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The End of the “Brain Drain”, the start of “brain circulation?”

There is no denying the healthcare work force inequity across the world. Ten years ago, the World Health Organisation described health worker emigration as the most critical problem facing health systems in low- and middle-income countries. It framed a devastating “brain drain” as doctors from resource-poor settings are actively poached by wealthy countries to inject a healthy dose of talent into their ‘more developed’ health services.

Since then there has been a move away from the terms “brain drain” and “brain gain” towards “brain circulation”, which recognises a pattern where highly skilled health workers cross international borders to acquire skills, gain competencies, earn money and then leave. This phenomenon is now being used by Health Education England to provide ‘ethical opportunities’ for overseas medical staff to come to the UK via their earn, learn and return scheme.

It is no secret that the NHS highly values and relies upon overseas workers to function, but is now starting to recognise the value of NHS staff volunteering overseas. Our last post acknowledges that the “top-down” transfer of learning is outdated. Our increasingly interconnected world facilitates the bidirectional movement of healthcare workers across all settings. It’s now all about partnerships; exchanging and sharing ideas and developments.

So what about NHS surgeons, anaesthetists, obstetricians and gynaecologists that want to volunteer overseas?

If you are reading this blog, you may be interested to know that in 2013 the All-Party Parliamentary Group on Global Health published their report “Improving Health at Home and Abroad; How overseas volunteering from the NHS benefits the UK and the world”. This is an encouraging read for anyone hoping to spend time working in low- and middle-income countries. Not only are volunteers considered to advance health globally, the UK government believes they facilitate knowledge and skills exchange to the benefit of both the host countries and the NHS.

Volunteering overseas is clearly not without barriers. How can NHS staff get time out of training and employment to do this? Can these experiences be formally recognised for professional development? Who monitors and evaluates the volunteering activities? How do we manage such a fragmented volunteering environment? Who trains and supports the volunteers? How expensive is it going to be and who is going to pay for it?

Those of us worrying about these dilemmas may be happy to hear that Health Education England is hosting the first “Going Global” conference on 21st March 2019 (Tickets are on sale until 13th March). A welcome dose of active encouragement and support for NHS staff to engage with overseas partnerships. If you are reading this after those dates have passed don’t worry - it looks like there will be more events! Watch this space…

by Alice Campion

“brain circulation”: Tung. Brain Circulation, diaspora and international competitiveness

“Improving Health at Home and Abroad; How overseas volunteering from the NHS benefits the UK and the world”.

157 views2 comments


Mar 15, 2019

Some interesting points on healthcare inequality. Looking forward to hearing more at the going global event


Mar 15, 2019

This is such an interesting and well-written post. Thank you for exploring these issues. Would be very interested learn more.

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