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patterns of emigration among the four groups of countries. It has been observed that given the wage benefit, physicians from all MENA countries could be moving to practice in the Other European Countries (OEC). Besides this, Medical doctors from ECE Countries could move to practice in the Other European Countries and the ECE physicians could be moving to practice in all MENA countries except Egypt, Yemen and Algeria. Given that emphasis has been made on the role of medical education in the emigration decision of physicians, the cost of medical education has been considered in this chapter as an important element in the emigration reasoning. It has been observed that the Other European Countries have the highest education costs in average when considering all groups except the Other MENA Countries (because of their special context). The ECE and the MENA countries have approximately comparable tuition fees with some exceptions such as Morocco, Tunisia and Yemen. These observations confirm the pattern of emigration defined above. For example, a MENA student can seek medical education in an ECE Country and then emigrate to one of the Other European Countries to practice medicine. However, the effect of the increasing high costs of medical education can have reverse effects on the affordability of medical education to good applicants from poor families. Providing medical education for wealthier students increases their chances of emigration to wealthier countries and leaving the developing country of origin in shortage of skilled medical doctors and in public health crisis. Increased costs of medical education can also create long-term indebtedness for medical students. The elevated cost of medical education represents a major problem that is in search for applicable strategies and solutions as to help extract the benefits from the increased emigration of medical doctors. This evidence leads to future studies on the role of medical schools, governments and the public sector in ensuring the optimal number and quality of medical doctors. I.3 Understanding the Economics of Migration of Medical Doctors in the Context of the EU The objective of this sub-part is to analyze the mobility of health professionals, in particular medical doctors in the context of the European Union (EU) to address some ! &#!
major policies and strategies related to immigration. This provides the major characteristics of the health systems in relation to availability of medical doctors and their mobility. In this process, both the qualitative and quantitative components of the migration of medical doctors are addressed. Annual data and information are gathered from national reports and from several international organizations. The Organization for the Economic Cooperation and Development (OECD) and World Health Organization (WHO) are major sources. The attained results show that immigration of medical doctors occurs within and outside the EU. There is a great variation in the proportion of foreign doctors across countries in Europe. In some countries, the reliance of foreign medical doctors is high: Switzerland, Ireland, United Kingdom (UK), and Slovenia. The largest inflows of medical doctors are reported to be in the UK, Germany, and Spain. Outflows of medical doctors have increased in Germany, UK, Italy, and Austria. But, the net balance between emigration and immigration matters. Germany looses more doctors every year that it gains through immigration. Migration of health professionals has globally increased in the last years. By loosing health professionals, already fragile health systems in middle and low income countries may be further weakened. This recruitment is threatening the viability of crucial health programs in poor countries. It also involves ethical aspects in this recruitment of health professionals. In respond to the global health workforce crisis, the WHO adopted on 21 May 2010, the Global Code of Practice for the International Recruitment of Health Personnel 62 . This code discourages the recruitment of health professionals from countries with shortages and provides guidance to strengthen the workforce and national health systems across the world. This code has also relevance for Europe, and the WHO Europe has strongly recommended the development and adoption of the Code. It stresses the strengthening and further development of education and training, coordination of labor market activities, and it addresses the misdistribution of health professionals through educational measures, financial incentives, and regulatory procedures. 62 Available at http://www.who.int/hrh/migration/code/practice/en/index.html ! &$!
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F E M I S E R E S E A R C H P R O G
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What Can Be Learnt from the New Eco
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AMGA: American Medical Group Associ
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USA: United State of America WB: Wo
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medical doctors are then free to en
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elate to quality research and educa
Page 13 and 14: This may concern also EU countries
Page 15 and 16: discussed both in theory and practi
Page 17 and 18: EU are then described and discussed
Page 19 and 20: specialties. This study shows that
Page 21 and 22: with this trade. Special arrangemen
Page 23 and 24: into the developed countries; where
Page 25 and 26: them as follow: Cross-border delive
Page 27 and 28: In this regard, the EU is suggestin
Page 29 and 30: Given the importance of health care
Page 31 and 32: Serbia. Low wages, poor working con
Page 33 and 34: • How does tertiary education wit
Page 35 and 36: Driouchi & Kadiri (2010) are promis
Page 37 and 38: annual living costs per student. Th
Page 39 and 40: Lithuania 4.12 4.15 4.01 4.03 3.97
Page 41 and 42: Egypt 67.57 68.86 70.17 71.52 72.89
Page 43 and 44: observed externally from developing
Page 45 and 46: Relative Wages : MIN MENA / By comp
Page 47 and 48: No future, Heavy workload, to save
Page 49 and 50: one-year qualification apprenticesh
Page 51 and 52: Other European Countries Austria 4
Page 53 and 54: one medical university and studies
Page 55 and 56: includes a three-year vocational tr
Page 57 and 58: has 18 medical universities and stu
Page 59 and 60: général du Gouvernement to gradua
Page 61 and 62: of Medical Science, Bachelor of Med
Page 63: Egypt Iran 29463 31445 32134 25990
Page 67 and 68: The aim of this sub-part is to prov
Page 69 and 70: • What is the role of mobility of
Page 71 and 72: Commonwealth of Independent states
Page 73 and 74: Dodani and LaPorte (2005) suggest t
Page 75 and 76: In regards to the mobility of Europ
Page 77 and 78: The general conclusions of these th
Page 79 and 80: Specific factors Impact of HIV/AIDS
Page 81 and 82: Portugal X X Romania X X X Russian
Page 83 and 84: Germany Italy Spain Lithuania Slova
Page 85 and 86: Italy (2%) and Russia (4) in 2008 (
Page 87 and 88: theory assumes perfect transferabil
Page 89 and 90: The data available suggest potentia
Page 91 and 92: This chapter deals with the migrati
Page 93 and 94: networks and on the major channels
Page 95 and 96: assumed here that emigration decisi
Page 97 and 98: Increases (respectively decreases)
Page 99 and 100: Figure II.1.2: The shape of H as a
Page 101 and 102: The optimal emigration rate that ca
Page 103 and 104: Figure II.1.4: Effects of the Level
Page 105 and 106: empirical investigation focuses on
Page 107 and 108: Table II.1.3.1: Country annual tren
Page 109 and 110: Table II.1.3.2: Country annual tren
