News
1,489 doctors left the country from 2022-2024: Lanka loses Rs. 12.5bn
View(s):By Kumudini Hettiarachchi
Sri Lanka lost 1,489 doctors, including specialists, to brain drain in the three-year period from 2022 to 2024, following the unprecedented economic crisis, resulting in a huge estimated financial loss of around Rs. 12.5 billion (US$ 41.5 million) to the government and taxpayers, a study has found.
This migration has strained healthcare infrastructure, particularly in rural and underserved areas, led to shortages in critical specialities, disrupted medical education, and exacerbated inequities in access to care. Existing retention mechanisms, such as post-training service bonds, have been largely ineffective, states the review article published this month in the peer-reviewed
‘International Journal of Health Planning and Management’ based in the United Kingdom. The journal is published by John Wiley and Sons Ltd.
The article titled ‘The Exodus and Its Toll: Sri Lanka’s Economic Crisis and the Migration of Doctors’ is by Madunil Niriella, Krishanni Prabagar, Pathum Premaratna, Ravini Premaratna, Nilanthi de Silva & Janaka de Silva of the Faculty of Medicine, University of Kelaniya, Ragama; Saroj Jayasinghe of the Faculty of Medicine, University of Colombo; and Tiloka de Silva of the Faculty of Business, University of Moratuwa.
They had conducted a mixed‐methods policy analysis using national and international data between 2022 and 2024, including those from the Health Ministry, the Post‐Graduate Institute of Medicine (PGIM) and international Medical Council reports.
Currently, Sri Lanka’s healthcare workforce comprises around 23,000 doctors, including around 2,800 specialists.
Analysing data from 2022 to 2024, coinciding with the country’s economic crisis, the study found that during this period 1,085 doctors were undergoing specialist overseas training, with 477 and 449 doctors leaving Sri Lanka in 2022 and 2023, respectively, which was “significantly” higher than during the civil war (from 2006 to 2009).
Of the 1,085, almost 20%, or 205, did not return to the country even for PGIM certification.
This is while, through Health Ministry data, the team had found that of a total of 3,839 medical graduates, 75 intern medical doctors did not apply for post‐internship appointments from 2022 to 2024. The ministry had also estimated that 1,209 medical officers with varying levels of work experience left their positions vacant over these three years, a significant loss of medical officers (6%) in a country with a total of about 20,000 medical officers.
Looking at some of the countries to which doctors migrated in search of greener pastures, the team found that by 2024, there had been a 121% increase in Sri Lankan staff, with a total of 3,082 doctors, including 391 consultants and 413 speciality doctors, in the National Health Service (NHS) and Community Health Service of the UK, whereas before December 2019, it had been less than half, at 1,396, inclusive of 182 consultants and 199 speciality doctors.
A 2022 study based on the Medical Directory of Australia had found that Sri Lanka ranked as the fourth largest source country of international medical graduates practising in Australia.
To ‘quantify’ the direct monetary loss of the doctor exodus from the country, the team had taken into account the 2024 national budget estimates of around Rs. 7 million to produce an MBBS doctor through the free education system, adding another Rs. 1 million for specialist training, with the salary paid during training for two years amounting to around Rs. 5.3 million, thus totalling Rs. 13.3 million.
Using these estimates and the number of intern medical officers, medical officers and trainee consultants who left the government service during the 2022–2024 period, the team has estimated the loss to the Sri Lankan taxpayer at around Rs. 12.5 billion.
On the impact on healthcare services and health equity, the study has stated that the doctor shortage has “serious” implications for the public, patients, caregivers, and the functioning of healthcare facilities, citing specialities such as psychiatry, anaesthesiology, emergency medicine, radiology and paediatrics being disproportionately affected.
On the other side of the coin would be the major impact of a shortage of medical professionals on medical education and workforce sustainability.
With regard to mitigating the migration of doctors from Sri Lanka while respecting the right of an individual to migrate, the team has suggested a range of policy options, including improved enforcement of bonds, strategic use of dual citizenship, bilateral tax‐sharing agreements, and investments in working conditions and training infrastructure to retain medical talent.
Reiterating that the migration of doctors presents a “multi-dimensional threat” to the country’s public healthcare system, the study team urges urgent, evidence‐based interventions as being “essential” to preserve the sustainability of free healthcare and medical education systems in Sri Lanka and other low- and middle-income countries under similar duress.
The best way to say that you found the home of your dreams is by finding it on Hitad.lk. We have listings for apartments for sale or rent in Sri Lanka, no matter what locale you're looking for! Whether you live in Colombo, Galle, Kandy, Matara, Jaffna and more - we've got them all!