CoChat
Sign Up
Cited by 119Global Health Workforce IssuesGlobal Health and SurgeryMigration and Labor Dynamics

Physician Emigration from Sub-Saharan Africa to the United States: Analysis of the 2011 AMA Physician Masterfile

Open access
Tankwanchi, Akhenaten Benjamin Siankam, Özden, Çağlar, Vermund, Sten H.·2013·PLoS Medicine
DOI 10.1371/journal.pmed.1001513PMC PMC3775724
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: The large-scale emigration of physicians from sub-Saharan Africa (SSA) to high-income nations is a serious development concern. Our objective was to determine current emigration trends of SSA physicians found in the physician workforce of the United States. METHODS AND FINDINGS: We analyzed physician data from the World Health Organization (WHO) Global Health Workforce Statistics along with graduation and residency data from the 2011 American Medical Association Physician Masterfile (AMA-PM) on physicians trained or born in SSA countries who currently practice in the US. We estimated emigration proportions, year of US entry, years of practice before emigration, and length of time in the US. According to the 2011 AMA-PM, 10,819 physicians were born or trained in 28 SSA countries. Sixty-eight percent (n = 7,370) were SSA-trained, 20% (n = 2,126) were US-trained, and 12% (n = 1,323) were trained outside both SSA and the US. We estimated active physicians (age ≤ 70 years) to represent 96% (n = 10,377) of the total. Migration trends among SSA-trained physicians increased from 2002 to 2011 for all but one principal source country; the exception was South Africa whose physician migration to the US decreased by 8% (-156). The increase in last-decade migration was >50% in Nigeria (+1,113) and Ghana (+243), >100% in Ethiopia (+274), and >200% (+244) in Sudan. Liberia was the most affected by migration to the US with 77% (n = 175) of its estimated physicians in the 2011 AMA-PM. On average, SSA-trained physicians have been in the US for 18 years. They practiced for 6.5 years before US entry, and nearly half emigrated during the implementation years (1984-1999) of the structural adjustment programs. CONCLUSION: Physician emigration from SSA to the US is increasing for most SSA source countries. Unless far-reaching policies are implemented by the US and SSA countries, the current emigration trends will persist, and the US will remain a leading destination for SSA physicians emigrating from the continent of greatest need. Please see later in the article for the Editors' Summary.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1371/journal.pmed.1001513

Cites

87 of 87 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Africa is a continent plagued by continuous and massive emigration of clinicians to technologically advanced and high income countries.

    “Africa is a continent plagued by continuous and massive emigration of clinicians to technologically advanced and high income countries [29].”

    From The dentist-scientist career pathway in Africa: opportunities and obstacles (2018) · cites this paper as [29]

    The Introduction describes large-scale emigration of physicians from sub-Saharan Africa to high-income countries, and the Discussion expects that emigration to increase. The claim broadens the source’s focus from sub-Saharan Africa and primarily physicians to Africa as a whole and clinicians generally; the source does not establish that broader scope. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

2 of the 89 references couldn’t be matched to a known paper.

Research works printed but not linked: 5

  1. [23]Alkire S, Chen L (2005) Medical exceptionalism in international migration: should doctors and nurses be treated differently? Tamas K, Palme J, editors. Globalizing migration regimes: new challenges to transnational cooperation. Burlington: Ashgate Publishing Company. pp. 100–117.
  2. [36]American Medical Association - How the data elements of the AMA physician Masterfile are collected, maintained, and verified. Available: http://www.ama-assn.org/ama1/pub/upload/mm/eProfiles/mm/primarysource.pdf. Accessed 14 February 2013.
  3. [39]American Medical Association – More about AMA database licensing. Available: http://www.ama-assn.org/ama/pub/about-ama/physician-data-resources/ama-database-licensing/more-about-ama-database-licensing.page? Accessed 17 February 2013.
  4. [92]The Structural Adjustment Participatory Review International Network (2004) Structural adjustment: The SAPRI report. The policy roots of economic crisis, poverty and inequality. London & New York: Zed Books. 242 p.
  5. [94]Cornia AG, Jolly R, Stewart F (1987) Adjustment with a human face: country case studies. Oxford: Clarendon Press. 328 p.

Cited by

Sorted by citations

Related

Authors
Tankwanchi, A. B. S., Özden, Ç., & Vermund, S. H.
Affiliations
  • Vanderbilt University (US)
  • World Bank (US)
Corresponding author
Tankwanchi, Akhenaten Benjamin Siankam
ORCID
Venue
PLoS Medicine
Publisher
Public Library of Science (PLoS)
Published
2013-09-17
Volume
10
Issue
9
Pages
e1001513
ISSN
  • 1549-1277 (ISSN-L)
  • 1549-1676
DOI
10.1371/journal.pmed.1001513
PMC
PMC3775724
OpenAlex
W2150437981
Cited by
117
References
89
Citations by year
2026: 5 · 2025: 6 · 2024: 10 · 2023: 5 · 2022: 3 · 2021: 9 · 2020: 12 · 2019: 5 · 2018: 4 · 2017: 10 · 2016: 19 · 2015: 11 · 2014: 15 · 2013: 2
FWCI
24.31
Type
journal article
Language
en
Update notices
correction (2013-12-16)
Open access
Licence
Locations
  • PLoS Medicine (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
Funders
  • World Bank Group
  • Vanderbilt University
Topics
  • Health Sciences › Health Professions › Emergency Medical Services › Global Health Workforce Issues
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health and Surgery
  • Social Sciences › Sociology and Political Science › Migration and Labor Dynamics
Keywords
physician emigration, brain drain, sub-Saharan Africa, physician migration, structural adjustment programs, residency training, migration trends, Liberia, Nigeria, South Africa, Ghana, Ethiopia, Sudan, health workforce policy
MeSH terms
Adult, American Medical Association, Demography, Emigration and Immigration, Foreign Medical Graduates, Humans, Internship and Residency, Medicine, Middle Aged, Physicians, Schools, Medical, United States, Africa South of the Sahara, Internationality

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review