title: Quality of medical training and emigration of physicians from India.
abstract: BACKGROUND
  Physician 'brain drain' negatively impacts health care delivery. Interventions to address physician emigration have been constrained by lack of research on systematic factors that influence physician migration. We examined the relationship between the quality of medical training and rate of migration to the United States and the United Kingdom among Indian medical graduates (1955-2002).
  
  
  METHODS
  We calculated the fraction of medical graduates who emigrated to the United States and the United Kingdom, based on rankings of medical colleges and universities according to three indicators of the quality of medical education (a) student choice, (b) academic publications, and (c) the availability of specialty medical training.
  
  
  RESULTS
  Physicians from the top quintile medical colleges and of universities were 2 to 4 times more likely to emigrate to the United States and the United Kingdom than graduates from the bottom quintile colleges and universities.
  
  
  CONCLUSIONS
  Graduates of institutions with better quality medical training have a greater likelihood of emigrating. Interventions designed to counter loss of physicians should focus on graduates from top quality institutions.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA. kaushik.manas@gmail.com
authors.forename: Manas
authors.initials: M
authors.lastname: Kaushik
authors.forename: Ananya
authors.initials: A
authors.lastname: Roy
authors.forename: Anand A
authors.initials: AA
authors.lastname: Bang
authors.forename: Ajay
authors.initials: A
authors.lastname: Mahal
mesh_terms: D004522:Educational Status; D004641:Emigration and Immigration; D005550:Foreign Medical Graduates; D006801:Humans; D007194:India / Q000208:ethnology; D010820:Physicians; D006113:United Kingdom; D014481:United States