Fawad Taj ( SW Cleveland Sleep Center, Cleveland, OH-44122, USA )
Zarmeneh Aly ( Final Year Medical Student, Medical College Aga Khan University, )
Madam, We would like to congratulate the author on beautifully highlighting a debate which is by no means new but pertinent both globally and nationally (Migration of doctors: should we apply the index of Happiness).1 It echoes our sentiments as expressed recently2 and brings in the interesting aspect of happiness (or the lack of in associated with migration. To the question that whether migration should be discouraged, our answer is no. It has been established that one of the major reasons for migration is to he free of everyday stressors which are indigenous to a region like ours.3 Discouraging migration to save graduates from pre and post migration stress would be the proverbial straw which breaks the camels back for them. These stresses are believed to be worth their while in pursuit of happiness, forcing people against their will to serve in an environment that is unsuitable for them will drastically hinder their performance.
To the question that if current circumstances at the base are conducive for mental well-being, the answer is also no. To reduce migration the first responsibility for action belongs with each country to "train, retain, and sustain" its workforce through implementing national plans that improve salaries, structured training and working conditions.2
It may well be that we see the world through rose tinted glasses but it is our belief that migration is not an evil. Some of these migrating doctors in search of self satisfaction, after having fulfilled their personal ambitions and family obligations, return to their homeland and do great things. Greater than those they could have if they'd stayed.
Fawad Taj11, Zarmeneh Aly2
SW Cleveland Sleep Center1, Cleveland, OH-44122, USA.
Final Year Medical Student2, Medical College Aga Khan University, Karachi.
1. Gadit AAM. Migration of Doctors: Should we apply the Index of Happiness? J Pak Med Assoc 2008; 58: 342
2. Aly Z, fa) F: Why Pakistani medical graduates must remain free to emigrate. PLoS medicine 2008; 5: e2.
3. Goyal SK Understanding the medic brain drain. Student BMJ 2005; 13: 474. Available: http://www.studentbmj.com/search/pdf/05/12/shmi474.pdf
. Citcd I June 2008.