Cardiovascular Perfusionist from South Africa

Growing up in a beautiful country called South Africa, I did my Master's degree in Clinical Technology and specialised in cardiovascular perfusion in Bloemfontein. In 2008 I got an opportunity to do an internship in Oxford UK, and after that I was open to move abroad. At the end of 2009 I got a job offer at Leiden University Medical Centre as a senior cardiovascular perfusionist, and I was also offered a senior position at a private clinic in Australia, however the offer including the full 30% ruling for 10 years by LUMC convinced me that my financial situation would be best served by accepting the LUMC offer, and I moved to Leiden in March 2010. Even though I received the 30% ruling I still found that the cost involved to maintain my previous standard of living in South Africa where a lot higher, and without the benefit of the 30% ruling life would have been tight, living salary by salary without the possibilities for saving up, and not knowing if bills and mortgage responsibilities could be met.

Since 2007 there became a huge shortage of perfusionist in the Netherlands and ever since then perfusionist from Germany, Belgium, Italy, Poland, Turkey, India, South Africa and USA have been employed by hospitals all over the Netherlands, which makes out 15% of all perfusionist currently working in the Netherlands. It has been predicted that this number will increase to 25% in the next 5 years. This is the highest number of foreigners in any health care profession. Currently there is approximately 145 perfusionist in NL, and according to reportage by the NeSECC (Dutch Board of Cardiovascular Perfusion) this is not enough for the current and future work load. Approximately 16500 open heart surgeries are done per year in the Netherlands, and that doesn’t even include the responsibilities of 24/7 standby and care for emergency cases, ICU care for ECMO, ECPR, LVAD’s patients etc., and the service we deliver to oncology for liver and lung perfusion and HIPEC’s. 

We as expats didn’t only just bring our expertise to the Netherland, but we are also working hard and actively involved in the training and education of the student to become future perfusionist.

This shortage of perfusionist is not just in the Netherlands, but worldwide. Now a day the shortage of health care workers in the UMC’s is growing day by day.

If the Netherlands did decide not to honour their previous commitment to the 30% ruling, then financially I would be at a disadvantage in my long term financial planning. I made this 10-year commitment to the Netherlands on the understanding that they will fulfil their 30 % ruling commitment to me. I have continued to base my career path on this, and indeed turned down lucrative contracts and opportunities in other countries in the believe that the Netherlands tax department will honour the agreement that brought me to this country. If this 30 % ruling is rescinded it will force the international health care community working in the Netherlands into financial disadvantage and seek future employment in other countries where their expertise is also in high demand. 

This is not what I desire to do, because even though I moved here leaving my family and love ones behind, the Netherlands grew on me, the culture, the people, I even like the cheese. I made life time friends, making many memories, stories that I can tell for the rest of my life. But at the end of the day the uncertainty and the resentment for not taking the opportunities that came my way is staring me straight into my face, and ultimately I might have to move to another country way earlier than I have planned.