The reliance by affluent English-speaking countries on foreign doctors is creating a "brain drain" in lower-income nations and exacerbating the health problems that those nations face, according to a report in the New England Journal of Medicine.
Using data from the World Health Organization, American Medical Association, the Educational Commission for Foreign Medical Graduates and other sources, Fitzhugh Mullan, M.D., a professor of medicine and public health at George Washington University, calculated that international medical-school graduates account for between 23% and 28% of the physicians in the U.S., United Kingdom, Canada and Australia. The range of international medical graduates from low-income countries ranged from 40% in Australia to about 43% in Canada, about 60% in the U.S. and about 75% in the U.K.
In the U.S., there are about 41,000 physicians who were trained in India (or almost 5% of the workforce), nearly 18,000 from the Philippines (about 2%), and just under 10,000 from Pakistan (about 1%). The U.S. also has slightly more than 25,000 physicians who are U.S. citizens but were trained abroad.
Mullan noted that almost 14% of the physicians trained in Sub-Saharan Africa and more than 8% of those trained in the Caribbean emigrate to the U.S., U.K., Canada or Australia, and expressed concern about the unreturned financial investment these nations make in their citizens' education as well as the "human capital" that is lost when "gifted, ambitious people" leave the country.
"The brain drain has also weakened the physician workforces of many poor nations and limits the ability of those nations to respond to HIV infection, AIDS and other pressing needs," Mullan wrote.