Pakistan is the Second Biggest Source of Foreign Doctors in US and UK

[Riaz Haq]

When US Ambassador Richard Holbrooke suffered a massive heart attack in 2010, the doctors who responded to this emergency were both foreign: one from India and the other from Pakistan. Dr. Farzad Najam, a graduate of King Edward Medical College in Lahore, was the chief heart surgeon at George Washington University Hospital at the time. Dr. Monica Mukherjee, a junior cardiologist at the hospital, assisted Dr. Najam in the operating theater. This episode illustrates the high profile presence of South Asian doctors in the United States. 

Doctor Brain Drain. Source: Statista

More recently, Dr. Mansoor Mohiuddin, a 1989 graduate of Karachi's Dow Medical College, made global headlines when he implanted a pig heart in a patient at University of Maryland School of Medicine. Considered one of the world’s foremost experts on transplanting animal organs, known as xenotransplantation, Muhammad M. Mohiuddin, MD, Professor of Surgery at UMSOM, joined the UMSOM faculty five years ago and established the Cardiac Xenotransplantation Program with Dr. Griffith. Dr. Mohiuddin serves as the program’s Scientific/Program Director and Dr. Griffith as its Clinical Director.    

Top Countries of Origin of Foreign Doctors in the US. Source: OECD

The pervasive presence of South Asian doctors in the United States is confirmed by OECD (Organization for Cooperation and Development) statistics on foreign doctors in OECD member nations. While India has remained the top source of foreign doctors since 2013, Pakistan has moved up from third to second spot in this period.  As of 2016, there were  45,830 Indian doctors  and 12,454 Pakistani doctors among 215,630 foreign doctors in the United States. India (45,830) and Pakistan (12,454) are followed by Grenada (10,789), Philippines (10,217),  Dominica (9,974), Mexico (9,923), Canada (7,765), Dominican Republic (6,269), China (5,772), UAE (4,635) and Egypt (4,379). 

In percentage terms, 21% of foreign doctors come from India, 6% from Pakistan, 5% each from Grenada, Philippines and Dominica and 4% from Mexico.

Pie Chart of Origins of Foreign Medical Graduates in US. Source: OECD

Many of these "foreign doctors" are US citizens, born and raised in the United States, who travel abroad to study at foreign medical schools. Their reasons vary from ease of admissions to lower costs. This is particularly true of the medical schools  in the Caribbean nations.  

Many Caribbean nations have established medical schools to especially cater to the demand from the United States. In 2007, Pakistan, too, set up Dow International Medical College as part of Dow University of Health Science (DUHS). 

Indians and Pakistanis also make up the top two nationalities among 66,211 foreign doctors in the United Kingdom. There are 18,953 doctors from India, 8,026 from Pakistan, 4.880 from Nigeria and 4,471 from Egypt in the UK.

The list of 25,400 foreign doctors in Canada is topped by South Africans (2,604) followed by Indians (2,127), Irish (1,942), British (1,923), Americans (1,263) and Pakistanis (1,087). 

There are 25,607 Pakistani medical school graduates currently working in all of the OECD member countries which are considered the rich industrialized nations. These Pakistani doctors account for 10.6% of 242,000 Pakistan-trained doctors practicing now. 74,455 Indian doctors working in OECD nations make up 7.3% of about 1,020,000 of all India-trained doctors in practice. 

In spite of losing 10.6% of its doctors to "brain drain" compared to India's 7.3%, Pakistan still has more doctors per capita (1.1 per 1000 population) than India (0.7 doctors per 1000 population), according to the World Bank.  Pakistani medical colleges admit 16,000 students a year compared to 92,000 in India.

As the populations age and demand for medical services grows in the West, more and more of it is being met by recruiting health care workers, including doctors and nurses, from the developing world. 

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Riaz Haq's Youtube Channel

PakAlumni: Pakistani Social Network

[Akhtar Hussain]

Dear Riaz Sb.

I recently read an article that has surprised me about the production of Solar Energy in Morocco. I am wondering if Pakistan is planning such power plants?  Morocco has a surplus of energy and is looking to supply power to Europe.  I do not see why Pakistan cannot at least produce 5000 MW from Solar.  As things stand Pakistan is generating total power of about 15,000 MW.  The demand is for 20,000 MW. 

https://www.washingtonpost.com/climate-solutions/2023/04/13/morocco...

We really need to start companies that can make quality inverters locally.  I am not yet aware of large scale Solar panel manufacturing in Pakistan.  Wind energy generation may be a little more expensive for Pakistan.

