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Part II: New Economics of Migration of Medical Doctors from ECE & MENA with Focus on the Moroccan Case This part focuses mainly on the promising theoretical and empirical features of the new economics of skilled labor and its applications to medical doctors from ECE and MENA economies. The first sub-part is precisely devoted to show the outcomes from the implementation of a new view on the perception of the emigration of medical doctors. The second sub-part introduces the case of the Moroccan economy with its prospects regarding medical doctors. It also provides the outcomes from a survey of medical doctors from Morocco where most of the findings and implications of the new economics approach to migration. II.1 New Economics of Migration of Medical Doctors from MENA & ECE to the EU: Theoretical and Empirical Applications ! This is a contribution to the new economics of skilled labor emigration that focuses on the mobility of physicians inside European Union from ECE and MENA countries. Economic models under risk neutrality and aversion are used. The findings show that the education could change significantly the results on the emigration benefits. Comparisons of theoretical and observed relative human capital per country averages are conducted. They ensured the statistical validity of the model used. The empirical results based on the available data on emigration by Docquier and Marfouk (2006 and 2008) and Bhargava, Docquier and Moullan (2010) allowed further use of the model to understand the current trends in the emigration of physicians and the border between brain gain and brain drain. The countries included in the study are all exhibiting brain gain under 1991-2004 emigration data. Each country is encouraged to anticipate the likely effects of this emigration on the economy with the increase of health demand, the domestic wages and the increase in education capacity for medical doctors. ! In the context of globalization in general and of EU enlargement in particular, migration is one of the most important and sensitive aspect with a lot of implications on social, economical and demographical changes. ! ()!
This chapter deals with the migration of physicians inside European Union. Economic models under risk neutrality and aversion are used. The model used in this paper is not different from the one developed in Driouchi, Baudassé, Boboc and Zouag (2009). The basic features of this model are from Stark et al., (2005). After the underlying assumptions, the cases of risk neutrality and aversion are introduced with their related comparative statistics. It begins with a literature review of the main papers about the new economics of skilled labor emigration. Many authors analyzed these imbalances. In the countries when health care needs are often greater than in developed countries the workforce shortage seriously compromise the ability to deliver adequate and equitable health care to a large proportion of population. But, the new economics of skilled labor has identified potential gains that could benefit the source economy as emigration of skills can induce further quantitative and qualitative domestic training and graduation from domestic higher education systems. The overall net effects of the emigration and the domestic training and graduation is translated into a net effect that can be either “brain drain” or “brain gain” depending on the situation of each economy. The chapter continues with description of the model developed in Driouchi, Baudassé, Boboc and Zouag (2009). The empirical results based on the available data on emigration by Docquier and Marfouk (2006 and 2008) and Bhargava, Docquier and Moullan (2010) allowed further use of the model to understand the current trends in the emigration of physicians and the border between brain gain and brain drain. The countries included in the study are all exhibiting brain gain under 1991-2004 emigration data. Each country is encouraged to anticipate the likely effects of this emigration on the economy with the increase of health demand, the domestic wages and the increase in education capacity for medical doctors. II.1.1 Literature Review Physician migration is a complex and multifaceted phenomenon. Imbalances in the production of physicians lead to workforce shortages and surpluses. Many authors analyzed these imbalances. In the countries when health care needs are often greater than in developed countries the workforce shortage seriously compromise the ability to deliver ! )+!
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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
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This may concern also EU countries
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discussed both in theory and practi
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EU are then described and discussed
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specialties. This study shows that
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with this trade. Special arrangemen
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into the developed countries; where
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them as follow: Cross-border delive
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In this regard, the EU is suggestin
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Given the importance of health care
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Serbia. Low wages, poor working con
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• How does tertiary education wit
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Driouchi & Kadiri (2010) are promis
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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 and 64: Egypt Iran 29463 31445 32134 25990
Page 65 and 66: major policies and strategies relat
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: The data available suggest potentia
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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
Page 115 and 116: Using these parameter estimates, co
Page 117 and 118: different websites for different co
Page 119 and 120: the theoretical values of the relat
Page 121 and 122: p-value 0.33 0.03 t test 0.99 2.25
Page 123 and 124: The following set of graphs are the
Page 125 and 126: The countries with higher number of
Page 127 and 128: Turkey (m*=0.41, m**=0.77) Yemen (m
Page 129 and 130: periods but should be concerned abo
Page 131 and 132: health report “Comptes Nationaux
Page 133 and 134: In accordance with the health insur
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Page 137 and 138: To achieve progress in the health s
Page 139 and 140: 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,
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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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