GDP per capita and physician migration across world regions, 2000–2021

Physician migration is a problem of international concern, and studies have attempted to determine whether macroeconomic and developmental factors predict nationwide decreases in physician migration. Like the nutritional and epidemiologic transitions, there is an understood “migration transition” as well, with migration levels for highly educated individuals decreasing as national income increases. This approach can provide insights into the macroeconomic determinants and predictors of medical emigration. We drew annual data from 2000 to 2021 on new physician migration (i.e., flows) to the Organization for Economic Co-operation and Development (OECD), converted into logged flows, and charted against logged origin country real GDP per capita (2017 international dollars, purchasing power parity). We fit an ordinary least squares (OLS) model and gravity model, testing the relationship between the year-lagged natural log of real GDP per capita and the natural log of total annual emigration flows separately in ordinary least squares and gravity model analyses. Descriptive results show overall a U-shaped relationship between origin GDP and emigration rates; however, descriptive trends disaggregated by region of the world show that as origin GDP rises, migration outflows generally decline in Central Asia and East Asia & the Pacific; generally increase in Europe; are bimodal in the Middle East and North Africa and Latin America; and remain the same in sub-Saharan Africa. Gravity models demonstrate, across all regions, no quadratic relationship and a negative linear relationship. However, within-region models showed a negative relationship with origin GDP per capita in East Asia and the Pacific, Central and South Asia, and North America and no statistical effect elsewhere, although with increasing lags, there was a positive relationship in sub-Saharan Africa and the European Union (EU) and a positive relationship nearing statistical significance in non-EU European countries. The relationship between national income and physician emigration is complex and heavily dependent on geography, indicating that different mechanisms might be driving physician migration trends in different regions.