In Europe heat pumps have caught on, and I basically define them as using the same technology as a fridge. They are able to heat in reverse. 

Thank you.

Regards,

Akhtar.

[Riaz Haq]

Akhtar sahab,

The maximum power demand met by Pakistan during the year ended June 2022 was 28,250 MW, more than 35% lower than power generation capacity of 43,770 MW.

https://www.reuters.com/business/energy/pakistan-plans-quadruple-do....

Solar is only good when the sun is shining unless it is coupled with battery storage. 

But battery storage is currently very expensive. Its costs need to come down a lot before solar becomes a more useful option for 24X7X365 grid electricity like that generated by coal or oil or gas. 

[Akhtar Hussain]

AOA Riaz Sb.

Thank you for providing the numbers.  Wow, I cannot believe that Pakistan has the capacity to produce almost 44,000 MW power.  Actually it is way beyond what I was expecting.  Then why do they have power cuts?  Pardon my arrogance, but I believe Pakistan has at least 300 days of sunshine.  Also, in Europe we do not store power in batteries.  We feed it directly into the home supply by using inverters to convert to AC.  I agree that the grid in Pakistan may not be ready in some parts of the country, to connect inverters, but I believe Islamabad can.  If the whole city of Islamabad can adopt this technique that will be a big saving. 

I have just moved into a brand new apartment in the Netherlands. There is no gas supply to the apt and everything runs on electric.  I have 8 solar panels and a heat pump. My electric bill is Euro 140 per month in winter for an apartment that is 150 meter cube. I may get some money back at the end of the year if we have a warm and sunny summer.  

For the mountains and northern areas of Pakistan we need to build and install heat pumps.  The technology is old.  I just love them.

https://www.siemens-energy.com/global/en/offerings/power-generation...

Thank you.

Akhtar.

[Riaz Haq]

Remittances Sent By Pakistani Expats Reach $2.5 Billion In March: Central Bank
Pakistan and the IMF have been negotiating the programme's resumption for months but have yet to reach an agreement

https://www.outlookindia.com/business/remittances-sent-by-pakistani...

Pakistani expatriates sent home $2.5 billion in remittances in March, a seven-month high, the State Bank of Pakistan said on Monday, as the cash-strapped country tried to avert a major economic crisis. The data from the central bank showed that the inflow of workers’ remittances was 27 per cent higher compared to February. However, it was 11 per cent lower compared to March 2022, Geo News reported.

Pakistan, currently tackling a major economic crisis, is grappling with high external debt, a weak local currency and dwindling foreign exchange reserves. According to the report, historical trends suggest that Pakistanis living abroad sent record-high remittances ahead of Eid festivals each year.

According to the report, inflows remained comparatively high as non-resident Pakistanis used legal channels to send funds to their family, given the shrinking gap between rates in the interbank and the open market. Pakistani expatriates in Saudi Arabia topped the list of remittances by sending an amount of $563.9 million in March. However, it was 24.04 per cent lower than the $454.6 million received in February, the report said.


Pakistanis living in the UAE sent home 25.52 per cent more as receipts increased from $406.7 million to $324 million. Remittances from overseas Pakistanis in the UK increased 33.12 per cent to $422 million, the report said, adding that they sent $317 million in February. Head of Research at Arif Habib Limited, Tahir Abbas, said that the monthly increase in the remittances is due to the Ramzan factor that usually fetches higher flows due to family commitments, welfare, and charity, among other things.

"The flows in the upcoming months are expected to remain elevated due to another Eid falling by the end of this fiscal year," Abbas was quoted as saying in the report. Terming the increase a “good omen”, Head of Research at Pakistan-Kuwait Investment Company, Samiullah Tariq, said, “Remittances number is highest for past seven months; however, this year Ramzan has started earlier which is why remittance inflow increased earlier than last year,” the report said.

According to a prominent US-based think tank, the United States Institute of Peace, Pakistan needs to repay a whopping $77.5 billion in external debt from April 2023 to June 2026. It added that the cash-strapped country might face disruptive effects if it ultimately defaults. Pakistan is awaiting a much-needed $1.1 billion tranche of funding from the Washington-based International Monetary Fund, originally due to be disbursed in November last year.

The funds are part of a $6.5 billion bailout package the IMF approved in 2019, which analysts say is critical if Pakistan is to avoid defaulting on external debt obligations. The IMF programme, signed in 2019, will expire on June 30, 2023, and under the set guidelines, the programme cannot be extended beyond the deadline. Pakistan and the IMF have been negotiating the programme's resumption for months but have yet to reach an agreement.

