Measuring the migration of surgical specialists

Area of Science:

• Global Health
• Medical Workforce Migration
• Surgical Care Access

Background:

• Essential surgical care access is limited in low-income countries, exacerbated by specialist emigration.
• The global migration patterns of surgeons, obstetricians, and anesthesiologists from low- and middle-income countries (LMICs) are not well-documented.
• It remains unclear if surgical specialists migrate internationally at higher rates than other medical specialists.

Purpose of the Study:

• To quantify the proportion of surgical specialists from LMICs who are currently practicing in high-income countries (HICs).

Main Methods:

• Utilized the World Health Organization Global Surgical Workforce database for workforce data from 48 HICs and 102 LMICs.
• Compared domestic workforce data with information on the country of initial medical qualification for surgeons, anesthesiologists, and obstetricians in 14 selected HICs.
• Calculated the proportion of surgical specialists working abroad based on qualification origin.

Main Results:

• Identified 1,118,804 specialists from 102 LMICs; 33,021 (3.0%) worked in 14 HICs.
• African and South East Asian regions had the highest proportions of surgical specialists abroad (12.8% and 12.1%, respectively).
• No significant difference was found in the proportion of migrating surgical specialists compared to other physicians (P = .465). Countries with the lowest surgical specialist density had the highest emigration rates (P = .011).

Conclusions:

• A substantial percentage of surgeons, anesthesiologists, and obstetricians trained in LMICs are now practicing in HICs.
• Strategies to improve surgical care in LMICs should address migration and consider engaging the international pool of specialists.
• Innovative approaches are needed to retain and strengthen the surgical workforce in underserved regions.