Albanian doctors' mobility in a permeable but well distinguished professional environment, a one direction flow.

Background: Albanian doctors’ mobility towards developed countries entices questions on subsequent needs for health care workers which starts with needs assessment and finding gaps from the beginning of medical school education. Methods: Public sources of information were consulted and data were subject to search for variables; number, age, county, sex and specialty. Sources of information; Mandatory Health Insurance Fund (MHIF), INSTAT Albania, Tirana University of Medicine, Order of Physicians of Albania (OPA), and historical documents. Results: The Order of Physicians of Albania database includes doctors who contacted the institution at least once. The working number of doctors must exclude migrants and other statuses. The inclusion criteria for our calculations, age 25 to 68 years, 2024, produces a dataset of 6,984 doctors, female 4,402 (63.0%). INSTAT, 2022, report 1,777 doctors on the primary care services. Based on Census 2023 data the number of doctors per 1,000 inhabitants, on this age range, who contracted at least once with the Order of Physicians is 2.9 per 1,000 inhabitants. The distribution ranges from Tiranë, 5.7 to Dibër, 1.4. Berat, 1.4, Korçë,1.4 and Kukës, 1.5. Data from the archives of Faculty of Medicine (FM) report; 301 enrolled first year students during the academic year 2017-18, (females, 223, 74.1%) and 456 and 2024-25, (females, 333, 73.0%), p=0.747. Female students’ percentage by county, range; for academic year 2017-18, from Vlorë (61.1%) to Berat (90.9%), and Tiranë (73.3%), for academic year 2024-25, Gjirokastër (60.0%) to Kukës (90.9%), and Tiranë (69.1), p=0.03. Conclusions: The firs recommendation is to shift the political rhetoric from stopping to retaining. This democratization must be followed practically by creating a negotiating system from the beginning of the first year of studies, offering financial benefits in change of future service time on the Albanian health care system.