Page 111 and 112: ! ! C/D>)! 01::! 0103! 5881::7! E#%
Page 113 and 114: "#$%&'!()*)+!Eurostat Database Abou
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Using these parameter estimates, co
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different websites for different co
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the theoretical values of the relat
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p-value 0.33 0.03 t test 0.99 2.25
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The following set of graphs are the
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The countries with higher number of
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Turkey (m*=0.41, m**=0.77) Yemen (m
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periods but should be concerned abo
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health report “Comptes Nationaux
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In accordance with the health insur
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95 adults >15 years old per 100000
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To achieve progress in the health s
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The external problems comprise (1)
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first four hospital universities ex
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monitoring trends and economic fact
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Other support staff 6300 2.11 2004
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areas, the case of doctors who reti
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areas of Morocco. It is computed ye
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political instability, economic dep
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1. Gender VS Intention to Migrate A
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salaries differs according to the w
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Results The results are given below
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These results suggest that the numb
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Finally, the questionnaire records
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The past decades have witnessed an
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changed the notion of space, where
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implications on health, Huynen et a
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Figure III.1.3: Social stratificati
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Lee et al., (2007) primarily focus
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However, Collins (203) does recogni
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America. In Africa, where there are
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physicians from Liberia practice in
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Figure III.1.7: Migrant care worker
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espectively. An interesting particu
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Table III.1.5: Supply of foreign (-
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Table III.1.6: Health care wages in
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Figure II.1.11: Factors affecting h
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Figure III.1.12: Factors contributi
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Table III.1.10: International Quali
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health as integral to wellbeing thr
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III.2.1 Need for A cooperative Fram
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graduate spends of certain number o
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III.2.2 Migration of Medical Doctor
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The convexity condition is simply a
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• A payoff vector (ai)i S is said
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III.2.2.2 Discussion and Public Pol
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Europe. Second, in the North Africa
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In the short run, the country of or
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great incentive for medical student
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system, and therefore to the rest o
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MENA countries could be moving to p
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of their medical school. The other
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Beine, M., Docquier, F. & Rapoport,
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German Medical Association.(2011).
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World Bank Database, 2007. World Ba
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http://gse.buffalo.edu/org/inthighe
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Berland, Y. (2002). Demographie des
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Gericke, C.A. (2006). Finance healt
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Salehi-Isfahani, D., Tunali, I., As
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Beine, M., Docquier, F. & Rapoport,
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Docquier, F., Lohest, O. & Marfouk,
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Labdelaoui, H. (2010). Les dimensio
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Stark, O. (1991), The Migration of
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WHO - World Health Organization (20
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Linacre, S. (2007). “Migration: p
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Challenging Inequities in Health: F
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Mullan, F. (2007). Doctors and Socc
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Vujicic M, Zurn P, Diallo K, Dal Po
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Collins, T. (2003). Globalization,
Page 253 and 254:
Kana, M.A., (2009). From Brain Drai
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Sagoe, K. (2004). Using the Diaspor
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Sub-part II.1: Appendix I Appendice
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means that So if , then: > which is
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A, B,C>0 and , , Then Demo 5: Sign
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t test 3.21788138 1.86856175 3.1713
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Lithuania Years m Relative wage H/H
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Romania Years m Relative wage H/H0
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MENA Countries Risk Neutral Model C
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Tunisia Turkey 1993 0.1781 2.50 1.9
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Syria Tunisia Turkey Yemen Stand.de
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Morocco Syria Tunisia t-stat (theor
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Risk aversion model summary table C
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Table II-2-1.2: Projections of the
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Observations 5 Coefficients Erreur-
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Figure 4: Age distribution within r
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Figure 11: Migration conditions dis
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