The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #58175

Amy Hagopian, MHA¹, Matthew J. Thompson, MBChB², Meredith Fordyce², Karin Johnson, PhD², and L. Gary Hart, PhD¹. (1) Department of Family Medicine, University of Washington, Box 355330, Seattle, WA 98195-4696, 206-616-4989, hagopian@u.washington.edu, (2) Family Medicine, University of Washington, Box 354696, Seattle, WA 98195-4696

Physician migration from poor countries to rich ones contributes to worldwide health workforce imbalances that threaten the health of poor country citizens. We reviewed American Medical Association data on physicians trained in other countries, particularly sub-Saharan Africa, who have migrated to the U.S. Among the 771,518 physicians in the U.S. in the year 2000, 24.6% were trained abroad. Among these, 61% are from low or lower middle income countries. A total of 5,334 physicians from sub-Saharan Africa are in that group. Most of these come from a handful of countries, with 86% from Nigeria, South Africa and Ghana alone. More than half (59%) come from only five medical schools—two in South Africa, two in Nigeria, and one in Ghana. Among sub-Saharan African physicians in the U.S., 21% are in residency, 38% are practicing primary care, 94% are in urban places, and 45% are concentrated in only five states. The population of Africa’s sub-Saharan region is 650 million people, and has a ratio of fewer than 15 physicians per 100,000 population, or a total of 79,000 doctors. By comparison, the UK enjoys 164 physicians per 100,000 and the U.S. has 279 physicians (or almost 800,000 doctors for a population of 282 million). The World Health Association has recognized migration of health personnel from developing to developed countries creates imbalances in the global health workforce, and is sponsoring research and conferences to address the problem.

Learning Objectives:

• Understand the magnitude of the presence of international medical graduates in the U.S.; Describe the countries that send substantial numbers of physicians to the U.S.; Identify the characteristics of countries most affected by this "brain drain"; Understand the physician emigration phenomenon from sub-Saharan Africa to rich countries; Identify the countries in the region that produce and lose the most physicians.

Keywords: International Systems, Developing Countries

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Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: NA
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.