“Brain drain” and “brain waste”: experiences o | RMHP
Aisha Lofters,1–4 Morgan Slater,2 Nishit Fumakia,2 Naomi Thulien5
1Department of Family and Community Medicine, University of Toronto, Toronto; 2Department of Family and Community Medicine, St Michael's Hospital, Toronto; 3Centre
for Research on Inner City Health, The Keenan Research Centre in the Li
Ka Shing Knowledge Institute of St Michael's Hospital, Toronto; 4Canadian
Institutes of Health Research Strategic Training Fellowship,
Transdisciplinary Understanding and Training on Research – Primary
Health Care Program, London; 5Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
Background:
“Brain drain” is a colloquial term used to describe the migration of
health care workers from low-income and middle-income countries to
higher-income countries. The consequences of this migration can be
significant for donor countries where physician densities are already
low. In addition, a significant number of migrating physicians fall
victim to “brain waste” upon arrival in higher-income countries, with
their skills either underutilized or not utilized at all. In order to
better understand the phenomena of brain drain and brain waste, we
conducted an anonymous online survey of international medical graduates
(IMGs) from low-income and middle-income countries who were actively
pursuing a medical residency position in Ontario, Canada.
Methods:
Approximately 6,000 physicians were contacted by email and asked to
fill out an online survey consisting of closed-ended and open-ended
questions. The data collected were analyzed using both descriptive
statistics and a thematic analysis approach.
Results:
A total of 483 IMGs responded to our survey and 462 were eligible for
participation. Many were older physicians who had spent a considerable
amount of time and money trying to obtain a medical residency position.
The top five reasons for respondents choosing to emigrate from their
home country were: socioeconomic or political situations in their home
countries; better education for children; concerns about where to raise
children; quality of facilities and equipment; and opportunities for
professional advancement. These same reasons were the top five reasons
given for choosing to immigrate to Canada. Themes that emerged from the
qualitative responses pertaining to brain waste included feelings of
anger, shame, desperation, and regret.
Conclusion:
Respondents overwhelmingly held the view that there are not enough
residency positions available in Ontario and that this information is
not clearly communicated to incoming IMGs. Brain waste appears common
among IMGs who immigrate to Canada and should be made a priority for
Canadian policy-makers.
