The American Embassy in Moscow states, in this regard, Many Americans choose to leave Moscow for treatment of serious medical problems that arise. The Russian health system suffers the residual effect of the old Soviet system. Doctors were, and still are, very poorly paid. Monetary tips from patients continue to supplement their salaries. Some doctors also supplement their incomes with part-time jobs outside of their profession.
Problems also persist regarding the training of doctors.
From the time they entered medical school they were trained in separate programs to be pediatric doctors, adult doctors, and public health doctors, rather than generalist doctors. While the training system has now changed to train generalist doctors first, and then specialists, the transition is slow. Many Russian citizens receive primary care and many specialty services in polyclinics. Patients may, however, bypass the primary care doctor and see a polyclinic specialist. While women doctors dominate both primary and specialty care in the polyclinics, hospital specialists are mostly men.