Dr Semyon Galperin spent a decade in medical research in Russia and as much time in the United States, working at top hospitals and research companies.

Despite his expertise, Dr Galperin was recently given a stark ultimatum from the Moscow hospital where he works: leave or stay on as a lowly hospital attendant.

Dr Galperin’s job is being eliminated as part of a sweeping reform in which at least 28 Moscow hospitals are to be closed and up to 10,000 medical staff sacked, an overhaul that officials say is needed to modernise a decrepit Soviet-era health system. On Sunday, thousands of doctors and their patients are set to march against the reform as part of the first mass social protest in Russia in nearly a decade – a threat to President Vladimir Putin, who faced down a wave of political protests launched in 2011 and is now struggling with a faltering economy.

The doctors’ rebellion started early this month, when thousands took to the streets to protest against the redundancies and hospital closures. Aware of the potential fallout from this protest, last week Mr Putin asked the Moscow government to reconsider the reform as his human rights council hosted a round-table discussion with prominent doctors and trade unions that were not consulted when the reform was launched.

At Moscow’s Hospital 11, Dr Galperin is vowing to stay on even if that means working as an attendant: “I can’t leave work because we decided to fight till the end.”

Moscow officials say they are only complying with a 2010 Russian law designed to help hospitals complete a transition from the Soviet-era economy and make them self-reliant by cutting budget subsidies to a minimum. Moscow Health Care Department spokeswoman Elina Nikolayeva defended the loss of jobs as inevitable: “Some of the doctors who are being fired are underqualified. Some of them don’t have enough workload.”

The doctors’ unrest is particularly problematic for Mr Putin because almost all of them are state employees – the core of his support base. Moscow officials are carrying out the healthcare reform in order to make good on Mr Putin’s election pledge to boost the livelihoods of public servants – including a vow to make doctors’ salaries twice that of the average employee by 2018.

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Moscow healthcare officials are focusing on promoting neighbourhood clinics that will provide comprehensive care and keep people out of hospital beds. The reforms were not discussed with the medical community and the details only became public in October following a leak to the press.

At Hospital 11, where Dr Galperin works, 136 out of its 320 medical staff, mostly doctors, were given the notice and the hospital is to be closed by April. Asked about the hospital’s closing, the Deputy Mayor Leonid Pechatnikov told a session of the presidential human rights council last week that the hospital “monopolised” the treatment of multiple sclerosis in Moscow, making it impossible to get treatment elsewhere. Dr Galperin and his colleagues say they provide multiple sclerosis treatment that cannot be obtained elsewhere in Moscow. Their suggestion to set up a multiple sclerosis clinic on the grounds of the hospital to keep the expertise and equipment in one place has not received a response.

The presidential human rights council has called for a halt to the redundancies and insisted that the reform violates a constitutional right to free healthcare.

Ales Kochevnik, 29, was diagnosed with multiple sclerosis two years ago. Treatment allows her to live a more normal life, albeit one interrupted by fits that can leave parts of her body temporarily paralysed. “They taught me to walk five times,” the artist says of Hospital 11. On a recent afternoon, Ms Kochevnik went to Red Square to lay down on its pavement in protest. Supporters stood by, each carrying an IV drip. One held a poster reading: “A hospital without doctors is a mortuary.”