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[afro-nets] The Metrics of the Physician Brain Drain

The Metrics of the Physician Brain Drain
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Fitzhugh Mullan, M.D.
Editorial by Chen, L. C.

NEJM Volume 353:1810-1818 October 27, 2005 Number 17
Read full text online at:
http://content.nejm.org/cgi/content/full/353/17/1810


ABSTRACT

Background
There has been substantial immigration of physicians to devel-
oped countries, much of it coming from lower-income countries.
Although the recipient nations and the immigrating physicians
benefit from this migration, less developed countries lose im-
portant health capabilities as a result of the loss of physi-
cians.

Methods
Data on the countries of origin, based on countries of medical
education, of international medical graduates practicing in the
United States, the United Kingdom, Canada, and Australia were
obtained from sources in the respective countries and analyzed
separately and in aggregate. With the use of World Health Or-
ganization data, I computed an emigration factor for the coun-
tries of origin of the immigrant physicians to provide a rela-
tive measure of the number of physicians lost by emigration.

Results
International medical graduates constitute between 23 and 28
percent of physicians in the United States, the United Kingdom,
Canada, and Australia, and lower-income countries supply between
40 and 75 percent of these international medical graduates. In-
dia, the Philippines, and Pakistan are the leading sources of
international medical graduates. The United Kingdom, Canada, and
Australia draw a substantial number of physicians from South Af-
rica, and the United States draws very heavily from the Philip-
pines. Nine of the 20 countries with the highest emigration fac-
tors are in sub-Saharan Africa or the Caribbean.

Conclusions
Reliance on international medical graduates in the United
States, the United Kingdom, Canada, and Australia is reducing
the supply of physicians in many lower-income countries.

--
Rana Jawad Asghar MD. MPH.
Coordinator South Asian Public Health Forum
mailto:jawad@alumni.washington.edu
http://www.DrJawad.com
Typhoid Net http://www.typhoid.net

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