West takes away foreign-trained doctors 

December 11, 2025

Wealthy nations are becoming increasingly dependent on medical professionals trained outside their borders, drawing heavily on international talent to sustain their health-care systems. Across North America, Western Europe, Australia, and other members of the Organisation for Economic Co-operation and Development (OECD), foreign-born and foreign-educated doctors now play a central role in meeting patient needs. This growing reliance, however, has intensified concerns that the migration of trained professionals from developing countries is deepening existing shortages in regions that can least afford to lose them.

Recent OECD data indicates that nearly one in four doctors practising in member nations were born abroad, and close to one in five completed their medical education outside the country in which they now work. High-income nations are not only attracting these professionals but are increasingly shaping immigration and workforce policies to ensure a steady supply of foreign-trained physicians. Meanwhile, developing nations, particularly in Africa and Asia, are witnessing a steady outflow of medical professionals that they struggle to replace, raising questions about long-term health-care equity.

The dependence of Western nations on imported medical talent is evident across several regions. In the United States, international medical graduates account for about 25 per cent of the entire physician workforce. Out of nearly 987,000 practising doctors, more than 262,000 are immigrants. India remains the single largest contributor, representing about 6 per cent of all doctors in the country. These figures underscore how integral foreign-trained doctors have become to the US health-care system, particularly in underserved areas, rural communities, and high-pressure specialties.

Across Europe, the trend is equally prominent. Between 2014 and 2023, the number of foreign-trained doctors in the WHO European Region rose by 58 per cent. In 2023 alone, an estimated 60 per cent of new entrants into the medical labour market had completed their medical education abroad. This surge points to systemic gaps in domestic training pipelines, ageing workforces, and an inability to meet rising demand for care without international recruitment.

In Australia, Ireland, and New Zealand, foreign-trained doctors make up some of the highest proportions anywhere in the world. The share reaches close to 40 per cent in Ireland and New Zealand. Israel stands out further, with nearly 60 per cent of its doctors trained overseas. These numbers collectively highlight a structural dependence on international medical graduates, many of whom originate from lower- or middle-income countries where health-care systems are already overburdened.

Canada has emerged as a prominent example of how high-income nations are seeking to address staffing shortages by prioritising the retention of foreign-trained physicians. Faced with persistent challenges including long wait times, limited access to primary care, and chronic shortages across hospitals, the federal government has announced major changes aimed at stabilising the medical workforce.

Immigration Minister Lena Diab recently unveiled a significant policy shift designed to retain international doctors already working within Canada. Her announcement confirmed that 5,000 additional federal immigration spots will be allocated for provinces and territories to nominate licensed physicians who hold valid job offers. This expansion goes beyond existing immigration quotas and reflects the urgency with which Canada is attempting to secure long-term medical capacity.

According to Diab, losing physicians already contributing to the health-care system would further strain communities facing shortages. Many international medical graduates who are already treating patients find themselves navigating complicated immigration pathways that increase the risk of losing skilled workers to competing countries. The new initiative is intended to reduce that uncertainty and encourage foreign-trained doctors to remain in Canada permanently.

Beginning in early 2026, the government will introduce a dedicated category under the Express Entry immigration system. This pathway will be open to doctors who have accumulated at least one year of Canadian work experience in the previous three years. It will cover a wide range of practitioners, including those in primary care, medical and surgical specialties, clinical roles, and laboratory medicine.

As part of the new programme, physicians nominated for permanent residency will receive work permit processing within 14 days, allowing them to continue treating patients without interruption. The government believes this streamlined approach will help stabilise staffing levels in provinces struggling with shortages, while ensuring that capable foreign-trained doctors are retained rather than pushed out by bureaucratic obstacles.

While these measures may strengthen health-care systems in wealthier nations, they also raise ongoing concerns about the global distribution of medical talent. As high-income countries build policies around attracting and retaining foreign-trained professionals, developing nations may face even deeper staffing shortages unless comprehensive international strategies are adopted.