specialists are concentrated in large cities and shortages are a particularly pressing issue in rural areas shortages in emergency medical specialists anaesthetists intensive care specialists and ophthalmologists are reportedly particularly pressing in rural areas rural municipalities have tried a number of initiatives to attract specialists including salary supplements and free accommodation shortages persist however signaling a complex problem that is likely to need additional initiatives such as improvements to rural schooling and other services to attract health professionals and their families the demand for specialised nurses such as surgical nurses and intensive care nurses is particularly high in europe leading to a relatively high expatriation rate for nurses at as discussed earlier oecd c although many returned to work in nursing following the global financial crisis as it offered more stable employment compared with other sectors affected by the economic downturn on average about nurses choose to discontinue to work as nurses while about to nurses are trained every year