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Pakistan Loses 1700 doctors a year to Brain Drain

Pakistan Loses 1700 doctors a year to Brain Drain

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27th November 2006, 16:36

Hussain

International Star

Debut: Sep 2004

Venue: Pakistan/Islamabad

Runs: 7,658

Wickets: 235

Pakistan Loses 1700 doctors a year to Brain Drain

http://www.dailytimes.com.pk/defaul...-11-2006_pg7_10

Salient Features of the Article

* In Feb 2006 Pakistan had 18,000 registered specialists
* Pakistan will have about 150,500 physicians in 2020 for 208.4m people
* Pakistan has 1.95% of the world’s medical schools

Quote:

Daily Times Monitor

KARACHI: Brain drain has been a chronic problem for Pakistan over the years. However, a new study of the phenomenon in medicine has revealed that Pakistan is the third leading source of international medical graduates (IMGs) in affluent countries.

Jamsheer J. Talati and Gregory Pappas published their findings in an article titled ‘Migration, Medical Education, and Health Care: A View from Pakistan’ that appeared in ‘Academic Medicine. Impact of International Medical Graduates on U.S. and Global Health Care: Proceedings of the 50th Anniversary Invitational Conference of the Educational Commission for Foreign Medical Graduates’ in December 2006. They pointed out that 60 percent of IMGs in the United States and 75% in the United Kingdom originate from poor countries. Most physicians practicing in Pakistan are graduates of Pakistani medical schools or reentering migrant citizens. Combined, the 39 medical colleges in Pakistan produced an average of 5,038 physicians per year from 2000 to 2004. In 2000, 50 physicians migrated into Pakistan with the MBBS or an equivalent degree and no postgraduate qualification; this number reached 395 in 2004. These graduates were trained in China, the Philippines, the Caribbean, and former Russian Republics. The PMDC has recognized five Chinese medical schools.

Combined, the number of graduates from Pakistan’s medical schools and number of reentering IMGs can be reasonably expected to reach 6,800 per year as schools mature. Since 1960, Pakistani-trained physicians have assumed teaching posts in medical colleges after their postgraduate medical education abroad. At the Aga Khan University Medical College (AKUMC), 63% of faculty in professorial ranks have foreign qualifications.

As of February 2006, Pakistan had 18,029 registered specialists. Many returning specialists may not have registered themselves as the CPSP alone has certified 6,418 members (MCPS) and 7,329 fellows (FCPS) since its inception in 1962.

The number of medical colleges doubled from 1997 to 2005 despite a dearth of teachers, facilities, and teacher training institutions for medical colleges. The number of students entering medical colleges increased from 400 (in four medical colleges) in the 1960s to 4,239 (of whom 3,552 qualified) in 16 colleges in 1981. Since the first private medical college, AKUMC, was established in 1983, 18 other private sector colleges have been established. Class size, at times exceeds 300 in some public institutions. Fortunately, access to medical education is not limited by poverty or educational or geographical disadvantage. Although the total cost of providing the five years of medical education is U.S. $100,000, students are charged tuition of U.S. $833 at public colleges and U.S. $10,000–35,000 at private colleges.

Causes of physician loss include emigration and cessation (or diminution) of practice for a variety of reasons, including migration.

The researchers estimate that 1,700 physicians per year are lost from the pool of practicing physicians. The Bureau of Emigration and Overseas Employment estimates that annually about 1,000 to 1,500 physicians leave the country, of whom 10–15% return, for a net migration of 900 to 1,275 physicians. They can account for 1,150 emigrating physicians per year. Of this number, they estimate that 418 (the number starting graduate medical education in 2004 according to the Association of American Medical Colleges’ GMEtrack database to 500 emigrate to the US. As 4.4% of IMGs in the United Kingdom are from Pakistan, and there were 4,185, 4,325, and 5,904 IMGs in the United Kingdom (2000–2002), they have calculated expected annual emigration to the United Kingdom as 260. They extrapolated that 16 emigrate to Canada annually and 6 to Australia. However, they know that 1,061 and 367 candidates have attempted the Medical College of Canada MCCEE and MCCQE qualifying Part 2 examinations, respectively, indicating a possibly higher rate of migration to Canada.

The flows to Arabic-speaking nations (ASNs) are probably about 350 annually; 300 a year have emigrated to Saudi Arabia alone. There are an estimated only 31 fellows in the ASN and 38 in other countries.

Although as reported in 2005, 12,813 physicians from Pakistan were in the United States, the United Kingdom, Australia, and Canada, they cannot determine the total number in ASNs. It was assumed that there were 25,000 graduates outside Pakistan, implying that there were 12,200 emigrants in countries other than the above four, chiefly in ASNs. At least 3,000 are accounted for: 2,000 in Saudi Arabia and 1,000 in the Persian Gulf states. They assume that this outflow will continue. An additional 20,000 Pakistani doctors are required in Saudi Arabia.

