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Published in: Human Resources for Health 1/2004

Open Access 01-12-2004 | Research

The migration of physicians from sub-Saharan Africa to the United States of America: measures of the African brain drain

Authors: Amy Hagopian, Matthew J Thompson, Meredith Fordyce, Karin E Johnson, L Gary Hart

Published in: Human Resources for Health | Issue 1/2004

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Abstract

Background

The objective of this paper is to describe the numbers, characteristics, and trends in the migration to the United States of physicians trained in sub-Saharan Africa.

Methods

We used the American Medical Association 2002 Masterfile to identify and describe physicians who received their medical training in sub-Saharan Africa and are currently practicing in the USA.

Results

More than 23% of America's 771 491 physicians received their medical training outside the USA, the majority (64%) in low-income or lower middle-income countries. A total of 5334 physicians from sub-Saharan Africa are in that group, a number that represents more than 6% of the physicians practicing in sub-Saharan Africa now. Nearly 86% of these Africans practicing in the USA originate from only three countries: Nigeria, South Africa and Ghana. Furthermore, 79% were trained at only 10 medical schools.

Conclusions

Physician migration from poor countries to rich ones contributes to worldwide health workforce imbalances that may be detrimental to the health systems of source countries. The migration of over 5000 doctors from sub-Saharan Africa to the USA has had a significantly negative effect on the doctor-to-population ratio of Africa. The finding that the bulk of migration occurs from only a few countries and medical schools suggests policy interventions in only a few locations could be effective in stemming the brain drain.
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Literature
1.
go back to reference Mejia A, Pizurki H, Royston E: Physician and nurse migration: analysis and policy implications. 1979, France, World Health Organization, xiii-476. Mejia A, Pizurki H, Royston E: Physician and nurse migration: analysis and policy implications. 1979, France, World Health Organization, xiii-476.
2.
go back to reference Bundred PE, Levitt C: Medical migration: Who are the real losers?. Lancet. 2000, 356: 245-246. 10.1016/S0140-6736(00)02492-2.CrossRefPubMed Bundred PE, Levitt C: Medical migration: Who are the real losers?. Lancet. 2000, 356: 245-246. 10.1016/S0140-6736(00)02492-2.CrossRefPubMed
6.
go back to reference Eckhert NL: The global pipeline: too narrow, too wide or just right?. Medical Education. 2002, 36: 606-613. 10.1046/j.1365-2923.2002.01257.x.CrossRefPubMed Eckhert NL: The global pipeline: too narrow, too wide or just right?. Medical Education. 2002, 36: 606-613. 10.1046/j.1365-2923.2002.01257.x.CrossRefPubMed
8.
go back to reference Stilwell B, Diallo K, Zurn P, Dal Poz MR, Adams O, Buchan J: Developing evidence-based ethical policies on the migration of health workers: conceptual and practical challenges. Human Resources for Health. 2003, 1: 8-10.1186/1478-4491-1-8.CrossRefPubMedPubMedCentral Stilwell B, Diallo K, Zurn P, Dal Poz MR, Adams O, Buchan J: Developing evidence-based ethical policies on the migration of health workers: conceptual and practical challenges. Human Resources for Health. 2003, 1: 8-10.1186/1478-4491-1-8.CrossRefPubMedPubMedCentral
10.
go back to reference Iglehart JK: Health Policy Report: The Quandary Over Graduates of Foreign Medical Schools in the United States. New England Journal of Medicine. 1996, 334: 1679-1683. 10.1056/NEJM199606203342521.CrossRefPubMed Iglehart JK: Health Policy Report: The Quandary Over Graduates of Foreign Medical Schools in the United States. New England Journal of Medicine. 1996, 334: 1679-1683. 10.1056/NEJM199606203342521.CrossRefPubMed
11.
go back to reference Johnson K, Kaltenbach E, Hoogstra K, Thompson MJ, Hagopian A, Hart LG: How international medical graduates enter U.S. graduate medical education or employment. 2003, Working Paper #76. Seattle, WA, University of Washington Center for Health Workforce Studies Johnson K, Kaltenbach E, Hoogstra K, Thompson MJ, Hagopian A, Hart LG: How international medical graduates enter U.S. graduate medical education or employment. 2003, Working Paper #76. Seattle, WA, University of Washington Center for Health Workforce Studies
