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Medical brain drain - crisis or opportunity?

Published:Sunday | March 21, 2010 | 12:00 AM

Egerton Chang, Contributor

I was browsing through an old edition of National Geographic (December 2008) and I came across the following graphics based on a 2005 study by Fitzhugh Mullan, George Washington University School of Public Health and Health Services.

The graphics show that most of the underdeveloped and developing world is losing trained doctors to the United States, the United Kingdom, Canada and Australia (I will call them the 'Big 4'). These doctors are dubbed International Medical Graduates (IMGs).

Jamaica ranked at the top in terms of losing the highest per cent of medical doctors (IMGs) to 'forren'. According to Mullan, 41.4 per cent of these trained medical professionals have migrated from Jamaica to the 'Big 4'. This compares to 10.6 per cent for India, 11.5 per cent for Singapore, 18.5 per cent for South Africa, and 41.2 per cent for Ireland, for example.

This is a serious problem for Jamaica, with all its natural implications.

But for every crisis there is an opportunity.

I asked myself, what if we made a business of training doctors, nurses and other medical professionals principally for export? One is apt to say, that is money down the drain. But I say, not if these students were charged at or near to the going rate instead of being subsidised. In addition to the straight profit of such a venture, surely there would be spin-offs to the eco-nomy of the town that is closest to wherever this facility is established - rental income for accommodation, entertainment for the students, meals, stationery and other supplies, etc. The sort of benefits that normally accrue to a university town.

Moreover, the amount of money remitted from the diaspora to Jamaica is one of the highest in the world by whatever yardstick is used to measure it. I am sure that the success of these 'exports' will accrue back to Jamaica in the form of monies being remitted to family left back in Jamaica and possible/probable investment in Jamaica.


Migrant remittances for the calendar year 2009 were US$1,791,500,000, off from a high of US$2,021,300,000 in 2008 (Source: Bank of Jamaica - based on information submitted by institutions). It is instructive to note that while remittances for 2009 were down 11.4 per cent over the previous year, January 2010 marks the third month in succession that there has been improvement - albeit not enough to crow about - over the corresponding month in the year previous.

The same Mullan study states that 25.0 per cent, or 208,733, of all doctors in the United States were IMGs. It wouldn't be too optimistic to expect that this market would absorb 208 graduates, or 0.1 per cent per year. Then again, why stop there? Canada, Australia and the UK also have 69,313 IMGs, and 0.1 per cent of this means an additional 69 doctors per year. To churn out 277 doctors per year would require quite a big faculty.

The potential is even greater in that perhaps medical students from other countries would find it convenient to study in Jamaica (sand, sea and sun, etc). Couldn't we enter into a partnership with a well-known medical school to establish such a facility here in Jamaica? For instance, New York's Weill Cornell Medical College helps train medical students at the Weill Bugando University College in Mwanza, Tanzania.

There is a spin-off for the local medical practice in terms of the internships that are a requirement of such schools. Further, chances are that some of these graduates may actually stay in Jamaica, at least for a few years.


And what about other trained medical personnel like Licensed Practical Nurses, Registered Nurses and Advanced Practice Nurses? Is there any reason to expect that the rate of migration to the Big 4 is any less than for doctors? I would even guess that the need for nurses probably exceeds that for doctors.

Couldn't this idea be extended to include the training of these and other personnel in the medical field? Medical needs and expenditure have been increasing in the Big 4 and should continue to do so at a faster rate than the general economy, as medical expenditures as a per cent of their total economy climbs.

Furthermore, because personnel in this field tend, on average, to earn more than the general migrant population, Jamaica should benefit from increased remittances for years to come.

This facility could even become the focus of a much-talked-about medical/ health-tourism centre, making a not insignificant contribution to the tourism dollar earned by Jamaica.

This would be an investment from which benefits flow from Day 1 and keeps on giving and giving for years to come in the form of remittances.

Egerton Chang is a businessman. Feedback may be sent to or