The departure of health professionals to Europe and North America is placing an intolerable burden on public health systems in many African countries. Various retention, recall, and replacement policies to ameliorate the impact of this brain drain have been suggested, none of which have been particularly successful to date. The key question for the future is whether the brain drain of health sector skills is likely to continue and whether the investment of African countries in training health professionals will continue to be lost through emigration. This paper examines the emigration intentions of trainee health professionals in six Southern African countries. The data was collected by the Southern African Migration Program (SAMP) in a survey of final-year students across the region which included 651 students training for the health professions. The data also allows for the comparison of health sector with other students. The analysis presented in this paper shows very high emigration potential amongst all final-year students. Health sector students do show a slightly higher inclination to leave than those training to work in other sectors. These findings present a considerable challenge for policy makers seeking to encourage students to stay at home and work after graduation. 1. Introduction Studies of working health professionals across the African continent show extremely high levels of interest in emigration and a strong desire to leave, either temporarily or permanently [1–7]. Concerns about the long-term impact of the migration of health professionals from developing countries have recently led to a focus on the next generation, both in Africa [8–14] and elsewhere [15–20]. Many countries invest substantial financial resources in the training of physicians and nurses. Clemens [21] has recently argued that the actual costs of health professional emigration are difficult to quantify and are often exaggerated. However, African governments clearly expect a return on their investment in the form of an increased pool of health human resources. As Chikanda [22, 23] shows in Zimbabwe, however, the training of new health workers has not kept pace with the exodus of qualified and experienced professionals. This is probably inevitable in a country experiencing a massive crisis-driven skills exodus [24]. The more general question is whether trainee health professionals in other developing countries are committed to remaining in their home countries and, if so, for how long. If the answer to the question is negative, then strategies need to be developed to
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