[Riaz Haq]

UK Adds 226 New Visa Categories to Urgently Hire Skilled Workers


https://propakistani.pk/2023/05/18/uk-adds-226-new-visa-categories-...


Exciting opportunities have emerged for Pakistani youth seeking employment abroad as the United Kingdom opens its doors to skilled workers from around the world, including Pakistan.

In response to the severe manpower shortage currently faced by Britain, the country has introduced a significant expansion in its immigration policies.


According to official reports, a total of 226 new immigration categories have been established, accompanied by a noteworthy increase in the minimum wage across all job categories.

This development marks the first time that professions such as police officers, journalists, judges, secret officers, barristers, lawyers, and flight pilots have been included in the immigration category. Furthermore, an additional 31 categories have been designated, encompassing diverse fields such as musicians, dancers, doctors, actors, and scientists.

The expanded opportunities extend beyond specific professions, as drivers, instructors, railway station assistants, air hostesses, cabin crew, veterinary doctors, and tailors are now eligible to pursue employment in the UK. Moreover, individuals with expertise in areas such as masonry, aircraft engineering, AC/fridge engineering, welding, charity work, and estate agency will also find potential avenues for relocation.

Students pursuing education in the UK can now benefit from the post-study work facility, which allows them to gain valuable work experience following the completion of their studies. Notably, highly-educated professionals can anticipate a substantial 20 percent increase in their remuneration, as highlighted in the official letter.

To facilitate the approved manpower shortage category, the UK government has taken steps to keep visa fees at a reasonable level, ensuring accessibility for individuals seeking employment opportunities in the country.

These progressive changes in the UK’s immigration policies provide an encouraging prospect for skilled workers from Pakistan and around the world. The reduced visa fees and the inclusion of a diverse range of professions reflect the British government’s commitment to addressing the pressing shortage of manpower while simultaneously welcoming talented individuals to contribute to the country’s workforce.

Aspiring professionals from Pakistan are encouraged to explore these newfound possibilities, which not only promise career growth but also cultural exchange and personal development. The opportunities available in the UK cater to a wide spectrum of skills and talents, fostering an environment where individuals can thrive and make significant contributions to their chosen fields.


With these favorable policy revisions, Pakistanis can now embark on a transformative journey, utilizing their expertise to build successful careers and establish meaningful connections in the United Kingdom.

[Riaz Haq]

The UK has become one of the world’s most accepting places for foreign workers, according to a survey in 24 nations revealing a sharp increase in British acceptance of economic migration.


https://www.theguardian.com/uk-news/2023/feb/23/uk-now-among-most-a...


Shortfall of 330,000 workers in UK due to Brexit, say thinktanks
Read more

People in the UK emerged as less likely to think that when jobs are scarce employers should give priority to people of their own country than those in Norway, Canada, France, Spain, the US, Australia and Japan. Only Germany and Sweden were more open on that question.

In what the study’s authors described as “an extraordinary shift”, only 29% of people in the UK in 2022 said priority over jobs should go to local people, compared with 65% when the same question was asked in 2009.

The findings come as employers call for more migration to help fill more than 1m vacancies, and after the prime minister appointed the anti-immigration firebrand Lee Anderson as deputy chair of the Conservative party. He has called people arriving in small boats on the south coast “criminals” and called for them to be “sent back the same day”. Police have been deployed to hotels where asylum seekers are being housed amid violent protests by anti-immigration activists.

“It was unthinkable a decade ago that the UK would top any international league table for positive views of immigration,” said Prof Bobby Duffy, the director of the Policy Institute at King’s College London, who shared the findings from the latest round of the survey exclusively with the Guardian and the BBC. “But that’s where we are now, with the UK the least likely, from a wide range of countries, to say we should place strict limits on immigration or prohibit it entirely.”

The UK ranked fourth out of 24 nations for the belief that immigrants have a very or quite good impact on the development of the country – ahead of Norway, Spain, the US and Sweden.

One factor in the shift in opinions on the question of “British jobs for British workers” may be that in 2009 the UK was in a deep recession, with more than double today’s unemployment, whereas today the economy suffers from a worker shortage, with 1.1m vacancies in the UK, 300,000 more than before the pandemic.

Robert Jenrick, the immigration minister, last year urged employers to look to the British workforce in the first instance and “get local people”, although the government has widened visa programmes for seasonal workers and care staff.

