WHAT IS A PROFESSION?

THE MIGRATION OF HIGHLY SKILLED PROFESSIONALS from poor to rich countries is not a new phenomenon. The losses attributed to this global migration, commonly referred to as " brain drain " , have been recognised internationally since the 1960s. 1 This migration has had particularly serious ramifications in sub-Saharan Africa, where it severely limits the provision of even basic health services infrastructure. One study has commented that " the haemorrhage of health professionals from African countries is easily the single most serious human resource problem facing health ministries today ". 6 The Director-General of the World Health Organization , Dr Lee Jong-wook, has said that brain drain from Africa is severely limiting the ability of health workers to combat the HIV/AIDS epidemic and achieve any substantial progress towards the Millennium Development Goals. 7 Has Australia played a significant role in the development of this ominous situation? A recent report published by the Australian Health Ministers' Advisory Council (AHMAC) emphasised Australia's continuing dependence on overseas-trained doctors. 8 The number of temporary resident overseas trained doctors arriving in Australia to work in " areas of need " , such as rural and remote areas, has increased over the last decade, from 667 in 1992–93 to 2899 in 2001–02. 9 There is indirect evidence that a considerable number of these doctors may be from the developing world: in 2001, 5.7% (2930) of the Australian medical workforce was born in Africa or the Middle East and 16% (8348) in Asia. 10 However, these statistics do not show where these doctors were trained or when they came to Australia. A more reliable indicator may be the permanent migration to Aus-tralia of overseas residents. Data from the Australian Institute of Health and Welfare show that the number of doctors permanently migrating from South Africa, for example, has steadily grown over the 1990s, with 12 (2.5% of total medical migrants) migrating in 1992–93, increasing up to 32 (6% of total medical migrants) in 1999–2000. 11 Migration from certain Asian countries, particularly China, has also grown significantly, with 186 Chinese doctors (30% of total medical migrants) migrating to Australia in 1995–96. Between four and five thousand overseas-trained nurses enter Australia annually; while many of these come from other wealthy countries such as the United Kingdom, New Zealand, Canada, Ireland and Norway, source countries in the developing world, such as the Philippines, South Africa and Zimbabwe, are also important. …