gave up because the working conditions were not attractive to me. In addition, the entire relocation process seemed complicated to me because intermediary companies did not offer much help,” Kristina explains her reasons. After this experience, she decided to check what the opportunities are in Scandinavia, so she sought more information from a colleague who moved to Sweden a few years earlier. The experience of a colleague confirmed that this “distant, unreal country of social equality and excellent working conditions”, as Kristina called it, is very real, close and achievable, so the decision to move to Sweden was made, despite the cold climate, which she is not a fan of.

The reasons why she decided to relocate, she believes, are similar to the reasons of 99% of other colleagues who left Croatia: endless overtime hours and politics, corruption and nepotism, rule by the incompetent but eligible. However, there are no such problems in Sweden. “Sweden is far from an ideal country, society is also struggling with problems here, but everyone will get a job if they want it. Swedes respect diversity and develop tolerance, they look to the future and do not constantly return to the past. In kindergartens and elementary schools, they learn to argue and defend their positions, but always with respect for different opinions. Teachers, and later in life, bosses are not absolute authorities, but people who do their job and receive a salary for it.”

The working conditions of anesthesiologists in Sweden for this satisfied anesthesiology are incomparably better than in Croatia. “For me, the most important thing is the balance between private and work life. There are no 24-hour on-calls. My annual salary is 31 days, and throughout the year I accumulate at least that many more days off because every hour spent on duty is counted double and each worker chooses how many of these “double hours” he wants to be paid in money, and how many to turn into days off. The work is organized. Everything is planned.” What Kristina sees as common for Swedish and Croatian anesthesiologists is that they are the “last line of defense” in both countries, with the difference that in Sweden you can say “I don’t know” and “I can’t” without it being interpreted as a sign incompetence.

Kristina sees the biggest differences in the work of an anesthesiologist in the very organization and distribution of tasks. For example, the anesthesia of “simple” patients is managed by anesthesiology technicians who do not have to sit next to the patient all the time, but take care of the preparation and postoperative plan with an emphasis on analgesia. Another important difference in work between Croatia and Sweden is respect for all ethical principles.

About the Swedes, our interlocutor thinks that they are correct and realistic: “Swedes follow prejudices that they are cold and unfriendly.” I wouldn’t agree with that. Rather, I would say that they are moderate. “Lagom” is a term that means “not too much, not too little, but just right”. In the global world, Swedes strive to be easy in everything. Perhaps it will be a good example if I say that Sweden has never, nor will it ever prepare for anyone the kind of welcome that our football players had or the farewell that Split prepared for Oliver, but they will gather together every year in formal clothes, with a formal dinner at their home on the 10th. December and watch the awarding of the Nobel Prize because in this way they show how much they admire Alfred Nobel and his work. What is a welcome difference to me is the way of communicating at work. There are no raised tones, no insults, no one looks down on anyone.” Additionally, it is important to Kristina that colleagues talk with mutual respect and appreciation of different ideas, regardless of hierarchical position, because the focus is on the best possible outcome for patients.

The working day of an anesthesiologist in Kristina’s hospital is 8.5 hours a day. The day starts with a short meeting of 10 minutes, after which everyone goes to their workplaces. Lunch is a central part of the day, and employees are encouraged to use the time for a break. The workload per doctor is less, and 30 minutes are set aside for each patient. “It is usual to discuss a lot with colleagues about patients. Asking for help is a sign of strength, not weakness, and this is something that my Croatian colleagues who come to Sweden really need to learn. We are not pretending to be gods here and it is quite acceptable to admit that things are learned but also quickly forgotten. No one knows everything and no one is omnipotent. There is a great focus on assessing the patient and choosing the treatment method (in our case, anesthesia) that is best for that particular patient.” – emphasizes Kristina, and she also emphasizes the time she has available for education. “Educations at the hospital level are everyday, there are countless workshops that take place continuously from resuscitation training, through trauma exercises to practicing communication skills. In addition, in a very short period of time, I was able to complete education in the field of donation, after which I became responsible for donation at the hospital level. In a way, I came to the same position that I left in Croatia with a great possibility of advancement. That is why he firmly opposes the stories that he cannot progress as a foreigner and that “a foreigner always remains a foreigner”. In the hospital where I work, the only things that are valued are competence and commitment to the overall progress of the department.”

