So, why did you leave your country?

AUSTRALIA, like most western countries, relies heavily on a steady influx of international medical graduates to keep its health services running. Our top four ‘donor’ countries are Britain, India, New Zealand and South Africa. Together, they have ‘donated’ some 20,000 doctors. 

Indeed, Australia is becoming progressively more reliant on IMGs, with the 2006 census showing that half of our doctors were born overseas. Some commentators view this migration as an ‘unethical poaching’ of doctors from countries in the developing world, which can ill-afford to lose doctors. This view is echoed in other ‘importing’ countries – Britain, Canada and the US.

This fails to take into account the reasons these doctors have taken the drastic step to emigrate. There appears to be no appreciation of the personal, family, social and cultural costs of emigrating.

During my time as chair of the Registration Committee of the NSW Medical Board, I could not help but note the significant numbers of IMGs who belonged to minority groups in their own countries, whether religious, ethnic or linguistic. My observation was purely anecdotal, but stimulated me to study one IMG group with which I was familiar – being one of them myself.

I managed to contact, by e-mail, some 650 South African-trained doctors and received a 72% response to my detailed questionnaire about their backgrounds and reasons for migrating. With help from David Lewinsohn, who manages the Medical Journal of Australia’s Medical Masterfile, listing all doctors in Australia (but sadly, not their e-mail addresses), I managed to compare my 22% sample of all ex-South Africans with the ‘population’ of some 2,200 known to David.

Our study findings appeared in the 1 March 2010 issue of the MJA. Our conclusions can be summed up in the words of one respondent: “With all due respect to Australia, it was not so much the positives of the country that pulled us towards it, but rather a push from the negatives of South Africa.”

I would now like to find out how valid that is for immigrant doctors from other countries. There is a strong push at international level to prevent doctor-migration to countries like Australia. I believe that it is important that the views of immigrant doctors be more fully recognised, to counter misconceptions underlying this push.

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Dr Peter Arnold Former chair of the Registration Committee of the NSW Medical Board