Many OECD countries turn to foreign-trained doctors to expand their medical workforce quickly and at relatively low cost. Although these recruits relieve immediate staffing pressures, they introduce greater uncertainty into workforce planning and can deepen shortages in countries of origin. In 2023, OECD Members employed more than 600 000 foreign-trained physicians, a rise of just over 50% since 2010. Their distribution is uneven: nearly three‑fifths practise in only three destinations – the United States, the United Kingdom and Germany.
Foreign-trained doctors represented, on average, 20% of the medical workforce across OECD countries in 2023, up from 16% in 2010 (Figure 8.23). Their numbers rose faster than those of domestically trained physicians in almost every member country, pushing their share upwards. The proportion varied considerably in 2023, from 1% or lower in Lithuania and Italy to more than 40% in Switzerland, New Zealand, Ireland and Norway, and 59% in Israel. Growth between 2010 and 2023 was especially strong in Switzerland, where the absolute number of foreign-trained doctors doubled, and in Germany, where it tripled.
Many of these doctors are native‑born citizens who obtained their first medical degree abroad before returning home for postgraduate training and practice. They account for 80% of foreign-trained physicians in Greece, 57% in Norway, 55% in Israel and 25% in Sweden. This pattern reflects the internationalisation of medical education and an expanding cross-border market for medical degrees (OECD, 2019[1]), rather than a one‑way “brain drain”. Ireland, however, presents a paradox: although it has become an international training hub, with about half of its medical students now coming from overseas, the country increasingly recruits fully trained doctors from abroad as many of its own graduates leave after graduation (OECD, 2025[2]).
Growing reliance on foreign-trained physicians has taken place alongside an expansion of domestic training capacity. Between 2010 and 2023, domestically trained doctors still made up most of the growth in physician numbers in most OECD Members (Figure 8.24). Yet in five countries foreign-trained doctors drove more than half of the increase – notably in Switzerland (86%), Norway (70%) and Ireland (57%). Across OECD countries, foreign-trained doctors accounted for roughly one‑third of the total growth in physicians’ numbers.
Annual inflows of foreign-trained doctors are highly volatile, shaped by factors ranging from geopolitical tensions and economic cycles to forced displacement, migration pathways, qualification-recognition rules and active recruitment campaigns. Even so, inflows to the main countries of destination have trended upwards and accelerated since the COVID‑19 pandemic (Figure 8.25). The United Kingdom admitted more than 18 000 foreign-trained doctors in 2023, its highest annual intake on record and a three‑fold increase from 2010. Ireland and Israel have seen equally large rises.
One of the major barriers to effective labour market integration of foreign-trained professionals, including doctors, is recognition of qualifications and licensing procedures. They can contribute to “brain waste”, in which qualified workers are unable to practise, or work at a lower level than they have trained for. Canadian census data illustrate the scale of the problem: in 2021, 90% of Canadian-born and Canadian-trained doctors were practising medicine, whereas only 36% of foreign-born and foreign-trained doctors in the country held a medical post. Registered nurses show a similar, though narrower, disparity. Consequently, a sizeable pool of qualified doctors and nurses remains untapped despite ongoing workforce shortages, in part because lengthy bridging programmes and complex licensing procedures delay or prevent entry into practice (OECD, 2025[2]).
Migration policies for health professionals in OECD countries have long centred on shortage‑occupation lists and bilateral training or skills-development agreements. Dedicated pathways tailored to health workers are now emerging, and temporary measures adopted during recent crises – most notably COVID‑19 and displacement linked to the invasion of Ukraine – have prompted governments to test the capacity of existing systems and devise new strategies for attracting health workers. Although designed as temporary fixes, they have spurred broader interest in lasting reforms, in particular the introduction of temporary and conditional licences that ease labour-market entry for foreign-trained doctors (OECD, 2025[2]).
