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A young doctor couple، Anel Kurmanova and Sabirzhan Tolumkhanov، have traded the bustling streets of Almaty for a quieter life serving a rural community. Two years ago، they moved to the Irtysh district of the Pavlodar region under the "With a Diploma to the Village" program. Their recent online poll about doctors' salaries sparked widespread discussion، prompting a closer look at their decision، the challenges they face، and their hopes for the future.

The Move to the Village

Anel and Sabirzhan settled in the Irtysh district in August 2024، taking up positions at the local hospital. Sabirzhan works as a general practitioner، while Anel specializes as a therapist-infectious disease doctor. The government program provided them with a service apartment and assistance with placing their children in kindergarten. They also received a one-time relocation payment of 250،000 tenge per family member. Under the program's terms، they are committed to working in the village for at least five years، with a seven-year requirement to avoid repaying the relocation bonus.

Their lives have seen significant changes since arriving. Last year، they welcomed their second child and purchased a private home، moving from their initial accommodation to a house in the district center.

"With a Diploma to the Village" Program: Pros and Cons

Anel views the program favorably، particularly highlighting the access to subsidized loans for purchasing housing. However، she notes that program conditions can sometimes shift، as they experienced when the interest rate on their housing loan increased from 0.1% to 1%. Despite this، she acknowledges it remains far more advantageous than standard mortgages.

A drawback، according to Anel، is the modest relocation payment. "Who would move to a village for 100 MCI (approximately 432،500 tenge)؟" she questioned. She advocates for increasing this amount to at least 300-500 MCI and streamlining the application and disbursement process to prevent lengthy waits for young specialists.

Daily Life in a Rural Clinic

The couple purchased their home for 10 million tenge، but anticipate significant renovation costs. Their house is not connected to the central heating system، requiring work on a septic tank، water supply، flooring، heating system upgrades، and the installation of a powerful stove. This past winter، they had to manage two stoves.

Contrary to the common perception that rural living is cheaper، Anel points out that even staple products like meat and milk are expensive. A portion of their salaries is allocated to fuel، coal، and heating. Their initial plan to establish a large garden for growing vegetables was postponed due to a lack of time and energy after work، though they did manage to plant strawberries this year.

"The season for mosquitoes and midges has started. That's another 'charm' of rural life you have to get used to،" Anel jokes. While rural life isn't always romantic، it offers advantages like avoiding city traffic jams. "Clean air، the opportunity to save money for the future or pay off debts. Rural life teaches patience، finding joy in small things، and developing resilience،" the couple shares.

Work and Family Support

Anel expresses deep respect for her husband، Sabirzhan. Initially، he worked as a district therapist in Panfilovo village، 40 kilometers from Irtysh. He later transferred to the district hospital، where he currently practices.

"My husband often works late، sometimes until midnight. Especially when patients with strokes and heart attacks need to be transferred to the city، he coordinates with air ambulance services and doctors in Pavlodar to ensure timely specialized care،" Anel explains. She recently returned to work after maternity leave، with her father assisting with their 10-month-old son. "My father is a great help. We don't spend money on a nanny؛ we entrust the children to a relative. We can stay at work until the evening. This wouldn't be possible in the city،" she adds.

Anel admits she would prefer to stay home with her son if her husband's salary covered all family expenses. However، their son will need to attend kindergarten once he turns one.

Anel herself cut short her maternity leave with their elder son، enrolling in residency when he was eight months old. "When my son was one، he fell and hit his head on concrete، fracturing his skull. He spent a day in intensive care. Yet، I couldn't take regular hospital leave because I had exams. I studied for nine years to get my second degree، and now I earn 250-300،000 tenge a month. Is that fair؟" she asks.

The Reality of Doctors' Salaries

Anel's video asking for salary predictions went viral. Nurses and paramedics guessed her income as a therapist with six years of experience to be between 200،000 and 450،000 tenge per month، while patients suggested figures ranging from 250،000 to one million tenge.

Anel aimed to debunk the myth that many doctors in state hospitals earn over 500،000 tenge. She revealed her March salary was 242،000 tenge and her April salary was 318،000 tenge. The April figure included a bonus for confirming her second-category specialist status (approximately 45،000 tenge) and compensation for covering another doctor's workload.

"I believe medical professionals should earn a salary that allows them to fully focus on their work and patients، without worrying about loans، mortgages، or debts،" Anel states. "Doctors are forced to take on extra shifts and work multiple jobs to support their families. This leads to burnout، and many leave the profession."

"There was no reaction from management، but I received support from colleagues across Kazakhstan. Many doctors wrote that earning 500-900،000 tenge on a single shift is unrealistic،" Anel shared.

The young doctor notes that some people still believe doctors work only four hours a day، but the reality is different. "Currently، I work one full-time position، but my workload is equivalent to one and a half. I have to take documents home، meaning I spend nights compiling patient records. Generally، a general practitioner works eight hours if they have only one caseload. Five hours are for patient consultations، followed by house calls، screenings، check-ups، and processing disability paperwork. It's not just consultations؛ there are countless unseen tasks،" she explains.

To increase her income، Anel obtained second-category specialist status، a process available only to those with over five years of experience. She has also requested her management to review her workload and salary. "In our family، my husband takes on the night shifts، as I cannot yet do them with a baby. If both of us were constantly working، who would look after the children؟"

Personal Blog and Hope for Change

Anel is actively developing her blog، sharing insights into her rural life and offering practical advice. While it doesn't generate income yet، she hopes it will provide additional support for the young family in the future. "I will never promote ineffective 'miracle' cures، colon cleansers، or anti-parasitic supplements. In most cases، it's just marketing،" she asserts.

Recently، Anel returned to her passion for volleyball، participating in a district spartakiad and winning first place with her team. An upcoming regional competition awaits.

The couple doesn't hide the fact that they could leave Irtyshsk at any time. "But there's a sense of duty، responsibility، and conscience. There are patients waiting for help. Honestly، I don't want to live in a village for the rest of my life. However، for the next three years، we are not leaving. If، in the future، the work، salary، and village development satisfy us، we might stay for five or even ten years after the initial three،" Anel concludes.

Despite the hardships، domestic challenges، and demanding schedules، the young family continues to serve in rural healthcare، raise their two children، and make their house a home. They remain dedicated to their profession، hoping for greater appreciation of doctors' work and improved conditions.

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