Medical "Brain Drain" and Health Care Worker Shortages: How Should International Training Programs Respond?

AMA J Ethics. 2016 Jul 1;18(7):665-75. doi: 10.1001/journalofethics.2016.18.7.ecas1-1607.


The movement of health care workers from countries with resource scarcity and immense need ("source" countries) to areas of resource abundance and greater personal opportunity ("destination" countries) presents a complex set of decisions and relationships that affect the development of international health care systems. We explore the extent to which ethical quandaries arising from this movement are the responsibility of the said actors and the implications of these ethical quandaries for patients, governments, and physicians through the case of Dr. R, a surgeon from Nigeria who is considering working in the United States, where he is being trained to help develop surgical capacity in his country. We suggest how Dr. R, the United States, and Nigeria all contribute to "brain drain" in different but complementary ways.

MeSH terms

  • Delivery of Health Care
  • Education, Medical, Graduate / ethics*
  • Emigration and Immigration*
  • Foreign Medical Graduates
  • General Surgery / education
  • Humans
  • International Cooperation*
  • Medically Underserved Area*
  • Nigeria
  • Physicians / ethics
  • Physicians / supply & distribution*
  • Professional Practice Location*
  • Social Responsibility*
  • United States