Because of marriage, childbearing, and family, a sizeable number of women graduates are not practicing; anecdotal estimates of the percentage range from 5% to 50%. On average, 50% of those admitted to medical school are women; however, despite a higher pass rate for women than for men, as of December 2005 only 38% of registered physicians are women. Altogether, these causes result in loss of 370 physicians from practice.

They estimated that 73,890 physicians were practicing in Pakistan in December 2005.

The net annual physician gain is 5,100, as 6,800 physicians are produced and 1,702 lost. They assumed a static rate of production of about 6,000 MBBS graduates annually. The number of IMGs (mostly Pakistani IMGs) coming to Pakistan, is projected to be static at 800 per year. They therefore predict that Pakistan will have approximately 150,500 physicians in 2020.

Whereas the supply of physicians in Pakistan is somewhat predictable, the level of demand is less certain: Pakistan’s population is growing rapidly, and at medium growth rates, it will reach 173.6 million in 2010, 191.4 million in 2015, and 208.4 million in 2020. Life expectancy had increased to 62 years by 2004, from 45 years in the 1950s. A total of 6.7 % of the population was older than 60 years (in 2005). The economy is expanding rapidly.

Migration significantly depletes poor countries, but for Pakistan, with an anticipated shortfall in the year 2020 of 58,000 to 451,000 physicians, depending upon population demands, a total ban on migration, even stemming the loss of 1,500 emigrants per year, would still leave a deficit of 35,400–428,600 physicians in 2020. The United States had an IMG force of 10% in the 1960s, 18% in 1970, and 25% in 2002. The top 10% of Pakistani physicians are high achievers (some with United States Medical Licensing Examination scores in the 99th percentile).

The total health expenditure of Pakistan (2004) was 2.4% of the gross domestic product. There were 2,000 medical schools in the world (in 2003). Pakistan has 1.95% of the world’s medical schools. It has about 2.55% of the world population, and 39 schools, for a ratio of four million people per medical school.

Information was obtained from multiple sources, including the Pakistan Medical and Dental Council (PMDC) and College of Physicians and Surgeons (CPSP); publications indexed in PubMed; migration surveys; news items; annual publications of the Mehboob-ul Haq Human Development Center; the Web sites of the United States Agency for International Development, the World Health Organization, and the Government of Pakistan; and working papers for conferences.

27th November 2006, 18:57

lahori

ODI Star

Debut: Feb 2005

Venue: Austin, TX

Runs: 3,086

Wickets: 54

Brain drain is not necessarily bad especially if you earn abroad but send money back home.

27th November 2006, 19:07

Joseph K.

County Captain

Debut: Sep 2006

Runs: 2,419

Wickets: 35

This is a necessary consequence of the movement of population accross the globe. UK is mourning brain drain as more and more professionals are moving to Spain and Australia, Canadians are moving to the US, Indians from India to the UK and now back from the UK to India. This can not be a permanent loss. If situations back home get any better, these people will go back and while away they can always send valueable forex (as Lahori mentioned).

27th November 2006, 19:14

jusarrived jusarrived is offline

International Star

Debut: Dec 2005

Runs: 7,122

Wickets: 41

exactly , not really a bad thing....in few years you will see lot of people moving back to pakistan too as we are seeing in case of india...we call it 'Brain gain '

27th November 2006, 19:57

MIG

PakPassion Moderator

Debut: Oct 2004

Venue: Apnay ghar mai - aur kahan ?

Runs: 37,045

Wickets: 2,699

Occupation: Weekend Dad, Full time IT

We do have a large population - maybe it helps others to fill in the shoes of the departees and make a living for themselves ?

27th November 2006, 19:58

2DashingLahori 2DashingLahori is offline

Local Club Star

Debut: Sep 2006

Venue: Cloud 9

Runs: 802

Wickets: 56

Occupation: Smiling

Well bro 1000s graduate across the country.. some are bound to leave.. the point is dat we need enough to serve the country.. same goes with engineers etc etc

27th November 2006, 20:10

Naveed

Local Club Captain

Debut: Nov 2003

Venue: USA

Runs: 1,049

Wickets: 17

I think that this is a huge current problem for Pakistan and some other developing countries. No country can succeed if it's best and brightest continually leave. Yes this was an issue for Canada vs the US, but Canada responded very well by increasing R&D, creating a more business-friendly environment and has actually slowed the trend dramatically as it was viewed as major national issue.

The major reason for the economic success of the US is the ability to attract the best people from all over the world. It's almost a form of exploitation of the third world and I believe that countries like Pakistan need to react and look beyond the short-term foreign exchange gains.

27th November 2006, 20:11

robosapien robosapien is offline

Local Club Captain

Debut: Feb 2005

Runs: 1,314

Wickets: 13

when a professional leaves, he creates one job so thats not a bad thing.
i think the best thing a professional can do is to develop a link back home. I know a dr from family whos in usa and every once in a while goes back and works in shaukat khanam for free.

27th November 2006, 20:38

Gasherbrum Gasherbrum is offline

International Star

Debut: Nov 2004

Venue: Toronto, Canada

Runs: 6,041

Wickets: 26

Occupation: Finance

i'd like to know how many patients in Pakistan are lost to Pakistani doctors each year.

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