The International Flow of Doctors and Nurses

The OECD International Migration Outlook 2025, along with its usual overview of trends in migration, migration policy, and migrant integration policy, includes a topics chapter on “International migration of health professionals to OECD countries,” written by Ave Lauren, José Ramalho, Jean-Christophe Dumont, Gaetan Lafortune ,
Agya Mahat, and Tapas Nair. (For those not familiar with the OECD, it’s a research organization made up of 38 generally high-income member countries.) The authors point out that the number of doctors and nurses is on the rise in the world’s high-income countries–and the number of foreign-born

In all countries, doctors and nurses are critical to the functioning of health systems, and their numbers reflect this role. In 2023, OECD countries had over 4.5 million doctors and 12.3 million nurses, compared to 2.8 million and 8.1 million in 2000, respectively. Over the past two decades, the growth in the number of these professionals has outstripped population growth in virtually all OECD countries. The 38 OECD countries represent 17% of the world’s population but account for about 39% of the world’s medical doctors, nurses, midwifes, dentists and pharmacists. On average, the number of doctors per 1 000 population across OECD countries increased by 38%, reaching 3.9 doctors per 1 000 population …

Over the past two decades, the overall share of foreign-born health professionals in OECD countries has increased steadily. In countries with consistent data over the period, the total number of foreign-born doctors rose by 86% between 2000/01 and 2020/21, while the number of foreign-born nurses grew by nearly two and a half times … In both cases, this growth outpaced the general increase in the total number of doctors and nurses, which rose by 41% and 48%, respectively. … Among the main countries of residence, Germany and Australia saw the number of foreign-born
doctors nearly triple. The United Kingdom experienced a doubling, and more moderate increases were observed in the United States and France.

A similar pattern is evident among foreign-born nurses. Finland saw the steepest rise, with numbers increasing almost eightfold though starting from a very low level in 2000/01. In Norway, they increased more than fourfold. In Germany, Ireland and New Zealand, the numbers more than tripled, while in Australia and Spain, they nearly tripled. Switzerland also recorded a significant increase. Among the other major countries of residence, Canada, the United Kingdom and the United States all saw their numbers more than double …

The United States specifically had 196,000 foreign-born doctors in 2000/01, which was 24.4% of all doctors in the country. By 2020/21, this rose to 291,000 foreign-born doctors in the United States, or 29.7% of all doctors in the country. For nurses, the United States had 336,000 foreign-born nurses in 2000/01, or 11.9% of the total, and 736,000 by 2020/21, or 17% of the total nurses in the US. As the report notes: “In absolute terms, the United States remains the primary country of residence for both foreign-born doctors and nurses. … Among all foreign-born health professionals in OECD countries, 36% of all foreign-born doctors and 42% of nurses were practising in the United States in 2020/21.”

For some countries, the inflow of foreign-born doctors and nurses were trained in the sending country. In the US, in contrast, in 2023, about 25% of the inflow of doctors and 10% of the inflow of nurses were trained in the sending country; the rest arrived in the United States and did their training here. In this sense, coming to the UIS and then being educated and trained as a doctor or nurse can be viewed as a channel for being able to migrate to the United States.

Of course, some of the migration of foreign-born health professionals is from one high-income country to another: say, a nurse from Germany who ends up working in Austria or Switzerland. The authors of the OECD study write: “Movements of health professionals within the OECD are becoming increasingly complex. However, only a few countries within the OECD area are net gainers, meaning that they receive more doctors and nurses from other OECD countries than they lose. The United States stands out, with a net gain of more than 55 000 doctors and 144 000 nurses compared
to the rest of the OECD.”

What are the main countries of origin for the health care professionals who migrate to OECD countries? “In 2020/21, there were slightly less than 100 000 doctors born in India working in the OECD. Germany, China and Pakistan each had about 30 000 emigrant doctors in OECD countries. Romania and the United Kingdom followed with around 25 000. Among migrant nurses, the Philippines was by far the main country of origin, with nearly 280 000 nurses abroad. India ranked second, with 122 000 – less than half the number from the Philippines. Poland followed in third place, with about half the total of India. Nigeria and Germany completed the top five.”

Some of these sending countries–the Philippines with regard to nursing is a prominent example–have designed health care training programs that will have far more graduates than their domestic economy needs, with the expectation that many of them will migrate but plenty will remain (or return after migrating for a time) as well. However, some countries seem to have taken a role of being a home for training, but with an expectation that most of the graduates will leave.

One of the hoary arguments about immigration is whether the immigrants are mostly doing jobs that Americans don’t “want” to do. Whatever the degree of truth in this claim for jobs like tough physical agricultural labor, it’s not clear how it applies to the migration to the US of people who end up being health care professionals. Instead, health care jobs appear to be a case where, even given the considerable expansion of the industry, the US could do more to prepare students for such jobs in earlier grades and expand the slots for training doctors and nurses.

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