Research article

Quality of medical training and emigration of physicians from India

Manas Kaushik^1,3 , Ananya Roy² , Anand A Bang³ and Ajay Mahal⁴

¹  Departments of Nutrition and Epidemiology, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA

²  Department of Environmental Health Sciences, University of Michigan School of Public Health, 6655 SPH I, Ann Arbor, MI 48109, USA

³  SEARCH, Shodhgram P.O. District Gadchiroli, Maharashtra 442606, India

⁴  Department of Global Health and Population, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA

author email corresponding author email

BMC Health Services Research 2008, 8:279doi:10.1186/1472-6963-8-279

Published:	30 December 2008

Abstract

Background

Physician 'brain drain' negatively impacts health care delivery. Interventions to address physician emigration have been constrained by lack of research on systematic factors that influence physician migration. We examined the relationship between the quality of medical training and rate of migration to the United States and the United Kingdom among Indian medical graduates (1955–2002).

Methods

We calculated the fraction of medical graduates who emigrated to the United States and the United Kingdom, based on rankings of medical colleges and universities according to three indicators of the quality of medical education (a) student choice, (b) academic publications, and (c) the availability of specialty medical training.

Results

Physicians from the top quintile medical colleges and of universities were 2 to 4 times more likely to emigrate to the United States and the United Kingdom than graduates from the bottom quintile colleges and universities.

Conclusion

Graduates of institutions with better quality medical training have a greater likelihood of emigrating. Interventions designed to counter loss of physicians should focus on graduates from top quality institutions.