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      Tracking the leavers: towards a better understanding of doctor migration from Ireland to Australia 2008–2018

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          Abstract

          Background

          The recession of 2008 triggered large-scale emigration from Ireland. Australia emerged as a popular destination for Irish emigrants and for Irish-trained doctors. This paper illustrates the impact that such an external shock can have on the medical workforce and demonstrates how cross-national data sharing can assist the source country to better understand doctor emigration trends.

          Method

          This study draws on Australian immigration, registration and census data to highlight doctor migration flows from Ireland to Australia, 2008–2018.

          Findings

          General population migration from Ireland to Australia increased following the 2008 recession, peaked between 2011 and 2013 before returning to pre-2008 levels by 2014, in line with the general economic recovery in Ireland. Doctor emigration from Ireland to Australia did not follow the same pattern, but rather increased in 2008 and increased year on year since 2014. In 2018, 326 Irish doctors obtained working visas for Australia. That doctor migration is out of sync with general economic conditions in Ireland and with wider migration patterns indicates that it is influenced by factors other than evolving economic conditions in Ireland, perhaps factors relating to the health system.

          Discussion

          Doctor emigration from Ireland to Australia has not decreased in line with improved economic conditions in Ireland, indicating that other factors are driving and sustaining doctor emigration. This paper considers some of these factors. Largescale doctor emigration has significant implications for the Irish health system; representing a brain drain of talent, generating a need for replacement migration and a high dependence on internationally trained doctors. This paper illustrates how source countries, such as Ireland, can use destination country data to inform an evidence-based policy response to doctor emigration.

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          Most cited references15

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          Social Resilience in the Neo-Liberal Era

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            A cycle of brain gain, waste and drain - a qualitative study of non-EU migrant doctors in Ireland

            Background Ireland is heavily reliant on non-EU migrant health workers to staff its health system. Shortages of locally trained health workers and policies which facilitate health worker migration have contributed to this trend. This paper provides insight into the experiences of non-EU migrant doctors in the Irish health workforce. Method In-depth interviews were conducted with 37 non-EU migrant doctors in Ireland in 2011/2012. Results Respondents believed they had been recruited to fill junior hospital doctor ‘service’ posts. These posts are unpopular with locally trained doctors due to the limited career progression they provide. Respondents felt that their hopes for career progression and postgraduate training in Ireland had gone unrealised and that they were becoming de-skilled. As a result, most respondents were actively considering onward migration from Ireland. Discussion & conclusions Failure to align the expectations of non-EU migrant doctors with the requirements of the health system has resulted in considerable frustration and a cycle of brain gain, waste and drain. The underlying reasons for high mobility into and out of the Irish medical workforce must be addressed if this cycle is to be broken. The heavy reliance on non-EU migrant doctors to staff the medical workforce has distracted from the underlying workforce challenges facing the Irish medical workforce.
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              Developing evidence-based ethical policies on the migration of health workers: conceptual and practical challenges

              It is estimated that in 2000 almost 175 million people, or 2.9% of the world's population, were living outside their country of birth, compared to 100 million, or 1.8% of the total population, in 1995. As the global labour market strengthens, it is increasingly highly skilled professionals who are migrating. Medical practitioners and nurses represent a small proportion of highly skilled workers who migrate, but the loss of health human resources for developing countries can mean that the capacity of the health system to deliver health care equitably is compromised. However, data to support claims on both the extent and the impact of migration in developing countries is patchy and often anecdotal, based on limited databases with highly inconsistent categories of education and skills. The aim of this paper is to examine some key issues related to the international migration of health workers in order to better understand its impact and to find entry points to developing policy options with which migration can be managed. The paper is divided into six sections. In the first, the different types of migration are reviewed. Some global trends are depicted in the second section. Scarcity of data on health worker migration is one major challenge and this is addressed in section three, which reviews and discusses different data sources. The consequences of health worker migration and the financial flows associated with it are presented in section four and five, respectively. To illustrate the main issues addressed in the previous sections, a case study based mainly on the United Kingdom is presented in section six. This section includes a discussion on policies and ends by addressing the policy options from a broader perspective.
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                Author and article information

                Contributors
                niamhhumphries@rcpi.ie
                john.connell@sydney.edu.au
                joel.negin@sydney.edu.au
                james_buchan@hotmail.com
                Journal
                Hum Resour Health
                Hum Resour Health
                Human Resources for Health
                BioMed Central (London )
                1478-4491
                28 May 2019
                28 May 2019
                2019
                : 17
                : 36
                Affiliations
                [1 ]GRID grid.437483.f, Research Department, , Royal College of Physicians of Ireland, ; Dublin, Ireland
                [2 ]ISNI 0000 0004 1936 834X, GRID grid.1013.3, School of Geosciences, University of Sydney, ; Sydney, Australia
                [3 ]ISNI 0000 0004 1936 834X, GRID grid.1013.3, School of Public Health, University of Sydney, ; Sydney, Australia
                [4 ]GRID grid.104846.f, Queen Margaret University, ; Edinburgh, UK
                Author information
                http://orcid.org/0000-0003-2959-1652
                Article
                365
                10.1186/s12960-019-0365-5
                6540407
                31138211
                1e2b2c7f-990f-4f4d-aaaf-c7295aa863cd
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 30 December 2018
                : 11 April 2019
                Funding
                Funded by: Health Research Board (IRL)
                Award ID: EIA-2017-022
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2019

                Health & Social care
                Health & Social care

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