International mobility of health professionals is shaped by a mix of “push” factors (e.g. pay, working conditions, career progression and security) and “pull” factors (e.g. demand, active recruitment and recognition of qualifications). Mobility can generate benefits (skills acquisition, remittances and diaspora links) but can also accelerate shortages, especially where training capacity is limited. OECD analyses therefore use expatriation rates to distinguish large origin countries with sizeable numbers abroad from smaller states where outward mobility represents a large share of the domestically born workforce (OECD, 2025[1]).
Doctor expatriation to OECD countries is higher for the LAC33 as a whole (20.1%) than for the OECD average (10.2%), with very high exposure concentrated in several Caribbean states (Figure 8.16). The highest rates are observed in Grenada (68.6%), Jamaica (57.7%), Saint Vincent and the Grenadines (56.2%) and Dominica (50.9%); rates remain elevated in Suriname (46.0%), Guyana (43.5%) and Haiti (40.1%). By contrast, most larger continental countries have single‑digit rates – Cuba (8.6%), Panama (8.1%), Colombia (7.4%) and Ecuador (6.5%)–and very low rates in Mexico (2.2%) and Brazil (1.2%). This pattern implies that risks to domestic service capacity are driven less by where the largest stocks are, and more by where emigration constitutes a large fraction of the domestically born medical workforce.
The exposure profile is even more pronounced for nurses, with the LAC33 expatriation rate reaching 34.5%, compared with an OECD38 average of 8.7% (Figure 8.17). Several countries exhibit extremely high rates – Jamaica (89.9%), Haiti (85.2%), Guyana (78.4%), Grenada (74.5%) and Dominica (72.0%)–followed by Belize (65.8%), Saint Lucia (64.5%), Saint Vincent and the Grenadines (64.1%) and Trinidad and Tobago (61.6%). Rates are also high in Barbados (52.2%), Saint Kitts and Nevis (51.5%), Suriname (49.1%), Antigua and Barbuda (43.3%) and the Bahamas (43.0%). At the other end, several large countries have relatively low exposure – Brazil (1.0%), Paraguay (1.3%), Argentina (1.5%), Uruguay (3.5%) and Chile (4.6%)–with a group near the OECD average (Costa Rica 8.6%; Mexico 9.5%; Ecuador 9.6%). Overall, the nursing results indicate that outward mobility can represent a system-level supply shock for a subset of countries, particularly small island states.
Outward mobility to OECD countries is structurally different across the region: (1) large absolute stocks from major countries (driven largely by scale and long-standing corridors) and (2) very high expatriation rates in several Caribbean states – especially for nurses – where migration can exceed the domestically employed workforce. OECD analyses highlight, for example, that more nurses from Antigua and Barbuda, Barbados, Belize, Dominica, Grenada, Guyana, Haiti, Jamaica and Saint Vincent work in other countries than domestically. Workforce shortages are not “caused” by migration alone – investment in education, employment and working conditions remains the primary lever – but migration can meaningfully exacerbate shortages for specific origin countries and occupations (OECD, 2025[1]). This supports a dual policy response: strengthen domestic attraction and retention (pay, career pathways, workload and safety), while improving the governance of mobility (ethical recruitment, bilateral agreements and better data) to support sustainability in both origin and destination systems.
