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Internal migration of physicians who graduated in Brazil between 1980 and 2014
Mario Cesar Scheffer1, Alex Jones Flores Cassenote2, Aline Gil Alves Guilloux1
1Preventive Medicine Department, Medical School of University of São Paulo, São Paulo, Brazil.
Insights
Physician migration in Brazil shows higher rates from smaller towns, with over half of doctors moving states after graduation. Understanding these migration patterns is key for health workforce planning.
Area of Science:
- Public Health
- Health Workforce Research
- Medical Education Policy
Background:
- Internal physician migration significantly impacts national health system resource distribution.
- Physician migration decisions are influenced by economic, social, demographic, individual, and professional factors.
- The establishment of medical programs in Brazil's interior is debated for its potential to retain physicians.
Purpose of the Study:
- To analyze physician internal migration patterns in Brazil.
- To investigate the relationship between the location of medical schools and physician migration.
- To inform policies aimed at optimizing physician distribution within Brazil.
Main Methods:
- Cross-sectional study utilizing secondary data from 275,801 physicians registered with Regional Councils of Medicine (Conselhos Regionais de Medicina-CRMs).
- Data encompassed physicians who graduated between 1980 and 2014.
- Migration was defined as practicing or residing in a different state from where the medical program was completed.
Main Results:
- Over half (57.3%) of physicians migrated to a different state.
- Physicians graduating from schools in smaller municipalities (<100,000 inhabitants) exhibited higher migration rates (93.4%).
- Migration probability was lower in state capitals and varied by gender, age, graduation year, and specialty.
Conclusions:
- Physician migration is substantial, particularly for those trained in smaller towns, indicating a potential challenge for interior healthcare access.
- Migration patterns are complex, influenced by location of medical training and individual characteristics.
- Further research is essential to develop effective human resource for health policies addressing physician distribution and retention.
Background:
The internal migration of physicians from one place to another in the same country can unbalance the supply and distribution of these professionals in national health systems. In addition to economic, social and demographic issues, there are individual and professional factors associated with a physician's decision to migrate. In Brazil, there is an ongoing debate as to whether opening medicine programmes in the interior of the country can induce physicians to stay in these locations. This article examines the migration of physicians in Brazil based on the location of the medical schools from which they graduated.
Methods:
A cross-sectional design based on secondary data of 275,801 physicians registered in the Regional Councils of Medicine (Conselhos Regionais de Medicina-CRMs) who graduated between 1980 and 2014. The evaluated outcome was migration, which was defined as moving away from the state where they completed the medicine programme to another state where they currently work or live.
Results:
57.3% of the physicians in the study migrated. The probability of migration ratio was greater in small grouped municipalities and lower in state capitals. 93.4% of the physicians who trained in schools located in cities with less than 100,000 inhabitants migrated. Fewer women (54.2%) migrated than men (60.0%). More than half of the physicians who graduated between 1980 and 2014 are in federative units different from the unit in which they graduated. Individual factors, such as age, gender, time of graduation and specialty, vary between the physicians who did or did not migrate.
Conclusions:
The probability of migration ratio was greater in small municipalities of the Southeast region and strong in the states of Tocantins, Acre and Santa Catarina. New studies are recommended to deepen understanding of the factors related to the internal migration and non-migration of physicians to improve human resource for health policies.
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