“Brain drain” or ethical recruitment?

Mark L Scott, Anna Whelan, John Dewdney and Anthony B Zwi
Med J Aust 2004; 180 (4): 174-176.


  • Recruitment by wealthy countries of health personnel from developing countries is threatening the viability of crucial health programs in poor countries, especially in sub-Saharan Africa.

  • Australia has participated in this “brain drain”, although the extent and impact of this on different countries has not been adequately assessed.

  • Australia depends on overseas-trained doctors to fill vacancies in public hospitals and private practice, particularly in rural and outer suburban areas where locally trained professionals are reluctant to work.

  • Australia should adopt national strategies to minimise harm and maximise benefits of skills migration; concerted international action will also be required.

Please login with your free MJA account to view this article in full

  • Mark L Scott1
  • Anna Whelan2
  • John Dewdney3
  • Anthony B Zwi4

  • School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW.


  • 1. Carrington WJ, Detragiache E. How big is the brain drain? IMF Working Paper 98/102. Washington: International Monetary Fund, 1998. Available at: (accessed Jan 2004).
  • 2. Huddart J, Picazo O. The health sector human resource crisis in Africa. Washington, DC: Bureau for Africa, Office of Sustainable Development, United States Agency for International Development, 2003.
  • 3. Meeus W. “Pull” factors in international migration of health professionals: an analysis of developed countries’ policies influencing migration of health professionals. Bellville, RSA: University of the Western Cape, 2003.
  • 4. Ehman A, Sullivan P. South Africa appeals to Canada to stop recruiting its MDs. CMAJ 2001; 164: 387-388. Available at: (accessed Jan 2004).
  • 5. Padarath A, Chamberlain C, McCoy D, et al. Health personnel in Southern Africa: Confronting maldistribution and brain drain. EQUINET Discussion Paper 3 (undated; 2003). Available at: (accessed Jan 2004).
  • 6. Sanders D, Dovlo D, Meeus W, Lehmann U. Public Health in Africa. In: Beaglehole R, editor. Global public health: a new era. Oxford: Oxford University Press, 2003: 135-155.
  • 7. Lee J. Address to the Fifty-third session of the WHO Regional Committee for Africa, 1 September 2003. Available at:
  • 8. Butt D, Lapsley H, Brooks P. Tomorrow’s doctors: review of the Australian Medical Workforce Advisory Committee. Canberra: AHMAC, 2002. Available at: (accessed Jan 2004).
  • 9. Australian Medical Workforce Advisory Committee. Annual report 2001–2002. Sydney: AMWAC, 2002. Available at: (accessed Jan 2004).
  • 10. Australian Institute of Health and Welfare. Health and Community Services Labour Force 2001; National Health Labour Force Series No. 27, Canberra: AIHW, 2003.
  • 11. Australian Institute of Health and Welfare. Medical Labour Force 2000; AIHW Bulletin No. 5. Canberra: AIHW, 2003.
  • 12. Buchan J, Parkin T, Sochalski J. International nurse mobility; trends and policy implications. Geneva: World Health Organization, 2003.
  • 13. Australian Government Department of Health and Ageing. Medicare Plus. Canberra: Department of Health and Ageing, 2003.
  • 14. Stilwell B, Diallo K, Zurn P, et al. Developing evidence-based ethical policies on the migration of health workers: conceptual and practical challenges. Human Resources for Health 2003; 1: 8. Available at: (accessed Jan 2004).
  • 15. Pang T, Lansang MA, Haines A. Brain drain and health professionals. BMJ 2002; 324: 499-500.
  • 16. Commonwealth Secretariat. Commonwealth code of practice for the international recruitment of health workers. London: Commonwealth Secretariat, 2003.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.