Physician migration: views from professionals in Colombia, Nigeria, India, Pakistan and the Philippines
Physician migration: views from professionals in Colombia, Nigeria, India, Pakistan and the Philippines
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DOI：
10.1016/j.socscimed.2005.05.003
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发表时间：
2005-12-01
影响因子：
5.4
通讯作者：
Lie, RK
中科院分区：
文献类型：
--
作者：
Astor, A;Akhtar, T;Lie, RK
最近，关于医生从发展中国家向发达国家移徙的几个问题有很多争论。然而，很少有研究已经进行了系统地解决这些问题。为了开始产生系统数据的过程，我们设计并分发了一份调查问卷，以解决围绕医生迁移的几个核心问题，根据他们在印度，尼日利亚，巴基斯坦，哥伦比亚和菲律宾的特殊专业知识或经验选择受访者。所处理的问题涉及医生移徙到发达国家的原因，移徙与医学教育结构的关系，移徙对发展中国家保健基础设施的影响，以及处理医生移徙的各种政策选择。虽然各国的答复略有不同，但增加收入的愿望、更多地获得先进技术的机会、普遍安全和稳定的气氛以及改善子女的前景是医生移徙的主要动机。大多数受访者认为，医生在发展中国家提供了高度专业化的技能，他们可以更好地利用在发达国家，但受访者是矛盾的教育改革的效用。关于医生移徙是否导致医生短缺，各国的答复差异很大，但普遍认为，这加剧了农村和公共环境中的短缺。在政策选择方面，增加医生收入，改善工作条件，要求医生从医学院毕业后在本国工作一段时间，以及加强发达国家和发展中国家卫生部之间的合作，最受受访者欢迎。(c)2005爱思唯尔有限公司保留所有权利。
There has been much debate recently about several issues related to the migration of physicians from developing to developed countries. However, few studies have been conducted to address these issues in a systematic fashion. In an attempt to begin the process of generating systematic data, we designed and- distributed a questionnaire addressing several core issues surrounding physician migration to respondents selected on the basis of their special expertise or experience in India, Nigeria, Pakistan, Colombia, and the Philippines. The issues addressed relate to the reasons physicians migrate to developed countries, how migration is related to the structure of medical education, the effect that migration has on the health care infrastructure of developing countries, and various policy options for dealing with physician migration. Though responses varied somewhat by country, a desire for increased income, greater access to enhanced technology, an atmosphere of general security and stability, and improved prospects for one's children were the primary motivating factors for physician migration. A majority of respondents believed that physicians in developing counties are provided with highly specialized skills that they can better utilize in developed countries, but respondents were ambivalent with respect to the utility of educational reform. Responses varied significantly by country with regard to whether physician migration results in physician shortages, but there was widespread agreement that it exacerbates shortages in rural and public settings. With respect to policy options, increasing physician income, improving working conditions, requiring physicians to work in their home countries for a period following graduation from medical school, and creating increased collaboration between health ministries in developed and developing countries found the most favor with respondents. (c) 2005 Elsevier Ltd. All rights reserved.