Regulating the Movement of Doctors .Supply and Demand.

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Regulating the movement of Doctors SUPPLY
DEMAND Dr Vinod Singh ,DSM (Fiji ) ,
FRACP. Consultant Physician, Stroke and Internal
Medicine North Shore Hospital, Honorary Clinical
Senior Lecturer in Medicine, University of
Auckland. Tutor specialist ,Overseas Trained
Doctors, WDHB. Auckland
City at dusk
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Why Doctors move ?

• Better Academic opportunities
• Better renumerations
• Better opportunities for family
• Safer environment
• Familiy reuinion
• Friends
• Health
• Etc etc

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Supply and Demand orDemand and Supply
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Supply and Demand or Demand and Supply
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Demand the New Zealand Perspective

• Bar graph

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IMGs to NZ workforce

• 2001 3765
• 2002 3921 156
• 2003 4156 235
• 2004 4347 191
• 2005 4471 124
• 2006 4642 171

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IMGs to New Zealand workforce

• 2005 4471 124
• Newly registered doctors (1July2004-30th June
  2005)
• Trained in New Zealand 311
• International Medical Graduates 1434
• (NZREX clinical passes) 68

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SUPPLY the new Zealand perspective

• England SA Scotland Australia India
• SriLanka USA Iraq Ireland
• Bangladesh Germany Canada
• Wales China Egypt
• Fiji (58) Yugoslavia(FedRepub of)
• Pakistan Phillipines Northern Ireland
• Zimbabawe Netherlands Russia
• Singapore Poland Myanmar
• Romania Croatia PNG Bulgaria
• Malaysia CzechRepublic.
• Japan sweden Denmark Former
• YugoslavRepublicofMarcedonia,Hungry,Switzerland
• Ukraine,Belgium,Bosnia and Herzegovina,Iran,Norway
  
• Others -45 countries with fewer than six doctors
• Total of 88 countries.

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Fiji

• Developing country in the Pacific
• Population of about 800,000
• 430 Doctors in Govt Service
• 330 Locals graduates
• 100 IMGs 24
• India, Phillipines,Bangaldesh,China and Mynamar

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Doctor migration happens in Developed countries
and Developing countries.

• So what is the problem?
• Quality of graduates
• Ease vs difficulties in filling the positions
• Economics time and money

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Quality

• USMLE ( North American Exams
• USA Top 5-10 percentage English Language
• NZ - Pass in USMLE English Language
• Fiji NO exams Medical or Language

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Quality Extravirgin oil, Pomace or the grit
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Economics

• Time and money are needed in making a doctor.

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Time - about 6 years of training to make a
doctor
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Money

• In New Zealand
• About NZ250,000

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Time and Money

• Local graduate
• Six years and 250K
• IMG (overseas trained doctor )
• Ready
• in the can
• and FREE
• Is there any incentive to train more ?

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Summary

• Migration of doctors occur to developed and
  developing countries but developing countries
  seem to come out second best. There should be
  some form of compensation eg Financial ,
  technological or professional to the donor
  countries.
• Doctors migrate for a variety of reasons. Demand
  for service is the driving factor and this demand
  in Developed countries should be minimised by
  training more of their own doctors . This will
  cause a natural deciline in movement of doctors
  from countries where they are need the most .

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Thank You