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Migrant nurses and physicians now critical to OECD health systems

Foreign-born doctors and nurses are becoming increasingly numerous in the health systems of developed countries, highlighted a report published Monday by the Organization for Economic Cooperation and Development (OECD).

“The shortage of health personnel, driven by population aging, greater care needs, and rising demand for medical services, is today a major challenge for all OECD countries,” the organization states in its annual report on international migration.

“Many of them have responded by strengthening their capacity to train health professionals, but international recruitment of doctors and nursing staff has also continued to increase,” the authors note.

Data from the OECD, an international organization made up of 38 member states, can help governments shape their policies.

In its report, the organization notes that between 2001 and 2021, the number of doctors born in a country other than the one in which they practice rose by 86%, and the number of nurses surged by 142%.

In 2021, the United States, Germany, and the United Kingdom were the countries with the largest numbers of foreign workers in the health sector.

Spain turns to Latin America

Over the past 20 years, the number of doctors from other countries has more than tripled in Finland, Germany, Norway, Switzerland, and Spain. In Spain, data from 2000–2001 show that 7.5% of doctors were born abroad. In 2020–2021, the figure was 16.9%.

For comparison, foreign-born doctors represent 22% in Germany, 18% in France, 54% in Australia, 49% in Ireland, 41% in the United Kingdom, 37% in Canada, and 30% in the United States.

A similar trend is seen in nursing. In Spain, foreign-born nurses account for 5.5%, in Germany 19%, in France 6%, and in the United Kingdom 28%. As for origins, Asia remains the main continent of origin for doctors (40%) and nurses (37%). But in Spain’s case, 76.9% of foreign-born doctors are Latin American.

In Portugal and France, most doctors born abroad come from the African continent, at 39.6% and 49.4% respectively. Similar patterns are observed among migrant nurses. They made up a significant share in Spain within the group of migrant professionals (55.7%), and also in Italy (16.2%) and the United States (22.7%).

Chile and Colombia during COVID

In its report, the OECD points out that “recognition of qualifications and authorization to practice remain major obstacles to the professional integration of immigrants at a level commensurate with their skills.”

During the COVID-19 pandemic, many OECD countries implemented temporary measures to address urgent staff shortages in the sector, the report notes.

Chile, for example, authorized its national health services to hire foreign health professionals regardless of official recognition. Argentina and Peru did the same, even though they are not OECD members but candidates for accession.

In Colombia, these measures were also eased, specifically for Venezuelan health workers already in the country. The report also emphasizes Spain, the third OECD country relying on doctors trained abroad after the United Kingdom and the United States.

Between 2003 and 2023, Spain admitted 92,000 doctors trained abroad. Between eight and nine out of ten obtained their first degree in one of the ten South and Central American countries cited in the report. Colombia, Argentina, and Venezuela accounted for nearly half of that total.

“Linguistic and cultural proximity are obvious pull factors,” but the country also implemented recognition policies to facilitate the process, the OECD noted. The report also warns about the consequences of this international mobility of professionals for countries of origin.

“We are seeing recruitment processes accumulate and ultimately take place in the countries of origin, which become suppliers for the rest of the world,” explains Jean-Christophe Dumont, one of the authors interviewed.

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