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The migration decisions of physicians in Canada: The roles of immigrant status and spousal characteristics


  • McDonald, James Ted
  • Worswick, Christopher


Around 25% of practicing physicians in Canada are graduates of medical schools outside of Canada. These physicians are more likely to be working in rural communities, and in particular account for more than half of new physicians starting practice in rural regions. The extent to which particular health regions and provinces are able to retain their physicians is crucial if shortages in the delivery of physician and surgeon services in both the short and longer terms are to be avoided. In this paper, we use data from the confidential master files of the Canadian Census over the years 1991–2006 to study the geographic mobility of immigrant and non-immigrant physicians who are already resident in Canada. We consider both inter- and intra-provincial migration, with a particular focus on migration to and from rural areas of Canada. We exploit the fact that it is possible to link individuals within families in the Census files in order to investigate the impact on the migration decision of the characteristics of a married physician’s spouse. Our results indicate that the magnitude of outflows is substantial and that the retention of immigrant physicians in rural areas and in some provinces will continue to be difficult. We find strong evidence that migration is a family decision, and spousal characteristics (education, age, years in Canada for immigrants) are important. As well, we find that large Canadian cities (mainly in Ontario) are the likely destination for the types of immigrant physicians typically able to be recruited to other areas, implying recruitment efforts of smaller provinces may have significant implications for the size of health care costs in larger provinces.

Suggested Citation

  • McDonald, James Ted & Worswick, Christopher, 2012. "The migration decisions of physicians in Canada: The roles of immigrant status and spousal characteristics," Social Science & Medicine, Elsevier, vol. 75(9), pages 1581-1588.
  • Handle: RePEc:eee:socmed:v:75:y:2012:i:9:p:1581-1588 DOI: 10.1016/j.socscimed.2012.07.009

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    References listed on IDEAS

    1. Cloutier-Fisher, Denise & Joseph, Alun E., 2000. "Long-term care restructuring in rural Ontario: retrieving community service user and provider narratives," Social Science & Medicine, Elsevier, vol. 50(7-8), pages 1037-1045, April.
    2. Christopher Ferrall & Allan W. Gregory & William Tholl, 1998. "Endogenous Work Hours and Practice Patterns of Canadian Physicians," Canadian Journal of Economics, Canadian Economics Association, vol. 31(1), pages 1-27, February.
    3. Basu, Kisalaya & Rajbhandary, Sameer, 2006. "Interprovincial migration of physicians in Canada: What are the determinants?," Health Policy, Elsevier, vol. 76(2), pages 186-193, April.
    4. Jacobsen, Joyce P. & Levin, Laurence M., 2000. "The effects of internal migration on the relative economic status of women and men," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 29(3), pages 291-304, May.
    5. Jean-Christophe Dumont & Pascal Zurn & Jody Church & Christine LeThi, 2008. "International Mobility of Health Professionals and Health Workforce Management in Canada: Myths and Realities," OECD Health Working Papers 40, OECD Publishing.
    6. Benoit Dostie & Pierre Léger, 2009. "Self-selection in migration and returns to unobservables," Journal of Population Economics, Springer;European Society for Population Economics, vol. 22(4), pages 1005-1024, October.
    7. Michael Benarroch & Hugh Grant, 2004. "The interprovincial migration of Canadian physicians: does income matter?," Applied Economics, Taylor & Francis Journals, vol. 36(20), pages 2335-2345.
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    Cited by:

    1. Hennig-Schmidt, Heike & Wiesen, Daniel, 2014. "Other-regarding behavior and motivation in health care provision: An experiment with medical and non-medical students," Social Science & Medicine, Elsevier, vol. 108(C), pages 156-165.
    2. Mu, Chunzhou, 2015. "The age profile of the location decision of Australian general practitioners," Social Science & Medicine, Elsevier, vol. 142(C), pages 183-193.


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