Accelerating Reliance on Internationally Trained Nurses amid Stable Physician Dependence: Evidence from OECD Health Workforce Migration Data, 2021-2025
Ngobum Chinwengozi Ibe (Mrs)
Progress in Machines and Systems, Vol. 15, No. 2, 2026.
DOI: https://doi.org/10.6025/pms/2026/15/2/86-102
Link: https://www.dline.info/pms/fulltext/v15n2/pmsv15n2_3.pdf
Abstract:
Background: Global health systems face unprecedented workforce shortages, driving an increased reliance
on international health worker migration. While the migration of physicians has long been a structural
feature of many health systems, the dynamics governing nursing migration are rapidly evolving. This study
examines the temporal trajectories of reliance on internationally trained nurses and physicians across OECD
and partner economies between 2021 and 2025. Methods: We analyzed 269 country year profession
observations from the OECD Health Workforce Migration database, covering 36 economies. The primary
outcome was the percentage of the domestic workforce trained abroad. We employed descriptive statistics,
ordinary least-squares (OLS) linear trends, and non-parametric Mann-Kendall and Sen's slope analyses to
quantify the extent and direction of change, accounting for unbalanced panel structures and data quality
flags. Results: Dependence on foreign-trained physicians remained high but relatively stable, with aggregate
means hovering around 22-23% and a non-significant OLS slope (+0.18 percentage points/year, p=0.55).
In contrast, reliance on internationally trained nurses exhibited a sharp acceleration. After remaining stable
at approximately 7.8% from 2021 to 2023, the cross-country mean for nurses surged to 9.6% in 2024 and
13.2% in 2025, yielding a borderline-significant positive OLS slope (+1.26 percentage points/year, p=0.07).
This acceleration was heavily concentrated in a subset of high-income destination countries, notably the
United Kingdom, Ireland, and New Zealand. Conclusion: The 2021-2025 period marks a critical inflection
point in global health workforce dynamics, characterized by an accelerating reliance on internationally
trained nurses to fill acute staffing gaps. While international recruitment provides a vital stopgap for
destination countries, the rapid intensification of nurse migration underscores urgent needs for domestic
retention strategies and ethical, proportionate co-investment frameworks to mitigate workforce depletion
in source countries.