13.
go back to reference Buchan J, Dovlo D: International recruitment of health workers to the U.K. 2004, , UK Department for International Development Buchan J, Dovlo D: International recruitment of health workers to the U.K. 2004, , UK Department for International Development
14.
go back to reference Medical migration and inequity of health care. Lancet. 2000, 356: 177-10.1016/S0140-6736(00)02471-5. Medical migration and inequity of health care. Lancet. 2000, 356: 177-10.1016/S0140-6736(00)02471-5.
16.
go back to reference Hagopian A, Thompson MJ, Johnson KE, Lishner DM: International medical graduates in the United States: a review of the literature 1995 to 2003. 2003, Working Paper #83. Seattle, WA, University of Washington Center for Health Workforce Studies Hagopian A, Thompson MJ, Johnson KE, Lishner DM: International medical graduates in the United States: a review of the literature 1995 to 2003. 2003, Working Paper #83. Seattle, WA, University of Washington Center for Health Workforce Studies
17.
go back to reference Cooper RA, Getzen TE, McKee HJ, Laud P: Economic and Demographic Trends Signal an Impending Physician Shortage. Health Affairs. 2002, 21: 140-154. 10.1377/hlthaff.21.1.140.CrossRefPubMed Cooper RA, Getzen TE, McKee HJ, Laud P: Economic and Demographic Trends Signal an Impending Physician Shortage. Health Affairs. 2002, 21: 140-154. 10.1377/hlthaff.21.1.140.CrossRefPubMed
18.
go back to reference Grumbach K: Fighting Hand to Hand Over Physician Workforce Policy. Health Affairs. 2002, 21: 13-32. 10.1377/hlthaff.21.5.13.CrossRefPubMed Grumbach K: Fighting Hand to Hand Over Physician Workforce Policy. Health Affairs. 2002, 21: 13-32. 10.1377/hlthaff.21.5.13.CrossRefPubMed
19.
go back to reference Mullan F: Some Thoughts on the White-Follows-Green Law. Health Affairs. 2002, 21: 158-159. 10.1377/hlthaff.21.1.158.CrossRefPubMed Mullan F: Some Thoughts on the White-Follows-Green Law. Health Affairs. 2002, 21: 158-159. 10.1377/hlthaff.21.1.158.CrossRefPubMed
20.
go back to reference Mick SS, Comfort ME: The Quality of Care of International Medical Graduates: How Does It Compare to That of U.S. Medical Graduates. Medical Care Research and Review. 1997, 54: 379-413.CrossRefPubMed Mick SS, Comfort ME: The Quality of Care of International Medical Graduates: How Does It Compare to That of U.S. Medical Graduates. Medical Care Research and Review. 1997, 54: 379-413.CrossRefPubMed
21.
go back to reference Mick SS, Lee SY, Wodchis WP: Variations in geographical distribution of foreign and domestically trained physicians in the United States: 'safety nets' or 'surplus exacerbation'?. Soc Sci Med. 2000, 50: 185-202. 10.1016/S0277-9536(99)00183-5.CrossRefPubMed Mick SS, Lee SY, Wodchis WP: Variations in geographical distribution of foreign and domestically trained physicians in the United States: 'safety nets' or 'surplus exacerbation'?. Soc Sci Med. 2000, 50: 185-202. 10.1016/S0277-9536(99)00183-5.CrossRefPubMed
22.
go back to reference Massey D, Taylor S, Edward J: Theories of International Migration: A Review and Appraisal. Population and Development Review. 1993, 19: 431-440.CrossRef Massey D, Taylor S, Edward J: Theories of International Migration: A Review and Appraisal. Population and Development Review. 1993, 19: 431-440.CrossRef
23.
go back to reference Cheng L, Yang PQ: Global interaction, Global Inequality, and Migration of the Highly Trained to the U.S. International Migration Review. 1998, 32: 626-654.CrossRefPubMed Cheng L, Yang PQ: Global interaction, Global Inequality, and Migration of the Highly Trained to the U.S. International Migration Review. 1998, 32: 626-654.CrossRefPubMed
24.
go back to reference Stark O, Bloom D: The New Economics of Labor Migration. American Economic Review. 1985, 75: 173-178. Stark O, Bloom D: The New Economics of Labor Migration. American Economic Review. 1985, 75: 173-178.
25.
go back to reference Ranson MK, Beaglehole R, Correa CM, Mirza Z, Buse K, Drager N: The public health implications of multilateral trade agreements. Health Policy in a Globalizing World. Edited by: Lee K, Buse K and Fustukiam S. 2002, Cambridge, Cambridge University Press, 18-40. Ranson MK, Beaglehole R, Correa CM, Mirza Z, Buse K, Drager N: The public health implications of multilateral trade agreements. Health Policy in a Globalizing World. Edited by: Lee K, Buse K and Fustukiam S. 2002, Cambridge, Cambridge University Press, 18-40.
