The evolving landscape of doctor and nurse mobility in the OECD since 2000 with a focus on Canada

OECD health systems face rising demand for health workers, increasingly relying on international recruitment of doctors and nurses. Growing dependence raises "brain drain" concerns, particularly when recruits originate from WHO Health Workforce Support and Safeguards List countries.

This study examines how mobility to OECD countries has evolved over two decades, focusing on Canada, and considers implications for destination and origin countries.

Using harmonised data on foreign-born and foreign-trained doctors and nurses, we analyse stocks and annual inflows across OECD countries since 2000 and benchmark reliance through a foreign-trained dependency ratio.

Results demonstrate sustained growth in migrant health worker stocks and inflows, with international migration contributing substantially to workforce expansion. Canada exhibits amongst the highest foreign-trained dependency ratios for doctors, whilst recent years have shown marked acceleration in migrant nurse inflows. Census microdata reveals increased mobility accompanies rising "brain waste", with only a minority of foreign-born foreign-trained physicians and nurses working in their trained profession.

Policy frameworks have adapted through targeted migration channels and credential recognition reforms, yet further alignment is needed so admission, recognition and registration proceed cohesively. Following the WHO Global Code of Practice on International Recruitment of Health Personnel, closer cooperation with origin countries is essential to ensure mobility benefits both source and destination nations.