Satisfaction with new working conditions, culture and destination is important for anyone who decides to make a career change in life. And the only advice that Kristina shares is that you need to decide and step into that change. “There are no guarantees of success. It can be the best thing in life, it can be a complete fiasco. But what prevailed for me is that I would never have forgiven myself if I hadn’t tried. Because what I had to lose actually, I can always go back… If I want to. And as things stand now, I’m not even close to returning. I definitely recommend INCOR because on that scary journey of going into the unknown it is very good to have a warm and communicative person next to you, someone who will calmly explain a hundred times how the whole procedure works. ”

Patricia

Like Kristina, Patricia was motivated to move by the bad situation in healthcare and the state in general, as well as politics and corruption. With a doctor husband and two small children, working hours with on-call hours was almost impossible for this couple with 300 working hours a month. In addition, she is dissatisfied with the possibilities for education in Croatia. “We wanted to provide a better life for the children and ourselves. What I must emphasize is that salary was not one of the reasons why we decided to leave Croatia. With two doctoral salaries, and of course a lot of on-call work, we were able to live quite well in Croatia. This is far from the fact that we lived luxuriously and did not save or give up anything. But I must also mention that life with 2 PhD salaries is much easier in Sweden, ie the salaries are much better. And although the standard is higher and some things are more expensive (but some are also cheaper), life is much better.”

About the working conditions, like Kristina and Patricia, they have only words of praise: “As an anesthesiologist, I work 42 hours a week and have about 4-5 on-calls a month, with the fact that the on-calls are partly paid and partly counted as extra free hours that I can use whenever I wish, of course in accordance with the schedule at work. I generally work about 3 days a week. Of that, one to two on-call days plus one to two days off were earned on previous on-call days.” Many of her colleagues use their days off by taking the whole week off, but it’s easier for Patricia to use her days off when the kids are free for adventures. Education and advancement are not an obstacle, and when you become an Överläkare, i.e. a senior officer, then you also get your own specialist who does most of the work for you, and you come to the hospital only when necessary. All work is organized, and work plans are known up to 2 months in advance. The working day is organized so that colleagues consult with each other about patient care, and our interlocutor was surprised by the restrictiveness of Swedish colleagues in the use of antibiotics. “They are still most normally treated with penicillin. And the resistance to antibiotics is much lower than in Croatia, where every other IVA patient would be resistant to “more modern” antibiotics,” explains Patricia and continues: “Relative visits are allowed in the intensive care unit at any time of the day or night. Not like in Croatia, only for half an hour at a certain time. Even relatives get lunch or something to snack on if they are visiting for a longer period of time.”

When it comes to patient operations, usually 2 to 3 anesthesiologists cover about 10 rooms and do a preoperative assessment of patients, and Patricia does not examine the patient in person but via computer. Although it was a little strange to her at first, she realized over time that there are actually no omissions because the patients undergo several checks. First, the operator (surgeon, orthopedist, gynecologist, urologist…), then the anesthesiologist, and on the day of the operation itself, they meet with a specialized anesthesiologist nurse who puts the patient to sleep, intubates, maintains and wakes up the patient so that the anesthesiologist is not in the room, except in case of problems.

Patricia also covers neonatology at her workplace because there are no neonatologists in smaller hospitals. Anesthesiologists and pediatricians are responsible for a newborn child, and in cases of asphyxia they are the first to be called. But the work is less stressful. “There is a possibility of working 90%, 80% or less. I have 30 working days of annual leave. The employer somehow wants to use 4 weeks of annual leave in one piece. Of course, they can schedule the annual in a different way. In addition to the annual, I still have about 300 free hours, which in days would be an additional 37 free days.”

Education, congresses and seminars are not unavailable in Sweden, on the contrary, the employer covers the costs of education, transportation, accommodation, and a daily allowance is also provided. In Sweden, there is also an allowance called friskvårdbidrag, i.e. a fee of 250-300 euros that the hospital pays to employees for a contribution to their health. “All the interns also have a few “läs” days a month. In other words, a working day that is intended primarily for reading/education,” explains this experienced anesthesiologist who likes the Swedes as a people because they try to live life slowly and without stress. “There are prejudices that Swedes are cold and unfriendly. I would not agree with that at all. Swedes are very warm and open and willing to help. They know how to joke and party. But as I already mentioned – they don’t like stress. ”

Patricia also convinced herself that a hierarchy like the one in Croatian healthcare does not exist. In Sweden, everyone has the right to vote – from interns to residents and nurses. Although payroll taxes are high, a lot is returned through child benefit, free education and school supplies. Even children get falls at school. “Sweden is far from an ideal country. But no country or society is ideal. What is really an advantage here compared to other “western” countries is a good balance between private and business life. ” – concludes Patricia.