Thursday, March 15, 2012

“America Is Stealing the World’s Doctors.”

According to the New York Times “America Is Stealing the World’s Doctors.”

Is this really true? The article included interviews with a few foreign doctors. The ones who came to America appear to have done so of their own volition. As far as I could tell, they were not recruited. To the best of my knowledge, there is no concerted effort by any person or institution in the United States to coerce, shanghai, kidnap, seduce or otherwise lure physicians here.

How big a problem is this? According to 2010 data from the Educational Commission for Foreign Medical Graduates [ECFMG], 9399 physician graduates of foreign medical schools were certified as eligible for training in the US. Of those, 2287 were US citizens. Most of the rest were from India [1848], Pakistan [526], Canada [410], China [304], Nigeria [216], The Philippines [211], Egypt [209]. Libya [107] and Ethiopia [51]. For the geographically challenged, Nigeria, Egypt, Libya and Ethiopia are African countries.

Of the remaining 3914, all other African countries accounted for [presumably] far fewer than 960, which is how many countries had fewer than 50 doctors certified. In addition, possession of an ECFMG certificate does not guarantee a foreign doctor a residency position in the US.

The NY Times piece said, “The managing director of University Teaching Hospital in Lusaka [Zambia], Lackson Kasonka, suggested to me [the author] that doctors who received government financing for their educations and then left exhibited ‘a show of dishonesty and betrayal.’”

Interestingly, the surgeon featured in the article, although from Zambia, went to medical school in India. His tuition was paid by his parents. I am not sure that he was the best example one could find of “stealing” a doctor. Speaking of India, the country has a population of 1.2 billion, with about 320 medical schools.

From Wikipedia: “India is one of the few countries which produces many medical graduates from its medical schools who work not only in India but in many other countries all over the world, especially [the] Middle East, UK and USA.” Apparently, those other areas are “stealing” doctors too. It also said, “Most of the [Indian] graduates do not like to practice in rural areas due to under staffed hospitals & lack of facilities.”

While sipping a beer in his apartment in a gated complex in New Jersey, the surgical resident from Zambia did not give the impression that he will be returning to the bush any time soon.

I do not see how we could possibly deny qualified people who want to come here for training the right to do so. If this is such a big problem, perhaps the affected countries should not issue exit visas to selected citizens or otherwise detain them.

What do you think? Are we actually “stealing” the world’s doctors?


Thatgirl said...

I am Filipino and know several physicians who have come here. I also know many nurses and engineers who have immigrated to the US as well... It isn't that they are lured here (although there are recruitment programs) but that they chose to come here for better working/living conditions. There are a lot of regulations that govern who can practice once in the US and it isn't easy, so someone has to be fairly motivated to come here.

Skeptical Scalpel said...

Thanks for the comment. If the story had been about America stealing the world's nurses, I wouldn't have had anything to say because that is true.

Yes, like people with other occupations, doctors come here for better living and working conditions. That's why my father [not a doctor] came. The country was built on this principle.

Thatgirl said...

It also isn't uncommon to find someone who was trained as a physician and who practiced as one living in the US and unable to practice here. Even if they easily pass the TOEFL and the boards they still have to go through a residency program here and getting accepted to one is really difficult.

Libby said...

hmm Canada must be the country of choice for South Africans... the ones I've talked to come because of better living/working conditions (eg: less likely to get stabbed while working).
We have a lot of foreign trained doctors who aren't practicing because there are so few residency spots available for them. Alberta has implemented a special program (I can't remember what it entails) but it still comes down to those residency spots.
The biggest problem is that they aren't told that their credentials aren't immediately recognized BEFORE they hop the plane to pop over to live here. So we have taxi drivers who could take your gallbladder out...but not in Canada.
We've been accused of stealing doctors from S.Africa (my present family phys. is from absolute genius). And we (private citizens) think the US is stealing our doctors. (Like my first family doctor who sold his practice here and moved to PA).
Gosh, it is like they are commodities and not humans who like to experience different places.

Skeptical Scalpel said...

Good comments. Thanks.

I was trying to get at the fact that a lot of doctors move here because of opportunities for a better life. That's not stealing.

Thatgirl said...

If anything the difficulties that go along with trying to practice in the US as a foreign graduate would deter them, not entice them. So definitely not stealing in that respect.

Skeptical Scalpel said...


RobertL39 said...

So, to put a somewhat different spin on it, how do you all feel about US women who go through the training to get certified in a specialty and then practice only until the biological clock starts to run out? This is NOT uncommon! Isn't this similar to countries who invest lots of money to train their physicians only to have them leave for the financially greener pastures of the US? Both problems need to be addressed. We're not 'stealing' them, but since finances are a major factor, maybe we're bribing them away? But we'd be in even worse manure piles if they weren't here. Hmmmmmm.

Skeptical Scalpel said...


I have mentioned the issue of women surgeons focusing on narrow specialties and doing fewer cases than men. Here’s the link

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