site.btaStronger Paramedic Status Will Improve Emergency Care, President Radev

During a meeting with the leadership of the Union of Paramedics in Bulgaria, President Rumen Radev said that consolidating the professional status of paramedics and fully integrating them into Bulgaria’s emergency medical system will improve the quality of care and increase the effectiveness of life-saving interventions. He made this point at talks with Union Chair Iva Pehlivanska and Deputy Chair Dr Teodor Tsankov, the President’s Press Secretariat said on Friday.

The meeting was also attended by members of the Bulgarian team which, led by Dr Tsankov, represented the country for the first time at Euro SimCup 2025 emergency medicine competition in Vienna and ranked among the top five teams. Radev praised the team for their strong performance and stressed that paramedics’ skills should be fully integrated into the healthcare system to improve response during the “golden hour”. He noted that Bulgaria continues to face high cardiovascular mortality and said reversing this trend requires stronger prevention, early detection and better-resourced emergency medical services aligned with modern standards.

Radev also stressed that his caretaker governments launched key healthcare reforms under the Recovery and Resilience Plan, including the Presidency-initiated air emergency medical service (HEMS), new regional centres to prevent long-term disability in stabilized patients, 390 new outpatient clinics nationwide, and a digital diagnostic platform.

The Union’s representatives warned that severe staffing shortages across the healthcare system require structural reform and a national strategy for emergency medical services. They said that paramedics are trained in secondary and post-secondary programmes without a unified national standard or official recognition as medical professionals. Pehlivanska said that the Union has drafted a national educational standard for the profession to improve training and oversight. She added that proper regulation and integration of paramedics is essential to addressing workforce gaps and improving emergency care, while some areas already have ambulances but lack the personnel to operate them effectively.

According to the organization, in many EU countries physicians intervene in ambulances only in strictly specialized cases, while routine emergency care is provided mainly by paramedics. This model has reduced incident-related mortality by more than 70%.

The Union has long warned of a severe staffing crisis in emergency care, with analyses showing around 340 doctor posts chronically vacant and shortages reaching over 40% in Sofia and 60% in Silistra. Despite pay rises, roughly 500 doctor positions remained unfilled in 2024, leaving more than half of emergency centre posts vacant. The Union views converting some doctor vacancies into paramedic roles and introducing flexible employment as the quickest way to stabilize the system.

It also advocates expanding paramedics’ role in areas such as school healthcare to ease the chronic shortage of nurses and feldshers (mid-level medical practitioners trained to provide basic diagnosis, emergency care, and limited clinical treatment), and improving workforce allocation in hospitals and outpatient care. Additionally, the organization proposes standardizing paramedic training to European emergency medicine standards to support the profession’s professionalization and harmonization.