Mischa Willis

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Country: USA
Background: BA Social Science
Research Project: Motivations and incentives employed to prevent the “Brain Drain” of medical professionals in developing countries

BACKGROUND: The United States has 5% of the world’s population, but employs 11% of the world’s physicians, 25% of whom are international medical graduates. The number is even higher in the United Kingdom, Canada and Australia. Many of these graduates come from poor countries with high disease burdens (Kingma, 2001). Medical migration results from various “push” and “pull” factors effecting the decisions of medical professionals. It is the interplay between both forces, a reason to leave and a belief that there are chances for an improved situation elsewhere that fosters migration (Mejia, et al 1979). The economic and social impact of medical migration is profound and can cripple already weak health systems in the developing world.

AIM: This project aims to examine the effectiveness of interventions based on motivation within the context of medical migration and the “brain drain”, defined as the loss of skilled intellectual and technical labour through the movement of such labour to more favourable geographic, economic, or professional environments (Oxford, 2007).

Research Questions:

• What specific intervention has been recommended to increase the motivation of medical professionals within the developing world?
• What is the effectiveness of these interventions in reducing migration of medical professionals?
• What is the evidence used as the basis of these recommendations?

METHODOLOGY: The format of a systematic review using predefined and explicit steps to minimize bias in all parts of the process including identifying relevant studies, and collecting and combining their data (Cochrane, 2006). Criteria for inclusion and exclusion were developed and only data from studies included was extracted.

FINDINGS: Seven themes were identified as main factors effecting motivation including: financial incentives, career development, continuing education, hospital infrastructure, availability of necessities, hospital management and recognition/appreciation. The frequency of the times an incentive was addressed in various studies was determined to not conclusively equate the efficiency of the intervention. There is, however, a correlation between the number of times an incentive was addressed and the level to which that particular incentive is in the academic and research consciousness.

CONCLUSION: Medical migration will not stop without interventions from the countries on both sides of the migration equation. Developing countries must assess and address the motivational push factors within their country, as well as identify the particular pull factors that are luring their medical professionals away. Developed countries need to go about the recruitment of medical professionals in an ethical way that will not debilitate the health system of countries from which they seek medical professionals. A dialogue between countries in a formal setting is needed, and both should be allowed to give input on what is fair and just in the recruitment of medical professionals.