26.
go back to reference American Medical Association: Physicians' professional record (AMA-PPD). 2002 American Medical Association: Physicians' professional record (AMA-PPD). 2002
28.
go back to reference Dovlo D, Nyonator F: Migration by graduates of the University of Ghana medical School: A preliminary rapid appraisal. Human Resources for Health. 1999, 3: 40-51. Dovlo D, Nyonator F: Migration by graduates of the University of Ghana medical School: A preliminary rapid appraisal. Human Resources for Health. 1999, 3: 40-51.
29.
go back to reference Marchal B, Kegels G: Health workforce imbalances in times of globalization: brain drain or professional mobility?. Int J Health Plann Manage. 2003, 18 Suppl 1: 89-101. 10.1002/hpm.720.CrossRef Marchal B, Kegels G: Health workforce imbalances in times of globalization: brain drain or professional mobility?. Int J Health Plann Manage. 2003, 18 Suppl 1: 89-101. 10.1002/hpm.720.CrossRef
30.
go back to reference Mick S, Goodman D, Chang C: Medical Migration: Seasonal or Secular?. 4th International Conference on the Medical Workforce in San Francisco, CA,. 1999 Mick S, Goodman D, Chang C: Medical Migration: Seasonal or Secular?. 4th International Conference on the Medical Workforce in San Francisco, CA,. 1999
31.
go back to reference Baer LD, Ricketts TC, Konrad TR, Mick SS: Do International Medical Graduates Reduce Rural Physician Shortages?. Medical Care. 1998, 36: 1534-1544. 10.1097/00005650-199811000-00003.CrossRefPubMed Baer LD, Ricketts TC, Konrad TR, Mick SS: Do International Medical Graduates Reduce Rural Physician Shortages?. Medical Care. 1998, 36: 1534-1544. 10.1097/00005650-199811000-00003.CrossRefPubMed
32.
go back to reference Mullan F: Medical Migration and the Physician Workforce: International Medical Graduates and American Medicine. JAMA. 1995, 273: 1521-1527. 10.1001/jama.273.19.1521.CrossRefPubMed Mullan F: Medical Migration and the Physician Workforce: International Medical Graduates and American Medicine. JAMA. 1995, 273: 1521-1527. 10.1001/jama.273.19.1521.CrossRefPubMed
33.
go back to reference Gish O: Resource allocation, equality of access, and health. International Journal of Health Services. 1973, 3: 399-411.CrossRefPubMed Gish O: Resource allocation, equality of access, and health. International Journal of Health Services. 1973, 3: 399-411.CrossRefPubMed
34.
go back to reference Ellsbury KD, Baldwin LM, Johnson K, Runyun S, Hart LG: Gender Related Factors in the Recruitment of Generalist Physicians to Rural Areas of the Northwest. Journal of the American Board of Family Practice. 2002, 15: 391-400.PubMed Ellsbury KD, Baldwin LM, Johnson K, Runyun S, Hart LG: Gender Related Factors in the Recruitment of Generalist Physicians to Rural Areas of the Northwest. Journal of the American Board of Family Practice. 2002, 15: 391-400.PubMed
36.
go back to reference Baubock R: Ethical Problems of Immigration Control and Citizenship. Cambridge Survey of World Migration. Edited by: Cohen R. 1995, Cambridge, England, Cambridge University Press Baubock R: Ethical Problems of Immigration Control and Citizenship. Cambridge Survey of World Migration. Edited by: Cohen R. 1995, Cambridge, England, Cambridge University Press
37.
go back to reference Mullan F: The Case for More U.S. Medical Students. New England Journal of Medicine. 2000, 343: 213-217. 10.1056/NEJM200007203430312.CrossRefPubMed Mullan F: The Case for More U.S. Medical Students. New England Journal of Medicine. 2000, 343: 213-217. 10.1056/NEJM200007203430312.CrossRefPubMed
38.
go back to reference Physicians for Human Rights, An Action Plan to Prevent Brain Drain: Building Equitable Health Systems in Africa. 2004, Boston, MA, , 129- Physicians for Human Rights, An Action Plan to Prevent Brain Drain: Building Equitable Health Systems in Africa. 2004, Boston, MA, , 129-
39.
go back to reference Africa's Health-Care Brain Drain. New York Times. 2004, August 13: Africa's Health-Care Brain Drain. New York Times. 2004, August 13:
Metadata
Title
The migration of physicians from sub-Saharan Africa to the United States of America: measures of the African brain drain
Authors
Amy Hagopian
Matthew J Thompson
Meredith Fordyce
Karin E Johnson
L Gary Hart
Publication date
01-12-2004
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2004
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/1478-4491-2-17

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