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No future, Heavy workload, to save money, work tempo, declining health services,
economic decline, poor management and upgrade qualifications.
Other motives can lead to emigration such as negative reactions to training programs
(Shephard, 1977), unqualified medical education, cost of enrolling in a medical school or
enrollment selection methods. The description of the medical school system in the
countries under study is then necessary to understand the differences that lead to the
emigration choice. The medical schools systems will be discussed in a subsequent section
including the number of schools, the number of enrolled and graduates in addition to the
number of years to obtain a medical doctor degree per country.
Since the determinants of medical doctor emigration are established and they are heavily
related to salary benefits of receiving countries, the following section describes the facts
about the phenomenon of physicians’ emigration. There are databases in the literature
that report the level of emigration of such professionals along with demographic
description of each country considered. Data exists about the number of physicians per
country, the number of physicians per 10000 people in each country and the number of
graduates from health education in general. These elements are important in measuring
the effect of such emigration on the sending and receiving countries in addition to the
possible creation of collaboration between countries in terms of physicians’ need.
I.2.4 Medical Educational Systems & Costs of Education
Given that one of the determinants of physicians’ emigration is related to the quality of
medical education provided in the country, a description of the medical school systems
for the four groups of countries follows.
A. Eastern and Central European (ECE) Countries
Starting from the ECE countries, it has been found that the duration of education in these
countries is around 6 years for a degree as a medical doctor. The number of universities
or medical institutes differs per country with the largest number in Russia, Ukraine,
Poland and Romania. However, the large number of universities in Russia is explained by
the equally large total population compared with the countries in the group (Table
I.2.4.1). Besides, the costs of education are lower when compared to the remaining
European countries and costs of living are affordable for students.
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