Migration of specialist physicians in an economic community : a comparison of Thailand and Poland

Abstract

With the establishment of the ASEAN Economic Community (AEC) in 2015, the free movement of specialist physicians, whose competencies are the practicing of advanced diagnosis and treatments for severe patients, will be allowed within the region. However, their future migration patterns within the AEC still have not been assessed yet. This study aims to examine future migration patterns of Thai specialist physicians within the AEC. The methodology of this study consisted of three steps: (1) reviewing relevant literature regarding the migration of Polish specialist physicians in the European Union (EU). This review was used as a benchmark for Thailand’s case; (2) opinion surveying of 76 Thai resident physicians by self-administered questionnaires; (3) conducting in-depth interviews (IDI) of three Thai specialist physicians and seven resident physicians. The literature review shows that the number of emigrated Polish medical doctors had significantly increased after the country’s accession to the union since 2004. Most of them were anesthesiologists. Main destinations were the UK, Sweden, Germany, and Ireland, respectively. The main pull factors in the destinations included better income, working conditions, and professional development. The evaluation of questionnaires reveals that 97.3% of respondents intend to work in Thailand, for at least 5 years after finishing the specialist training. In fact, only 22.4% and 23.7% knew about the AEC, and the Mutual Recognition Arrangements (MRAs) on ASEAN medical practitioners, respectively. However, 33.8% were interested to work full-time in ‘Singapore’ for more than one year. The IDI shows that the main push factors in Thailand include heavy workload, poor financial management of hospitals, and medical malpractice litigations. The main pull factors in more developed ASEAN countries are reported to be better income and better working conditions. In addition, the health care system of Singapore is perceived to be ‘fairer’ and ‘more transparent.’ In conclusion, unlike Poland, Thailand does not seem likely to face a large flow of external migration of specialist physicians to other member states in the future. However, according to Thailand-Poland comparison, the improvement of domestic working and living conditions are recommended for the Thai government.