Graduate output is a leading indicator of future workforce supply, but it does not automatically translate into greater domestic availability if retention is weak, if graduates concentrate in certain locations or specialties, or if a sizeable share of training is provided to international students who subsequently leave. In several Caribbean settings, “offshore” medical schools cater largely to international students – often from North America – who typically leave after graduation, which can inflate national graduation rates relative to domestic health system needs (Halperin and Goldberg, 2016[1]; Morgan, Crooks and Snyder, 2017[2]). Since comparable data on admissions capacity, entrants and completion rates are limited, graduate output should be interpreted as only a partial proxy for training capacity. Differences across professions may also reflect variation in attractiveness, educational requirements and barriers to entry. Graduate indicators should therefore be interpreted alongside evidence on domestic labour market absorption and patterns of international student and worker mobility.
Medical graduate output ranges widely, from 33.9 graduates per 100 000 population in the Dominican Republic to 4.3 in Costa Rica (Figure 8.13). The LAC10 average is 12.8, close to the OECD average of 14.5, with Mexico (14.5), Colombia (14.7) and Uruguay (14.7) near the OECD average. The very high rate in the Dominican Republic may partly reflect the internationalisation of medical education in parts of the Caribbean, where a substantial share of enrolment can be foreign students who do not enter the domestic workforce (Halperin and Goldberg, 2016[1]; Morgan, Crooks and Snyder, 2017[2]).
Professional nurse graduate output generally exceeds medical graduate output but varies sharply across countries (Figure 8.14). The OECD average is 34.9 nurse graduates per 100 000 population, while the LAC19 average is 18.4. Saint Vincent and the Grenadines reports 44.6, and Chile reports 34.0 (close to the OECD average), whereas Guatemala reports 2.1 and Cuba 4.0. As with other indicators, small populations and differences in nursing education structures (e.g. professional vs. associate training routes) can affect comparability.
Pharmacist graduate output is highest in Brazil (8.2 per 100 000) and Costa Rica (5.6), above the OECD average of 4.2, while the LAC8 average is 3.4 (Figure 8.15). Mexico reports 3.4, whereas Panama reports 1.8 and Argentina and Colombia about 1.2. Given the expanding role of pharmacists in medicines management and continuity of care, sustained low graduation rates may constrain development of clinical pharmacy services.
Overall, the graduate indicators highlight substantial differences in training capacity across professions and countries, and they underscore that workforce planning needs to link education policy with retention, deployment, and differences in professional attractiveness and access to education. In countries with high graduate output, improving domestic absorption and working conditions can help translate training into service capacity. In countries with low graduate output, targeted expansion of education capacity may be needed, but should be paired with strategies to reduce emigration and address geographic maldistribution. Finally, where international student inflows are large, graduate output should be interpreted alongside evidence on the destination of graduates and domestic workforce needs (Lee et al., 2024[3]).
