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Global Promise Home Academic Medicine Brain Drain or Gain?

Health care professionals have always been attracted to developed countries in search of better career and educational opportunities, political stability, and greater personal freedom, among myriad other factors. However, we’ve seen this trend go up significantly in recent years.

The perceived need to relocate starts early for young people who dream of becoming nurses, physicians, pharmacists or other health care professionals. Would-be medical students often move to the United States or other nations for specialized training that isn’t available in their home countries.

Developed nations also have many options for post-graduate medical education, which is often limited in other countries. Once these students make the move, they often choose to stay in their adopted country to pursue their careers and build their lives.

Because developed countries, such as the United States, are experiencing medical staffing shortages, particularly in rural areas, we’re also seeing very active recruiting of recently trained graduates from less developed countries. Widespread shortages of medical staff at all levels have driven migration, creating a growing global labor market.

People everywhere deserve access to excellent medical treatments close to home. It becomes impossible, however, to deliver quality care in communities that lack skilled health professionals, who have either left for better opportunities or who have been cherry-picked by medical systems in wealthier, more developed countries.

Homegrowing Talent
When Johns Hopkins Medicine International pioneered the concept of international collaborative health 20 years ago, we knew we had to create a model where we work with our global partners to build and sustain their local workforce.

We wanted to create a new paradigm for meeting global needs for well-trained health care professionals. Although developed nations are used to strong-arming other countries to get the resources—including human resources—they need to prosper, we saw a great opportunity to level the field in medical education and training, recruitment and retention. Instead of draining emerging nations of their best and brightest, we help them gain the knowledge needed to grow and maintain their own local pools of talent.

We educate and support our affiliates’ workforce by sending our experts to the local site, bringing their employees here for training and observerships, working side-by-side with staff in mentorship programs, and presenting seminars and lectures, online and in person. We also help clinicians at our global affiliations become educators who, in turn, train tomorrow’s health care leaders at their institutions.

Advancing nursing practice is a key way we develop medical and management expertise. We’ve had nearly 300 nurses and nurse leaders from 10 affiliates in nine countries participate in education sessions we delivered with the Johns Hopkins University School of Nursing and the Institute for Johns Hopkins Nursing.

We’re working with Taikang Life Insurance Company in China to develop an innovative education and clinical training model and introduce a team-based care delivery system at Nanjing Drum Tower Hospital, the hospital linked to Nanjing University Medical School. This public-private collaboration model is addressing what may be the greatest needs in China’s health infrastructure: human resource development and improved delivery of patient care.

Also in China, we signed an agreement to help Southern University of Science and Technology establish a new medical school. Drawing on Johns Hopkins’ experience in medical education, we are providing support in curriculum and faculty development, admissions and administration, and facilities and technology infrastructure.

We also present experts from across Johns Hopkins as part of visiting professor programs at a number of our affiliates, including Fundación Santa Fe de Bogotá. Our experts travel to Colombia to explore areas for collaboration and present lectures and roundtable discussions on medical specialties, including nursing, urology, neurology, pathology, orthopaedics and patient safety.

These are all examples of how we work closely with all of our affiliates to help them attract, educate and retain skilled caregivers and administrators from their own communities. We are careful to tailor our educational approach to respect local considerations, but with every affiliate, we help create health systems with the human resources essential to providing sustainable access to high-quality care.


Pamela Paulk

As president from 2015 to 2018, Pamela Paulk oversaw Johns Hopkins Medicine International’s enterprises, including developing sustainable international health collaborations with affiliates in nearly 20 countries and providing medical concierge services for thousands of international and out-of-state patients.

2 thoughts on “Brain Drain or Gain?”

  1. thank you Pamela for this post. i agree with all that you stated , more so all that Johns Hopkins international has been doing to improve Global Health through education and cross training of healthcare professionals in other parts of the world.
    i only wish to add that like every other thing that developed nations do, the concentration seem to be in Asia , South America and Middle East. Nothing is heard about Africa in this forum. the epidemic of Ebola is an eye opener to how small disease can cross the continent and impact us here , therefore there is a huge need for a small focus to these areas to train, educate and collaboration with those who provide care to these teeming population of the world. Just my humble opinion.

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