Perception by Moroccan Physicians of Factors Affecting their Migration Decisions

Introduction

The problem of human capital flight, more commonly referred to as “brain drain”, has been widely discussed all over the world in recent decades. The reasons for such phenomenon usually include two aspects which come from both source and host countries. With regard to source countries, the reasons may include lack of opportunities, political instability, economic depression, health risks, ambition for an improved career, and others. In host countries, the reasons are mainly better opportunities, political stability and freedom, developed economy, better living conditions besides the shortage of human resources. Brain drain is usually regarded as an economic cost, since emigrants usually take with them the portion of value of their training sponsored by governments or other organizations (Linacre, 2007). Developing countries are most suffering from the migration of skilled individuals. Brain drain is often associated with de-skilling of emigrants in their country of destination, while their country of emigration experiences the draining of skilled individuals. One very common aspect of brain drain is the migration of health personnel in search of a better quality of life, higher salaries, access to advanced technology and more comfortable conditions. This migration of health professionals is of growing concern all over the world because of the international competition for skilled labor in general and the deficits in health workforce in particular. But, this emigration of health workers and mainly of doctors has negative impacts on health systems in the source countries and in developing economies. These countries loose huge investments in the education and training of young health professionals as a result of migration. But, the most important loss related to the difficulty of not responding to the needs of their population in term of healthcare.

Shortages and imbalances of medical personal have been recently regarded as an international problem (Marchal & Kegels, 2003). Data from OECD (Organization For Economic Cooperation and Development) countries show that medical doctors trained abroad make up a significant percentage of the medical core in most of these countries: 21% in Australia, 23% in Canada and 9% in Finland (Kumar and Simi, 2007). In 1972, about 6% of the world’s health professionals (about 140 000) settled down outside their countries of origin. Over three-quarters were found in only the USA, UK and Canada. The main exporting countries included: India, Pakistan and Sri Lanka (Dodani & LaPorte, 2005). Dodani and LaPorte (2005) convey also that the countries that produced more physicians than they had the capacity to absorb were identified as Egypt, India, Pakistan, Philippines and South Korea. Even though, the lack of reliable data and difficulties in defining whether a migrant is ‘permanent’ or ‘temporary’ still exist.

All these issues are addressed in the previous chapters of the present book. Furthermore, the model related to the new economics of migration of medical doctors is tested and validated using aggregate data on ECE and MENA economies and their mobility to EU. These empirical tests have shown the importance of economic, social and behavioral incentives in migration decisions. In addition, a cooperative framework is introduced as in chapter 11 of the current book. This model is based on collaboration between Northern and Southern countries of the Mediterranean region. It is suggested to be producing win-win effects through new incentives centered on medical education and research in both sending and receiving countries.