Study looks at physician migration

Physicians moving from developing countries to work in the United States, Canada, Australia and the United Kingdom are more likely to originate from wealthier developing countries than less developed countries.

These findings, from a new study published today in the American Journal of Public Health, are the first to indicate that physician migration from developing to developed countries is a differential phenomenon that mirrors the source countries' capacities and economic, social and health status.

Results from the study indicate that higher physician migration is significantly associated with higher human resources for health, which include current physician, nurse and public health work force densities and medical schools per million population. Increased physician migration was also significantly associated with higher per capita gross national income, higher health spending, better development and higher population health status.

“Both developed and developing countries have pressing shortages of nurses and physicians,” said Onyebuchi A. Arah, MD, DSc, MPH, PhD, lead author of the study. “Unfortunately, such staffing shortages, lack of specialist training in poorer countries, and the financial lure of the West have resulted in the migration of physicians and nurses from the mostly developing source countries to the more developed host countries.”

Physician migration also seems to increase with increasing physician capacity and wealth, but decrease with increasing poverty.

“Ultimately, developing nations will have to train, retain and sustain their physicians and other health workers if they are to save their health care systems from complete implosion,” said Arah. “International physician migration is a developmental issue. If source countries are to meet their pressing health needs and achieve the Millennium Development Goals, the global community must develop policies on human resources for health that are proactive, holistic and progressive, not merely reactive.”

Researchers analyzed data on physician brain drain from 141 countries with the highest emigration rates to the four large English-speaking countries to develop a new metric of physician migration density, which takes a country's population into account. Each country's level of human resources for health was quantified through work force density and number of medical schools per million people. Level of development was obtained through female literacy rates and the human development index.

The study, “Developmental and Global Health Correlates of Physician Migration to the United States, Canada, Australia and the United Kingdom,” will be presented at the launch event for the Global Theme Issue on Poverty and Human Development, organized by the Council of Science Editors. The study, which is featured in the January 2008 issue of the American Journal of Public Health , will also be published ahead of print online at http://www.ajph.org/first_look.shtml the day of the launch. The rest of the issue, dedicated to the global theme, will be published online Nov. 29 at 4 p.m. (ET).

As part of the Global Theme Issue, more than 230 science journals around the world will simultaneously publish papers of worldwide interest on or after Oct. 22 — to raise awareness and stimulate interest and research into poverty and human development. The issue is an international collaboration with journals from developed and developing countries.

The launch event will be held on the campus of the U.S. National Institutes of Health on Oct. 22, 10 a.m.–3:30 p.m. For more information, visit http://www.councilscienceeditors.org/globalthemeissue.cfm.

The American Journal of Public Health is the monthly journal of the American Public Health Association (APHA), the oldest organization of public health professionals in the world. APHA is a leading publisher of books and periodicals promoting sound scientific standards, action programs and public policy to enhance health. To learn more, visit http://www.apha.org.