US medicine and international “brain drain”

The Associated Press has an article out today discussing the effects of “brain drain”, which is the practice of using and/or recruiting physicians and other health care workers from developing countries.  I’ve read one of Dr. Fitzhugh Mullan’s papers on the topic, which basically looks at the ratio of physicians that emigrate to developed countries compared to the total number of physicians in the source country.  Sub-Saharan Africa and the Caribbean are particularly hard hit, with some countries losing up to 20 or 30% of their physicians.

It’s not just the US that are using international medical graduates – Canada, Great Britain, and Australia also take their share.  The problem I see is this: yes, these source countries have huge health needs that are not being met (even basics such as sanitary water), and taking their physicians and nurses is probably not helping matters…but is it possible or even ethical to stop their entry into the US?  Some advocate for stopping the use of these foreign-grads, but I don’t think it is ethical to simply ban them from practicing here – these are people who are presumably moving here so they can better provide for their family.  Who gets to say they aren’t allowed to do that?  It’s also likely that even if we did try to stop hiring physicians from these regions, they would simply emigrate someplace else and eventually make their way to the US anyway. 

So the best solution, in my opinion, is not to stop the use of foreign grads in the US, but to increase enrollment in US medical schools (and nursing schools for that matter) so that we don’t have to rely so heavily on foreigners to fill positions in the first place.  Some medical schools have already begun increasing enrollment, and new schools are opening in several locations, but only time will tell if this is enough to limit the effects of “brain drain.”

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