Working paper

What really is Brain Drain? Location of Birth, Education, and Migration Dynamics of African Doctors


Çaglar Özden, David Phillips


Proper analysis of skilled migration flows and their impact requires joint identification of where migrants were born, educated, and when they moved to the destination country. To highlight these issues and identify key patterns in career paths, we focus here on doctors practicing in the United States who were born and/or trained in Africa. We overcome data constraints by merging data from the American Medical Association (AMA) and American Community Survey (ACS) via propensity score matching techniques. Our results show that the standard assumptions on skilled migration lead to considerable overestimation of its extent and hide several economically important migration patterns. We find that almost half of African-born doctors were trained outside their country of birth. On the flip side, around 15 percent of all doctors trained in Africa were actually born outside the continent. There is significant variation across countries in terms of age of migration levels, implying that many African doctors migrate after years of service and that their human capital is not completely lost to their birth countries. In short, global labor and education markets for high-skilled professionals are integrated in more nuanced and thought-provoking ways than assumed in the literature.