Health Services and Population Research Department, Institute of Psychiatry, King's College London, London, United Kingdom.
PLoS One. 2010 Feb 4;5(2):e9049. doi: 10.1371/journal.pone.0009049.
Migration of health professionals from low and middle income countries to rich countries is a large scale and long-standing phenomenon, which is detrimental to the health systems in the donor countries. We sought to explore the extent of psychiatric migration.
In our study, we use the respective professional databases in each country to establish the numbers of psychiatrists currently registered in the UK, US, New Zealand, and Australia who originate from other countries. We also estimate the impact of this migration on the psychiatrist population ratios in the donor countries.
We document large numbers of psychiatrists currently registered in the UK, US, New Zealand and Australia originating from India (4687 psychiatrists), Pakistan (1158), Bangladesh (149), Nigeria (384), Egypt (484), Sri Lanka (142), Philippines (1593). For some countries of origin, the numbers of psychiatrists currently registered within high-income countries' professional databases are very small (e.g., 5 psychiatrists of Tanzanian origin registered in the 4 high-income countries we studied), but this number is very significant compared to the 15 psychiatrists currently registered in Tanzania). Without such emigration, many countries would have more than double the number of psychiatrists per 100,000 population (e.g. Bangladesh, Myanmar, Afghanistan, Egypt, Syria, Lebanon); and some countries would have had five to eight times more psychiatrists per 100,000 (e.g. Philippines, Pakistan, Sri Lanka, Liberia, Nigeria and Zambia).
Large numbers of psychiatrists originating from key low and middle income countries are currently registered in the UK, US, New Zealand and Australia, with concomitant impact on the psychiatrist/population ratio n the originating countries. We suggest that creative international policy approaches are needed to ensure the individual migration rights of health professionals do not compromise societal population rights to health, and that there are public and fair agreements between countries within an internationally agreed framework.
来自中低收入国家的卫生专业人员向富裕国家流动是一个大规模且长期存在的现象，这对捐助国的卫生系统不利。我们试图探讨精神科医生移民的程度。
在我们的研究中，我们利用每个国家各自的专业数据库，确定目前在英国、美国、新西兰和澳大利亚注册的原籍国为其他国家的精神科医生人数。我们还估计了这种移民对捐助国精神科医生人数比例的影响。
我们记录了目前在英国、美国、新西兰和澳大利亚注册的大量原籍国为印度（4687 名精神科医生）、巴基斯坦（1158 名）、孟加拉国（149 名）、尼日利亚（384 名）、埃及（484 名）、斯里兰卡（142 名）、菲律宾（1593 名）的精神科医生。对于一些原籍国，目前在高收入国家专业数据库中注册的精神科医生人数非常少（例如，在我们研究的 4 个高收入国家中，只有 5 名坦桑尼亚籍精神科医生注册），但与目前在坦桑尼亚注册的 15 名精神科医生相比，这个数字非常显著。如果没有这种移民，许多国家的每 10 万人中精神科医生人数将增加一倍以上（例如孟加拉国、缅甸、阿富汗、埃及、叙利亚、黎巴嫩）；而一些国家的每 10 万人中精神科医生人数将增加五到八倍（例如菲律宾、巴基斯坦、斯里兰卡、利比里亚、尼日利亚和赞比亚）。
目前，来自关键中低收入国家的大量精神科医生在英国、美国、新西兰和澳大利亚注册，这对原籍国的精神科医生/人口比例产生了影响。我们建议，需要采取创造性的国际政策方法，以确保卫生专业人员的个人移民权利不会损害社会的健康权，并且在国际商定框架内，国家之间有公开和公平的协议。
