Beyond Brain Drain: A Case Study of the Benefits of Cooperation on Medical Immigration

Beyond Brain Drain: A Case Study of the Benefits of Cooperation on Medical Immigration

Ahlam Fakhar (Al Akhawayn University, Morocco)
DOI: 10.4018/978-1-4666-4723-7.ch012


The past decades have witnessed an increase in the pace and a consolidation of immigration of medical doctors and the globalization of the health system. If properly managed, globalization of the health workforce could lead to perceptible gains in health status for all parties involved. In a world economy shaped by strong institutions, globalization could benefit those countries with a strong and human and physical capital. This chapter reviews the importance of immigration and aims at presenting different views on immigration of medical doctors. While the traditional view has been dominated by the rhetoric on “brain-drain,” a new and more promising thread of research has centered on the relatively new concept of “brain-circulation.” Mobility for medical workers and health workers, in general, can be a significant contributor to the formation of scientific and technical human capital, which has been an important driver in economic expansion and social development in many regions of the world. To illustrate the point, the authors use a cooperative framework to elucidate the relationship between immigration of medical doctors and economic development in the long-run using the potential agreement between North Africa and the European Union as an example. The finding could have implications for the capacity of developing countries to turn around and use “circular immigration” as a means to integrate into the emerging knowledge economy.
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1. The Circulation Of Health Professionals: A Growing Movement

One feature of globalization is the increased circulation of goods and services between countries. Migration of individuals and families has seen acceleration the past decade, among which the migration of professionals. Health workers are particularly concerned with this migration. Poorer countries have become a major supplier of health workers for the richer countries.

In Pakistan, students who are accepted into medical school are congratulated — only half jokingly — on three counts: that they will become doctors, that they will become certified by the American Board of Medical Specialties, and that they will soon be living in the United States (Shafqat & Zaidi,2007, p. 442).

The most frequent state is that medical graduate from US and other developed countries remain in those countries after graduation. Mullan (2005) states that 25% of the international medical graduates from the US remain in the country, the percentage is of 28.3, 23.1 and 40 for countries like UK, Canada and Australia, respectively.

This phenomenon could find justification in the fact that some countries, which suffer a shortage in doctors and nurses try to retain recently trained graduates from poorer countries. In Pakistan, in 2004 out of 1100 medical students’ graduates from the Aga Khan University Medical College in Karachi, 900 have gone to seek more medical training in the US (Shafqat & Zaidi, 2007).

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