As globalisation moves forward medical professionals are exposed to an increasing mobility regarding their choice of country. A higher income, better living or working conditions are just some of the many reasons which physicians choose to leave their country for.
The Treaty on the Functioning of the European Union assures all EU-citizens the right to free movement of persons and services. Furthermore, the EU directive 2005/36/EC directs member states to improve the mutual recognition of professional qualifications in the EU. The goal of this directive is to assure that the promised freedom of movement can be exercised.
As medical students we have put out statements regarding this directive, at German and European level. In its policy statement “Recognition of Medical Professional Qualifications” EMSA proposes a monitoring system for the elicitation of reliable data on the “health professional out- and inflows” in EU member states. Bvmd (German association of Medical Students) has endorsed the directive in a statement in 2012.
The situation in Germany has improved over the past years. Enacting the Blue card legislation (for third country citizens) and an amending law which guarantees the legal right to a review of qualifications acquired abroad (both 2012) have played a major role. However, the website http://www.medicalmobility.eu (courtesy of European Junior Doctors (EJD) and EMSA) shows that the recognition of foreign medical degrees still is complicated. For example, each German federal state has a different requirement regarding language certificates. There just is a lack of a federal registration authority.
Currently, trends in migration within the EU are not being recorded continuously. There are studies gathering that data, but they usually only cover certain time spans. The MoHP study and PROMeTHEUS for example cover the years 2011 and 2012 respectively. They find two major trends in migration of medical professionals: on one hand from the EU to America and Australia and on the other hand to Northern and Western Europe from Africa, Asia and Eastern Europe.
The aging of society cannot solely be compensated by training more physicians in ones own country. For Germany, an immigration friendly policy can be an additional means to encounter demographic change. According to BAMF (Federal Office for Migration and Refugees) Germany is the 4th most popular country of destination among trained professionals looking into leaving their country. Therefore, it can benefit from the westbound movement of immigrants.
However, the emigration of medical professionals negatively impacts the health care system in their respective countries of origin. This phenomenon is often called “brain drain”. A relatively large percentage of the staff in German hospitals consists of nurses born and trained in Poland, the former Soviet Union and former Jugoslavia. These countries now must consider ways to compensate their arising lack of doctors and nurses. It is evident that in respect of Germany’s role within the EU a solely national policy cannot be the solution.
As future doctors these issues are of utmost importance to us. The trends outlined above will increasingly shape our professional environment. As we move on in our lives and careers we want to be able to benefit from the freedom of movement in more and more ways. To ensure this, we need to find ways to overcome the obstacles arising from that freedom.
Some food for thought:
- How can we uphold the medical standards for patients and doctors given the shortage of skills?
- How can we shape migration, especially within the EU, sustainably in a way that all participants – countries of origin and destination, and migrating people in particular – profit by equal measures?
- What legal basis is there or needs to be created?
- And most importantly: How can we, as European medical students, influence this crucial development as we move on in our careers?