Adding insult to injury: the healthcare brain drain

Hooper, Carwyn

doi:10.1136/jme.2007.023143

Cited by 44 publications

(48 citation statements)

References 12 publications

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“…Although our small sample size precludes any extrapolation to the demographics of all foreign-born physicians in Ontario, this finding is consistent with the literature that indicates that Sub-Saharan Africa is one of the areas hit hardest by health worker migration [6][7][8][9]. For example, South Africa's estimated loss of returns from investment for physicians who have migrated is US$1.41 billion [10] and the World Health Organization estimates that 25% of doctors trained in Africa are working in high-income countries [11]. Unfortunately, Sub-Saharan Africa is also the area with the highest HIV prevalence in the world and arguably in greatest need of health care workers [12,13].…”

Section: Discussionsupporting

confidence: 80%

The “Brain Drain”: Factors influencing physician migration to Canada

Lofters¹,

Slater²,

Thulien³

2013

Health

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Context: Higher income countries have an average physician density of 300 physicians per 100,000 people. In stark contrast, lower income countries have an average physician density of 17 physicians per 100,000 people. A major cause of this discrepancy is the migration of healthcare professionals from lower income to higher income countries, a phenomenon colloquially known as the "brain drain". Objective: To explore factors that led International Medical Graduate (IMG) physicians to leave their home countries and migrate to Canada. Methods: An anonymous questionnaire with a mix of openand close-ended questions was sent to 500 randomly selected IMG physicians practicing in Ontario, Canada. Results were analyzed using a mixed-method design utilizing both descriptive statistics and a thematic analysis approach. Results: 39 physicians met inclusion criteria and completed the survey. The majority were 50 years or older, and over 60% were male. The most common reason for emigration from their home country was the socioeconomic and/or political situation, and the most common reason for selecting Canada was family issues. Suggestions for how brain drain could be stemmed fell into three broad categories: 1) more accurate information about lack of opportunities in Canada, 2) more continuing medical education opportunities in home countries, and 3) address issues such as safety and quality of life in home countries. Conclusions: This survey provides insights into the reasons for emigration and immigration for international medical graduates.The results of this survey can assist stakeholders in working toward appropriate and acceptable solutions to the brain drain.

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Section: Discussionsupporting

confidence: 80%

The “Brain Drain”: Factors influencing physician migration to Canada

Lofters¹,

Slater²,

Thulien³

2013

Health

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“…The loss of skilled health workers has been described in emotive and/or hyperbolic terms, as part of a confounding of the provision of doctors and nurses with the provision of health. The 'robbing', 'raiding' (Johnson 2005) and 'poaching' of trained professionals who constitute poor countries' 'educated elite' has been lamented as 'deeply immoral' (Hooper 2008). The 'devastating consequences for the source countries' (Larsen et al 2005) have been indicted as criminal (Mills et al 2008) and compared with slavery (Heath 2007).…”

Section: Problematizing Medical Migrationmentioning

confidence: 99%

International medical migration: A critical conceptual review of the global movements of doctors and nurses

Bradby

2014

Health (London)

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Background A critical appraisal of the discourse describing international medical migration around the turn of the 21 st century. Method A critical narrative review of a range of sources including grey literature, books, commentary and research reports, to trace the development and spread of specific causative models. English-language literature focussed on the Anglophone world. Findings The attribution of causative relations between the density of skilled medical workers (assumed to be linked with their migration), the provision of healthcare and population health outcomes illustrates how the global reach of biomedicine has to be understood in the context of local conditions. The need to understand migration as an aspect of uneven global development rather than a delimited issue of manpower services management is illustrated with reference to debates about 'brain-drain' of sub-Saharan Africa's healthcare professionals, task-shifting and the crisis in healthcare human resources. The widespread presumed cause of shortages of skilled healthcare staff in sub-Saharan Africa were over-determined by a compelling narrative of rich countries stealing poor countries' trained healthcare professionals. This narrative promotes medical professional interests and ignores historical patterns of underinvestment in healthcare systems and structures. Sociological theories of medicalization suggest that the international marketization of medical recruitment is a key site where the uneven global development of capital is at work. A radical reconfiguration of medical staffing along the lines of 'task-shifting' in rich and poor countries' healthcare systems alike offers one means of thinking about global equity in access to quality care.

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“…Furthermore, the inability to rigorously evaluate patient outcomes in this region has crippled local physicians' capacity to improve these outcomes. Thus, many talented and enthusiastic medical personnel have migrated to more developed countries to pursue their careers [3]. In fact, the ratio of doctors to patients in sub-Saharan Africa is now estimated to be 20 per 100,000, which is less than one-tenth the ratio in developed nations [5].…”

Section: Discussionmentioning

confidence: 99%

“…As challenging as research has become in the U.S., the obstacles are even larger in developing nations. Academic and research productivity among physicians in these regions has suffered from lack of human and material resources, which has resulted in a chronic loss of scientific and medical personnel to more developed countries [3]. This so-called ''brain drain'' has had a corrosive impact on the quality of medical education and clinical care in many West African countries, although no exact data exist to quantify this effect on the region.…”

Section: Introductionmentioning

confidence: 99%