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Restricting the migration of medical graduates from poor countries would be both against international law and counter-productive, say Zarmeneh Aly, a Pakistani medical student, and Fawad Taj, a research associate in neurology at the Aga Khan University in Karachi.

Such moves would limit graduates' job satisfaction and performance, they write in PLoS Medicine.

Rather than expecting graduates to lower their aspirations and standards, local working conditions should be improved, they say, by tackling the underinvestment that contributes to poor staffing and morale at government hospitals for example.

The authors say that, as students, their suggestion of returning to their homeland after satisfying ambitions abroad is often met with mockery and disbelief.

But staying in their home country might make them susceptible to the "mundane routine, devoid of intellectual stimulus, that comprises most of the postgraduates' lives here". They argue that, on their return, foreign-trained physicians often help build better healthcare systems.

Aly and Taj hope that a WHO-backed International Code of Practice on Health Worker Migration, called for at the 2004 World Health Assembly, would usher in a new era in which developing country students are able to serve their country while pursuing their ambitions.

Link to full article in PLoS Medicine