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Wealthy countries exploit the poor to plug doctor gaps

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Wealthy countries are relying on the recruitment of doctors from poorer nations to fill gaps in their medical workforce due to poor planning and inadequate support, the World Medical Association has said.

Highlighting the fact that the problems afflicting Australia’s medical training system are common worldwide, the WMA General Assembly, meeting in Durban, has accused affluent countries such as Australia of free-riding on the investment made by less well-off nations in medical training by recruiting doctors from overseas rather than ensuring they are training enough locally to meet future need.

In a statement, the General Assembly said many countries, including some of the wealthiest, have experienced a long-standing shortage of physicians because they have not trained enough, and have instead relied on recruiting them from offshore.

In an observation that reflects directly on the shortfall of intern places in Australia, the WMA said that, “young people seeking employment as physicians have often been seriously affected by poor medical workforce planning.”

It said many countries solved their need for doctors by recruiting offshore, typically from less affluent regions.

“The flow of international migration of physicians is generally from poorer to wealthier countries,” the WMA said. “The poorer countries bear the expense of education the migrating physicians and receive no recompense when they enter other countries. The receiving countries gain a valuable resource without paying for it, and in the process they save the cost of education their own physicians.”

Importantly, the WMA said the solution was not to limit the ability of doctors to choose where they work, but to bolster national medical training and workforce planning systems.

“Every country should do its utmost to educate an adequate number of physicians, taking into account its needs and resources,” it said. “A country should not rely on immigration from other countries to meet its need for physicians.”

The WMA Statement on Ethical Guidelines for the International Migration of Health Workers can be viewed at: http://www.wma.net/en/30publications/10policies/e14/index.html

Adrian Rollins