1246 



ironically, one in which society's needs are the greatest.®^^ Closed out 

 at home, they have the alternatives of moving into other career direc- 

 tions or going abroad to study and obtain, if successful, an inferior 

 medical degree with uncertain prospects as a USFMG. In this environ- 

 ment of declining expectation for young Americans aspiring to be 

 physicians, some Members of Congress are beginning to question pub- 

 licly the premise of the administration's policy on the utilization of 

 FMGs. 



Interconnection of Science^ Technology^ Brain Drain^ and National 

 Policy 



However difficult it may be to measure the effects of this admittedly 

 "unmeasurable problem" of brain drain, still there are certain inescap- 

 able realities suggesting that the problem does exist and that it is large. 

 The "internationalist" and "nationalist" models are convenient analyti- 

 cal devices; they provide insights that permit some grasp on these 

 realities, but they yield no absolute answers. Nor does evaluation of 

 demands and needs give grounds for a conclusive, incontestable judg- 

 ment — what is one man's demand is another man's need. Still, they, too, 

 can provide insights and some understanding. 



That brain drain has positive and negative effects for both the LDCs 

 and the United States there would seem to be little doubt. Certain 

 facts are self-evident. The LDCs benefit from a returning educated 

 elite; they share in the advancement of world knowledge in which 

 their gifted nationals working in advanced countries can participate 

 in creating; economic development may not necessarily be deterred, 

 according to some observers; emigration can produce economic and 

 political side-effects favorable to the problem-laden, pressure-filled 

 LDCs; and as a result of a combination of all these factors, possibil- 

 ities for social change and progress can be improved. 



Yet these gains appear to be more than counterbalanced by serious 

 losses in the professional manpower that could provide the nation with 

 human resources necessary for present and future development but 

 are now denied. Through the loss of these natural resources a nation's 

 intellectual infrastructure can be eroded and weakened; social costs 

 of medical brain drain can be very high, perhaps too high for the 

 general welfare of the medically underprivileged LDC ; nonreturning 

 students can reduce the professional reserves necessary for the future ; 

 donor nations can sacrifice certain elements of national prestige, per- 

 haps not vital but still important to the upward-striving LDC ; costs 

 to the donor LDCs from the loss of professional manpower invest- 

 ments can be exceedingly high, however imprecise the method for 

 measuring them and whatever compensating effects various offsetting 

 factors may have ; loss through mismatched training, possible genetic 



oi^ The continuing high prestige of the medical profession Is Illustrated by a Gallup Poll 

 published In December 1973. The poll confirmed a finding of surveys taken over a period 

 of more than two decades that "medicine Is the top choice among all adults as the best 

 profession for a young man." Three persons In 10 surveyed, I.e., 28 percent, cited medicine 

 as the most preferable career — hence the most prestigious. In 1950. medicine was first 

 choice with 29 percent. Variations during the intervening 23 yeara were minor. (The 

 Washington Post, Dec. 2, 1973, p. A17.) 



