Doctors For The World: Indian Physician Emigration

Fitzhugh Mullan

Health Affairs. 2006;25(2):380-393. 

In This Article


Greater self-sufficiency in recipient nations might allow India to focus medical education on domestic health care needs.

One of the great geopolitical stories of the past few years has been India's explosion onto the world stage as an "other" Asian economic powerhouse viewed by many in the West as the natural democratic counter to the increasingly muscular Chinese juggernaut. With gross domestic product (GDP) growth rates the envy of the old industrialized economies, India has enormous potential as both a consumer market and a center of production, along with an even more rapidly metamorphosing China. This represents a key factor motivating many strategic analysts to dub the twenty-first century as "the Asian century."

Yet for all its advances, India remains a developing country struggling with problems that confound even the most prosperous developed countries, including health and economic disparities between urban and rural spheres; and a poorly funded public health sector, ill-equipped to confront an oncoming AIDS epidemic. India's distinction as being the largest exporter of highly qualified physicians figures into this complex mix as well. Many who study global workforce migration through a public health lens tend to view this trend as a negative, draining needed native brains from meeting the health needs of India's massive population. Others in the economist community point to recent research documenting the economic value that donor nations, such as India, might accrue as a result of physician, among other workforce, emigration. Indeed, many Indian policymakers themselves openly view India's capacity to produce physicians for export as an asset for the mother country, and they consider shortfalls in domestic health care access as a function more of resource maldistribution than of actual shortages.

This paper delves into the issue by offering a compelling, journalistic exposé descriptive of India's medical education system and the drivers of the emigration phenomenon. The author comes down squarely on the side of curtailment and concludes by offering policy guidance intended to discourage emigration from both the supply and demand ends of the equation. Fitzhugh Mullan ( fmullan@ ) is the Murdock Head Professor of Medicine and Health Policy and a professor of pediatrics at the George Washington University, in Washington, D.C., and a contributing editor of Health Affairs.