Business Daily – "Why are medical students going to Bulgaria?"

BBC World Service | October 19, 2025
Host: Joel Dummigan

Episode Overview

This episode explores why a growing number of UK and international students are choosing Bulgaria to study medicine. It unpacks driving factors such as competitive entry to UK medical schools, the affordability and accessibility of Bulgarian medical education, and the thriving student support industry in Bulgaria. At the same time, it highlights the paradox these trends create: Bulgaria is successfully attracting foreign students (and their fees), yet it faces an acute shortage of healthcare staff as its own clinicians emigrate for better pay and work conditions elsewhere. The episode weaves together student perspectives, academic insights, and a look into Bulgaria's healthcare and educational policy context.

Key Discussion Points and Insights

1. Bulgaria’s Appeal for Medical Students

(02:00 - 10:00)

• Limited UK Medical School Places:

  • UK restricts medical student places because of high funding costs (£250,000/$330,000 per student to the state).
  • Intense competition leaves many qualified students without offers.
  • Freya Mandapali (08:20):

    "I got interviews but I didn't get offers. So I just decided instead of taking a gap year and reapplying, that I'd look at options abroad."

• Why Bulgaria?

  • English-taught programs make it accessible.
  • Lower entry barriers: Entrance exam instead of demanding UK-style A-levels.
  • Tuition of ~€10,000/year (US$11,500)—higher than for Bulgarians but much lower than other international options.
  • Globally recognized diplomas.

• First-Hand Student Experiences:

  • Mohammed Adnan Patel (05:10):

    "It was a big shock to my family that I was not only studying medicine, but I was also studying it abroad... living independently, doing it all without my family being around me."

  • Freya Mandapali (08:50):

    "Lots of international students tend to go there to study medicine and the course seemed pretty hands-on from the start."

2. The International Student Ecosystem in Plovdiv

(10:00 – 17:00)

• Student Demographics:

  • Over 7,500 foreign med students in Bulgaria; 1,700+ at Plovdiv Medical University.
  • 40% of Plovdiv's international med students from the UK, but includes Canada, Germany, Ireland, Japan, and more.
  • Professor Vasilina Garanova (12:20):

    “We have students from Greece, Turkey, then Italy and Germany, Canada, United States. But most of the students, about 40% come from UK.”

• Campus Life and Expansion:

  • Classes begin early; workload involves long days but is balanced with breaks.
  • University is rapidly expanding, financed by foreign student fees—new departments and housing construction to accommodate the influx.
  • Danny Karunadas (15:40):

    “Over the past like five years, I've noticed that the university has constructed a new department... they're constructing a new library. So the new students that do come along, they'll enjoy that a lot.”

• Living Support and Student Agencies:

  • Specialized agencies (like MedConnect Europe) assist students in all logistics: housing, airport pickups, groupings, SIM cards, and more.
  • Dr. Mohammed Hamza (16:50):

    "We get them in touch with the estate agents, we book the flights for them... setting them up because they don't know the language. And we have representatives in each country that do know the language."

  • Students often grouped for continuity—form close-knit support networks.

3. The Local Impact: Economy and Housing

(17:00 – 20:00)

• Booming Student-Driven Economy:
  • Surge in English-language advertising and premium housing.
  • Foreign students set higher expectations for comfort—and have the budget to meet them.
  • Erkan Altensoy (lettings agent, 17:50):

    “These apartments ... are higher in terms of the price level, but they are also well furnished because they want an apartment that they can move right in without having to look for some furniture ...”

4. The Other Side: Bulgaria’s Own Healthcare Crisis

(20:00 – 37:00)

• Healthcare Worker Shortage:

  • Bulgaria faces regular protests from underpaid, overworked nurses and doctors.

  • Milka Vasilova (union leader, 25:40):

    “The nurses, we were the first to demonstrate that we won't work anymore with such low salaries. ... The young doctors went with us ... to tell them that this must be changed. The model must be changed.”

  • Junior doctor salary: ~$1,200/month; nurse: ~$900/month—a fraction of Western Europe’s pay.

  • Around 25% of new med grads leave Bulgaria immediately after qualifying.

• Statistical Picture:

  • Bulgaria lacks 30,000 nurses; approximately 50,000 are working abroad.
  • Of ~20,000 nurses in Bulgaria, 1/3 are at pension age—imminent risk of collapse.
  • Milka Vasilova (32:00):

    "If tomorrow they decide to leave the system, the health care will collapse."

• Historical/Sociological Factors:

  • Communist legacy: Large, state-run healthcare system, but with modest wages.
  • EU accession (2007) accelerated emigration as mobility became easier.
  • Ralit Saganev (Sofia University, 28:10):

    “They left the country because of the pay gaps, the workload, the equipment, the limited career paths.”

5. Policy Response and the Global Competition

(33:00 – 37:20)

• Bulgarian Government Response:

  • Made nursing degrees free; new bursaries if students commit to working in Bulgaria for set years post-graduation.
  • Uncertainty remains about effectiveness in stemming brain drain.
  • Professor Garanova (35:15):

    "Every year we increase the number ... in nursing who are enrolled... when they become nurses, get their diplomas, maybe they are disappointed from the conditions ... and look for realization in different fields."

• The Global Race for Medical Talent:

  • Aging populations driving up demand for healthcare workers in richer countries.
  • Many richer countries "under-financed" their own medical training, relying on importing doctors/nurses.
  • Professor Saganev (36:05):

    “Many rich countries chose for decades to under finance medical training. ... Everybody's fighting over the same people, aren't they? Yes, they are.”

  • Clinicians are becoming “the most valuable assets in global markets.”

Notable Quotes & Memorable Moments

• Mohammed Adnan Patel (05:10):

  "It was a big shock to my family that I was not only studying medicine, but I was also studying it abroad."

• Barley Ryan (parent, 19:15):

  “It was hard to get in the uk. It's very, very hard. Too competitive... I feel more nervous. But no, I think it's the right decision. He can spread his wings and it's something that he wants to do.”

• Milka Vasilova (25:40):

  “The nurses, we were the first to demonstrate that we won't work anymore with such low salaries.”

• Professor Saganev (36:05):

  “Everybody's fighting over the same people, aren't they? Yes, they are. ... Nurses and physicians will be among the most valuable assets in global markets.”

Timestamps for Key Segments

| Segment | Timestamp | |------------------------------------------------------|------------| | UK med school barriers and student decisions | 02:00–09:00| | International life at Plovdiv Medical University | 10:00–15:45| | Expansion and student agency services | 15:45–19:00| | Family perspectives – parents and arrivals | 19:00–20:45| | Bulgarian healthcare worker crisis | 20:45–26:00| | Brain drain, history and pay issues | 26:00–34:00| | Government reforms and future outlook | 34:00–37:30|

Conclusion

The episode paints a vivid double-edged sword: Bulgaria’s efforts to tap into the lucrative market of international medical education contrast sharply with its struggle to retain the health professionals it trains, for Bulgarians and foreigners alike. Competing global forces mean that, as Professor Saganev notes, “nurses and physicians will be among the most valuable assets in global markets”—a reality with profound consequences for healthcare worldwide.

For students, Bulgaria offers opportunity, community, and recognition; for Bulgaria, the challenge is to find ways to keep its own talent at home.