With the start of the new academic year, thousands of freshly graduated doctors come from medical schools around the country to begin their residencies at U.S. hospitals. They will move across city and state lines, some crossing the country to begin their specialty training. Others will come from even further away.
About 25 percent of residents currently in the United States completed medical school outside of the U.S., coming from all corners of the globe.
India, the Philippines, Mexico, Egypt, and Grenada are among the top countries from which medical students graduate before starting residency in the U.S., and they end up primarily in states with diverse populations, such as New York, New Jersey, California, and Florida.
But the great resident migration doesn’t end with the US. Thousands of physicians who train and practice in the U.S. spend time abroad in a variety of capacities, ranging from short-term volunteer missions to opening practices and moving permanently to other countries. Within CIR’s ranks, thousands of members have travelled to other countries since the union’s inception out of a desire to serve and care for patients around the globe who may have limited access to medical services. In 1982 CIR Executive Committee member Dr. Joanna Palmisano travelled to El Salvador as part of a delegation of physicians investigating allegations of medical rights abuses following the 1979 coup d’état. In 2005, several members volunteered in Sri Lanka, Thailand, India, and Indonesia in response to the devastation caused by the December, 2004, earthquake and tsunami.
More recently, dozens of CIR members have taken advantage of CIR Policy and Education Initiative scholarships to volunteer their medical services in Haiti following the 2010 earthquake, while others have travelled to Eritrea, Ecuador, Jamaica, and elsewhere for similar volunteer efforts.
What are the effects of this global medical migration? Statistics and research paint contradicting pictures, suggesting a complex set of issues. Ghana currently has about 3,600 doctors serving its population of 24 million, giving it a rate of .15 doctors per 1,000 people, as roughly half of the country’s medical professionals leave the country to work elsewhere. In Grenada, medical schools must train 22 doctors in order to retain just one.
There have been concerns about the long-term effects of short-term medical missions abroad, specifically citing the inability of short-term volunteers to provide lasting care or to establish preventative care standards.
But statistics can’t tell the personal side of migration, including the reasons many from outside of the United States choose to complete their residencies here as well as the difficulties faced in making the transition from medical school outside of the U.S. to a residency program, or the importance of medical missions to areas in need of more doctors. CIR Vitals spoke with several current and former residents who have participated in this international exchange in different capacities to get their perspectives on health care in the global community.