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Initiated: May 2003 SMAClEtbRecruitfSept2003
THE WORLD MEDICAL ASSOCIATION STATEMENT ON ETHICAL GUIDELINES
FOR THE INTERNATIONAL RECRUITMENT OF PHYSICIANS
Adopted by the WMA General Assembly, Helsinki 2003
A. Preamble
1. The WMA acknowledges that temporary stays of physicians in other countries help both
the receiving and the sending countries to exchange medical knowledge, skills and
attitudes. The exchange of medical professionals is therefore beneficial for the
development of medicine and healthcare systems and in general deserves the support of
national medical associations as well as governments.
2. The WMA Statement on Medical Manpower – 1 (1983, 1986) called upon all National
Medical Associations to work with their governments towards solutions to the emerging
problems related to the medical workforce.
3. The WMA Resolution on the Medical Workforce (1998) identified the major components
of the medical workforce situation that need to be taken into account when developing a
national workforce policy.
4. For several decades many governments, employers and medical associations have
misinterpreted demographical data regarding the number of physicians that are required.
tllislllR::apren-“‘d -sealog.epmlavrnent ali- nhvsicians have often been seriously affected by
Young people seeing employment as physicians have often been seriously attectea oy
poor medical workforce planning.
5. In many countries, including the wealthiest ones, there is a shortage of physicians. A
major reason for the shortage is a failure to educate enough physicians to meet the needs
of the country. Other reasons for the net loss of physicians are the recruitment of
physicians to other professions, early retirement and emigration, and the problems of
combining professional and family responsibilities, all of which are often due to poor
working conditions for physicians.
6. Some countries have traditionally solved their need for physicians by recruiting medical
graduates from other countries. This practice continues today.
7. The flow of international migration of physicians is generally from poorer to wealthier
countries. The poorer countries bear the expense of educating the migrating physicians
and receive no recompense when they enter other countries. The receiving countries gain
a valuable resource without paying for it, and in the process they save the cost of
educating their own physicians.
8. Physicians do have valid reasons for migrating, for example, to seek better career
opportunities and to escape poor working and living conditions.
The World Medical Association Statement on Ethical Guidelines for the International Recruitment ofPhysicians
(Document SMACIEthRecruitiSept2003) is an officialpolicy document ofthe World Medical Association. the global
representative body for physicians. It was adopted by the WMA General Assembly. Helsinki 2003.
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9. There is considerable international activity underway at present to determine the nature
and extent of physician migration and related medical workforce issues. The World
Medical Association recognizes that there is an important ethical dimension to these
issues and has developed this statement to guide national medical associations and policy
makers in their efforts to find solutions to these issues.
B. Relevant Ethical Principles
10. Justice – Distributive justice requires an equitable allocation of resources among
individuals and groups. Corrective justice requires action to address inequities.
Procedural justice requires that efforts to achieve equity respect the rights of all who are
.involved.
11. Co-operation – Problems that affect two or more groups, including nations, should be
resolved by working together, either bilaterally or through multilateral organizations such
as the World Medical Association.
12. Autonomy – An individual’s right to determine his or her own destiny should be
respected as long as it does not interfere with the corresponding right of others, in which
case a fair process for resolving conflicts should be implemented.
C. Recommendations
13. National medical associations, governments and employers should exercise utmost care
in utilizing demographic data to make projections about future requirements for
physicians and in communicating these projections to young people contemplating a
jnedical career.
medical career.
14. Every country should do its utmost to educate an adequate number of physicians, taking
into account its needs and resources. A country should not rely on immigration from
other countries to meet its need for physicians.
15. Every country should do its utmost to retain its physicians in the profession as well as in
the country by providing them with the support they need to meet their personal and
professional goals, taking into account the country’s needs and resources.
16. Countries that wish to recruit physicians from another country should only do so in terms e
of and in accordance with the provisions 0 fa Memorandum 0 f Understanding entered
into between the countries.
17. Physicians should not be prevented from leaving their home or adopted country to pursue
career opportunities in another country.
18. Countries that recruit physicians from other countries should ensure that recruiters
provide full and accurate information to potential recruits on the nature and requirements
of the position to be filled, on immigration, administrative and contractual requirements,
and on the legal and regulatory conditions for the practice of medicine in the recruiting
country.
The World Medical Association Statement on Ethical Guidelinesfor the International Recruitment ofPhysicians
(Document SMAClEthRecruitiSept2003j is an officialpolicy document ofthe World Medical Association, the global
representative body for physicians. It was adopted by the WMA General Assembly, Helsinki 2003.
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3 SMAClEthRecruit/Sept2003
19. Physicians who are working, either permanently or temporarily, in a country other than
their home country should be treated fairly in relation to other physicians in that country
(for example, equal opportunitycareer options and equal payment for the same work).’
20. Nothing should prevent countries from entering into bilateral agreements and agreements
of understanding, as provided for in international law and with due cognisance of
international human rights law, so as to effect meaningful co-operation on health care
delivery, including the exchange ofphysicians.
***
17.9.2003
The World Medical Association Statement on Ethical Guidelines for the International Recruitment ofPhysicians
(Document SMACIEthRecruit/Sept2003) is an officialpolicy document ofthe World Medical Association, the global
representative body for physicians. It was adopted by the WMA General Assembly, Helsinki 2003.
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N
D
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