Duffy said the findings showed that “it’s time to listen more carefully to public attitudes”. He said: “Politicians often misread public opinion on immigration. In the 2000s, Labour government rhetoric and policy on this issue was more relaxed than public preferences, and arguably they paid the price – but the current government is falling into the reverse trap.”

People in the UK are now the least likely of the 24 countries that participate in the World Values Survey study to think immigration increases unemployment, and second from top in thinking that immigrants fill important job vacancies.

They are very likely to say immigration boosts cultural diversity, and very unlikely to think immigration comes with crime and safety risks. However, more people in the UK think immigration leads to “social conflict” than in several other countries, including Canada, Japan and China.

[Riaz Haq]

Why Americans Are Having Fewer Babies - WSJ

https://www.wsj.com/articles/why-americans-are-having-fewer-babies-...

The number of babies born in the U.S. started plummeting 15 years ago and hasn’t recovered since. What looked at first like a temporary lull triggered by the 2008 financial crisis has stretched into a prolonged fertility downturn. Provisional monthly figures show that there were about 3.66 million babies born in the U.S. last year, a decline of 15% since 2007, even though there are 9% more women in their prime childbearing years.

The decline has demographers puzzled and economists worried. America’s longstanding geopolitical advantages, they say, are underpinned by a robust pool of young people. Without them, the U.S. economy will be weighed down by a worsening shortage of workers who can fill jobs and pay into programs like Social Security that care for the elderly. At the heart of the falling birthrate is a central question: Do American women simply want fewer children? Or are life circumstances impeding them from having the children that they desire?


---------

To maintain current population levels, the total fertility rate—a snapshot of the average number of babies women have over their lifetime—must stay at a “replacement rate” of 2.1 children per woman. In 2021, the U.S. rate was 1.66. Had fertility rates stayed at their 2007 peak, the U.S. would now have 9.6 million more kids, according to Kenneth Johnson, senior demographer at the University of New Hampshire.



Federal agencies are treating the slump like a temporary downturn. The Social Security Administration’s board of trustees projects that the total fertility rate will slowly climb to 2 by 2056 and hold there until the end of the century. Yet it’s been over a decade since fertility rates reached that level. Last year there were 2.8 workers for every Social Security recipient. That ratio is projected to shrink to 2.2 by 2045, roughly two-thirds what it was in 2000.



Some other developed countries are in a far deeper childbearing trough than the U.S. In South Korea, the total fertility rate hit a world record low of 0.84 in 2020 and has since sagged to 0.78. Italy’s rate slid to 1.24 last year. China’s population fell in 2022 for the first time in decades because its fertility rate has been far below the replacement rate for years. Its two-century reign as the world’s most populous country is expected to end this year when India overtakes it, if it hasn’t already.

In a recent note to clients, Neil Howe, a demographer at Hedgeye Risk Management, pointed to a World Bank report showing that the 2020s could be a second consecutive “lost decade” for global economic growth, in large part because of worsening demographics. By 2026 or 2027, he wrote, the growth rate of the working-age population in the entire high-income and emerging-market world will turn from slightly positive to slightly negative, reversing a durable driver of economic growth since the Industrial Revolution.



This shift will make the U.S. more dependent on immigration to supply enough workers to keep the economy humming. Immigrants accounted for 80% of U.S. population growth last year, census figures show, up from 35% just over a decade ago. Yet the number of young immigrant women coming to the U.S. has diminished, Johnson said, and the decline in fertility has been greatest among Hispanics.

Having fewer children has already changed the social fabric of the country’s schools, neighborhoods and churches. J.P. De Gance, president and founder of Communio, a nonprofit that helps churches encourage marriage, said that lower marriage and birth rates are one of the largest drivers of the decline in religious affiliation that’s left pews empty across the country. That matters for the whole community, De Gance said, because churches give lonely people a place to form friendships, as well as feeding hungry people and running schools that fill gaps in public education. “When that’s diminished, the entire culture’s diminished,” he said.

[Riaz Haq]

Latest US Census Data Released in 2023

https://data.census.gov/table/ACSSPP1Y2022.S0201?q=S0201:+Selected+...

Pakistani-Americans Median Household Earning: $106,281, Mean Earnings: $149,178

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White Americans: Median household Income $78,636 Mean Earnings $112,415

African Americans : $52,238 $76,888

American Indian Alaska Native $61,778 $85,838

Asian Indian $152,341 $197,732

Bangladeshi $80,288 $116,500

Chinese $101,738 $160,049

Taiwanese $122,952 $180,906

Filipino $109,090 $122,635

Pakistanis $106,286 $149,178

Nepal $92,262 $120,146

Asians $104,646 $149,363