Why African Doctors Keep Choosing the West Over Others

Thousands of doctors from around the world, including large numbers from Africa, are preparing for the next sitting of the United Kingdom’s Professional and Linguistic Assessments Board examination, the gateway for international medical graduates seeking to practise medicine in the UK. The General Medical Council runs PLAB 1 four times a year, with sittings in February, May, August, and November, held at test centres across the UK as well as in Nigeria, India, Pakistan, Egypt, and several other countries. Candidates who pass PLAB 1 can then book PLAB 2, a practical clinical assessment held year-round exclusively in Manchester, England. The GMC does not publish exact sitting dates publicly in advance; these are released only to candidates through their GMC Online accounts closer to each exam window. This report builds on The AWB News’s earlier exclusive reporting on the PLAB pipeline, widening the lens beyond the UK to compare how the United States and Australia absorb the same pool of emigrating doctors.

An emerging picture of healthcare workforce migration shows a widening disparity in how high-income nations absorb African medical talent. The United Kingdom has established a dominant lead as the premier destination for emigrating African physicians, outpacing the United States, Canada, Australia, and the Gulf states in both annual recruitment volume and direct workforce integration.

At the centre of this divide lies regulatory transparency and examination reporting. The GMC does not publish a routine, country-by-country breakdown of PLAB candidates in its standard public reports, offering instead global aggregate candidate numbers and overall pass rates. It does, however, record the country of primary medical qualification for every applicant, data that becomes visible through periodic reporting and Freedom of Information disclosures, while publishing broader post-registration demographics through its public Data Explorer tool.

According to a General Medical Council report covered by Nigerian outlets including AllAfrica and ThisDay in May 2026, no fewer than 4,691 Nigerian-trained doctors relocated to the UK over the preceding three years. That report put the cumulative total of Nigeria-trained doctors currently practising in the UK at approximately 15,692, the largest source of foreign-trained doctors in Britain after India. For comparison, the figure stood at roughly 12,198 as of December 2023 and 9,976 in mid-2022, according to earlier GMC-sourced reporting, indicating the pace of registration has accelerated rather than slowed in the years since.

Across the African continent, Nigeria remains the single largest contributor of doctors to the UK, but it is supported by significant pipelines from other nations. Workforce tracking indicates the leading African source countries supplying the UK’s National Health Service annually include Nigeria, Egypt, Sudan, Ghana, and South Africa, roughly in that order by volume. These figures represent actual entry into the practising workforce rather than raw PLAB candidate pools; a substantial proportion of non-UK doctors bypass the PLAB exam entirely by securing recognised postgraduate qualifications, such as membership or fellowship of UK Royal Colleges, or by entering through GMC-approved sponsorship and Medical Training Initiative programmes.

The United States presents a stark contrast in physician absorption despite ranking as a preferred destination for emigrating African doctors. The most recent reliable, sourced figure for Nigerian-trained doctors in the US comes from the Federation of State Medical Boards, which in 2020 put the number at 3,895 licensed Nigerian-educated physicians, a figure the fact-checking organisation Africa Check confirmed directly with the FSMB after a widely circulated but unsupported claim put the number at 20,000. The FSMB’s more recent 2024 physician census counts over one million licensed physicians nationally, with roughly 23 percent trained abroad, but does not publish a public country-by-country breakdown for Nigeria or most African nations, so a current equivalent figure is not publicly available and should not be estimated. Annual inflow into the US pipeline remains constrained by the licensing apparatus itself rather than by demand. To practise independently in the US, international medical graduates must complete the United States Medical Licensing Examination sequence, obtain Educational Commission for Foreign Medical Graduates certification, and secure a placement through the National Resident Matching Program. Unlike the UK, where doctors can step directly into middle-grade NHS hospital posts upon registration, the US requires all foreign physicians to complete a multi-year residency programme regardless of prior senior specialist status in their home countries, a bottleneck that limits annual intake regardless of overall demand. Non-US-citizen international medical graduates matched into residency positions at a rate of 56.4 percent in the 2026 cycle, according to the National Resident Matching Program’s own Match Day results.

Australia has emerged as an increasingly attractive destination for African clinical talent, though its absolute numbers remain considerably smaller than those of the UK and US, and Africa is not among Australia’s top source regions overall. According to Australia’s Department of Health, 8,910 overseas-trained doctors joined the country’s health workforce between July 2022 and April 2024, with 60 percent of newly registered overseas doctors that period coming from just four countries: the United Kingdom, Ireland, India, and the Philippines. Neither the Australian Health Practitioner Regulation Agency nor the Medical Board of Australia publishes a public breakdown of registered doctors by country of primary medical qualification, so country-specific figures for Nigerian, South African, or other African-trained doctors in Australia are not independently verifiable from public sources. Entry via the standard Australian Medical Council pathway is widely regarded as one of the most demanding regulatory processes globally, requiring candidates to pass a computer-adaptive multiple-choice test, clear a tightly bottlenecked practical clinical examination, and secure an accredited supervised clinical position. Consequently, a growing trend has emerged among Nigerian and West African doctors: many first migrate to the UK to obtain full GMC registration or Royal College qualifications, then use Australia’s Competent Authority Pathway, a formally recognised route for doctors registered with authorities including the UK’s GMC, to obtain provisional and eventually general Australian registration after twelve months of supervised practice, without sitting the AMC’s full assessment sequence from scratch.

Behind these aggregate figures are individual calculations being made in real time. A doctor employed by a state government health service in Nigeria’s southern region, who spoke to AWB News on condition of anonymity given his continued employment there, described the reasoning driving his own plans to leave. According to him, the state government practically provides every reason for nurses and doctors to leave the country. “I graduated a few years ago, and it has been eight months of employment and hard labour, yet no salary, no incentives, absolutely nothing to encourage you,” he said. “I pay for transport, feed myself, and pay bills, yet no salary whatsoever. Why wouldn’t I hunger to fly out like a rocket from the country?” Asked whether the state’s finances were simply too strained to pay newly employed doctors, he rejected the explanation outright. “Not at all; in fact, far from it. They just do not care,” he said, alleging that state officials who can afford private treatment abroad have little incentive to invest in the local health system they themselves avoid using. He further alleged, without independent corroboration, that powerful interests within the state’s health ministry withhold new employees’ salaries and place the funds in interest-bearing accounts for months or years before disbursing them, an accusation AWB News could not independently verify and which the source declined to name individuals or provide documentation for, citing his ongoing employment. “The state of things is sad,” he said, “and every common citizen in the country should pray they do not fall sick.”

This sustained outflow continues to exert pressure on domestic health systems across Sub-Saharan Africa. Nigeria’s doctor-to-population ratio has been estimated at roughly one doctor per 3,500 people, or under three per 10,000, according to Medical and Dental Council of Nigeria data, well below the World Health Organization’s recommended threshold. The migration of thousands of doctors to a single European nation within a three-year period underscores a deepening global health resource divide that regulators, domestic governments, and international health bodies remain under mounting pressure to address.