Tuesday, January 1, 2019

Brain Drain From Emigration of Medical Professionals May Be Imaginary

The UK at one time (and possibly still) had a policy not to recruit aspiring physicians from the developing world to the UK's medical schools. Policy-makers thought that to do so would be to take the best and brightest from abroad and (selfishly) build human capital in the UK, immorally exacerbating the brain drain from already struggling countries - the assumption being that the newly-minted physicians would not return home to contribute to building their economy with their new skills. Sometimes true, yes, but it's worth pointing out that Dennis Mukwege, 2018's Nobel Peace Prize recipient (who is Congolese) got his obstetrics training in France, and was recognized for his surgeries to repair or save women raped by combatants in Congo. It's a good thing France does not have such a policy, or those women would have been disabled or killed by their traumas.

It should also be mentioned that if YOU are an aspiring physician in a developing world country who wanted to pursue your career, and you have your sights set on a British medical school but you're rejected because you're from a developing country - this might not seem to be the most moral choice for the British policy-makers to have made.

So a recent study of emigration of skilled medical professionals (nurses) from the Philippines is a useful contribution to this discussion. To be clear, these are nurses trained in the Philippines who then leave the country to work in the USA - an even "worse" brain drain than what the UK policy aimed to prevent, because the human capital investment is made at home in this case, and then creates value abroad. Therefore, if it turns out there's no damage to the home country's economy, in this even WORSE case, there wouldn't be a problem with developing-world physicians getting trained in the UK. So what did they find?

"...we show that enrollment and graduation in nursing programs increased in response to demand from abroad for nurses. For each new nurse that moved abroad, approximately two more individuals with nursing degrees graduated. The supply of nursing programs increased to accommodate this. New nurses appear to have switched from other degree types. Nurse migration had no impact on either infant or maternal mortality."

This is damning for the UK's policy, because it strongly suggests that all they were doing was discriminating against the developing world's applicants, without paternalistically "protecting" the developing world's economy. Whether this new information affects the policy is another question - if appearing to your countrymen as if you care is more important than actually helping the people you say you care about, then nothing will change.

Original paper here - Abarcar P and Theoharides C., "The International Migration of Healthcare Professionals and the Supply of Educated Individuals Left Behind." H/T Marginal Revolution.

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