One of every four doctors in North America, Britain and Australia is an immigrant who attended a foreign medical school, contributing to a “brain drain” that deprives poor countries of good medical care, researchers say.
As many as three-quarters of physicians who come to rich countries hail from less-developed ones grappling with AIDS, infectious diseases and other health scourges, the study found. In the United States, for example, most foreign doctors are from India, the Philippines and Pakistan.
The study comes on the heels of a World Bank report this week documenting the mass migration of middle-class professionals from impoverished nations in the Caribbean, Africa and Central America.
“The brain drain has also weakened the physician work forces of many poor nations,” wrote Dr. Fitzhugh Mullan, a professor of medicine and health policy at George Washington University, who led the study published in Thursday’s New England Journal of Medicine.
The foreign doctors typically come to the U.S. and other rich countries to complete their residencies — the post-medical school training period — and many stay on to practice medicine.
Because of the aging of the baby boom generation, experts say the United States faces a shortage of 200,000 doctors and 800,000 nurses by 2020. To deal with the problem, the Association of American Medical Colleges is asking the nation’s 125 medical schools to increase their enrollment. The number of first-year medical students in the United States is already at an all-time high of about 17,000.
Some say a boost in enrollment would help ease the U.S. medical system’s dependence on foreign doctors to fill residencies.
Dr. Edward Langston of the American Medical Association said the U.S. should not abandon its long-standing practice of training foreign doctors. But he said the U.S. and other rich nations need to strike a balance so that developing countries are not stripped of their own physicians.
“We have a responsibility to train international medical graduates because we’re looked upon as the gold standard around the world,” Langston said.
Before foreign doctors can do their residencies in the U.S., they must pass the same exams administered to graduates of American medical schools and must also prove proficiency in English.
In the latest study, Mullan culled data on doctors practicing or training in the U.S., Canada, Britain and Australia. He found that foreign-born and -trained physicians account for 23 percent to 28 percent of doctors in those four countries. The U.S. has the largest share of foreign doctors, with nearly 209,000.
Developing countries supply between 40 percent to 75 of the foreign doctors in the four nations, the study found.
Only 3 percent of U.S. doctors went to foreign medical schools and returned to the states to practice.
Africa has just 600,000 doctors, nurses and midwives for 600 million people, yet wealthy nations continue “poaching” them, Drs. Lincoln Chen of Harvard University and Jo Ivey Boufford of New York University wrote in an accompanying editorial.