• health policy
• human resource management
• medical education & training

The UK National Health Service (NHS) has used international medical graduates (IMGs) from its inception, and since the 1960s, particularly from India and Pakistan. Within the UK medical community, there has been a complex pattern of simultaneous dependency and denigration of IMGs.1 Although the number of UK medical schools has recently increased, policy-makers must also take account of the popularity of working in particular specialty areas and geographical regions. Once doctors have qualified, they are in an international jobs market, and can opt to migrate or take non-clinical roles rather than take jobs that they deem undesirable. This means that the policy goal of achieving medical ‘self-sufficiency’ is unlikely to be successful and the NHS will, therefore, continue to depend on doctors from overseas to fill the gap.

The movement of professionals from lower-income to higher-income countries is known as ‘brain drain’, and has particular ethical consequences in medicine. It has been suggested that where medical professionals cannot be dissuaded from moving, the country that trained them should at least gain from their movement.2 Such arguments have gained political traction in recent times, as demonstrated by the Doctors and Nurses (Developing Countries) Bill debated by the UK Parliament in November 2020, suggesting that the UK should pay to train two doctors or nurses in developing countries for each doctor or nurse recruited to the NHS from those countries. The exit of the UK from the European Union has caused additional uncertainty about migration …