Swedish medical students abroad: a case of return migration policy-making

Abstract

Recent years have witnessed a dramatic increase in the number of Swedes studying medicine abroad, especially in Central and Eastern European countries. It is estimated that every third Swedish medical student studies abroad. Having such a large group of new potential people to draw on can be a real “wet dream” for both central and local governments struggling with increasing shortages of doctors. Return and integration of these students into the Swedish health-care system creates unprecedented opportunities for dealing with the increasing shortages of physicians in Sweden. On the other hand, failure to do so can have serious consequences for the accessibility and quality of health-care for the public. The sheer size of this phenomenon makes it one of the key issues for human resource management in the health-care sector at both state and employer levels. Yet, the phenomenon has received surprisingly little if any attention in the literature on human resource management in health-care. It has also received no attention in the literature on student mobility, which instead focuses predominantly on mobility from less developed to more developed countries. This study aims at filling these gaps. It draws on three theories of return migration (structuralist theory, social network theory and transnationalist theory) to analyze the structural conditions in Sweden that limit(ed) the opportunities of students to return and the strategies that students have used to remove some of these obstacles. Thus, the study also describes the changing policy towards Swedish return medical student- migrants both at national and local levels alike. In so doing, it highlights the role of return student-migrants as drivers of this change vis-à-vis passive state and employers. This discussion is embedded in a wider theoretical discussion about the role of actors and institutions, conceptualized as being “mutually-constitutive of one another” (Jackson 2010).