Migration of doctors from developing countries to Australia: an estimate from surveys of doctors

Abstract

BackgroundAustralia is a developed country in a developing region and does not train enough doctors to meet demand. It is therefore a destination country for medical migration. Estimation of Australia's dependence on international medical graduates is crucial for effective policy planning for self-sufficiency. No reliable data exist for the number of international medical graduates from developing countries who practise medicine in Australia. The eight states and territories of Australia have had separate systems for medical registration and different practices for surveying practising doctors; even now, no national coordinating system exists that routinely collects and publishes data about doctors and their country of medical qualification. We assessed the number of doctors working in Australia who completed their primary medical qualification in a developing country, and identify the most common source countries for medical migrants in Australia. MethodsWe used data from the eight state and territory medical boards that cover Australia, surveys of doctors in these regions, professional conversion examinations that enable immigrant doctors to be eligible to practise, and the immigration department. We used aggregate data from the surveys to estimate the number of doctors who had completed their primary medical degree in any country outside Australia. Depending on whether they had been surveyed or not, international medical graduates were classified as being from developed and developing countries with a combination of self-reported survey responses, immigration department data, and data from a deidentified sample of 2000 doctors' medical board records. We adjusted this estimate by comparing each region's survey data with its medical board registration data, which enabled international medical graduates who were not surveyed to be included. We used immigration department and conversion examination data to establish the most common source countries. FindingsMedical board data show that Australia has roughly 87 000 registered doctors. Region survey methods varied, but all the surveys underestimated the number of international medical graduates. About 21 000 (24%) doctors in Australia completed their primary medical qualification in a developing country. Seven of the top ten source nations were developing countries. They were India (supplied 800 doctors), Malaysia (supplied 400 doctors), Sri Lanka (supplied 240 doctors), South Africa (supplied 190 doctors), Pakistan (supplied 150 doctors), Iran (supplied 150 doctors), and Philippines (supplied 100 doctors). InterpretationAustralia depends on international medical graduates from developing countries. All but one of the top seven developing source countries have fewer than one doctor per 1000 people, and thus are already below the doctor to population ratio recommended by WHO. FundingBritish Foreign Office.