Between 2020 and 2025, an estimated 5,800 Georgian physicians and nurses emigrated. PHIG maps where they went, why, and what pulling them back would — and would not — require.
“The debate about doctor emigration in Georgia misses the point. Physicians do not leave because they love Germany more than Georgia. They leave because Germany offers what Georgia does not: fair pay, professional respect, and a career development system that works.”
Pkhakadze G. Health Worker Emigration Analysis. Tbilisi: PHIG; 2025.[1]
Introduction
Health worker emigration is a global phenomenon intensified by an estimated global shortage of 10 million health workers projected by WHO for 2030.[2] In Georgia, the issue has particular political salience because the country simultaneously exports large numbers of health workers to Europe and the Gulf while experiencing perceived workforce shortages in rural and specialist areas. This analysis uses Geostat labour migration data, MoLHSA registry, and IOM’s 2024 Georgian health worker migration survey to characterise the emigration pattern and evaluate retention policy options.
| Cadre | Germany | Turkey | Poland | UAE/Gulf | Other EU | Total 2020–25 |
|---|---|---|---|---|---|---|
| Physicians | 820 | 620 | 340 | 440 | 680 | 2,900 |
| Nurses | 540 | 980 | 480 | 620 | 880 | 3,500 |
| Midwives | 60 | 80 | 40 | 30 | 90 | 300 |
| Pharmacists | 80 | 120 | 60 | 40 | 80 | 380 |
| Other health workers | 120 | 180 | 90 | 110 | 220 | 720 |
| TOTAL | 1,620 | 1,980 | 1,010 | 1,240 | 1,950 | 7,800 |
Sources: Geostat Labour Migration Survey 2024; MoLHSA exit tracking (partial); IOM Georgia Health Worker Migration Survey 2024; PHIG estimates.[1,2,3]
Push and Pull Factors
IOM’s 2024 survey of 480 Georgian health workers abroad identified the primary push factors (reasons for leaving Georgia): salary differential (cited by 88% of respondents), lack of career progression opportunities (62%), poor management culture in Georgian health facilities (48%), and inadequate professional development support (41%). The primary pull factors toward destination countries were salary (89%), working conditions (71%), and immigration pathways to permanent residence (58%).[3]
Figure 1. Average Monthly Physician Salary: Georgia vs. Main Destination Countries 2024 (USD)
Sources: IOM Georgia Health Worker Survey 2024; Eurostat earnings data 2024; PHIG analysis.[1,3]
| Policy Option | Estimated Cost (GEL/yr) | Evidence of Effectiveness | Feasibility in Georgia |
|---|---|---|---|
| 30% rural posting salary supplement | ~GEL 18M | Effective for rural retention (WHO evidence) | High — UHC framework exists |
| Student loan forgiveness for 5-yr rural service | ~GEL 8M | Moderate evidence; common in US, UK rural programmes | Medium — requires legislation |
| Mandatory 2-yr national service after graduation | Revenue neutral | Weak evidence; drives emigration of graduates | Low — counterproductive evidence |
| Accelerated career progression track (specialist pathway) | ~GEL 5M | Effective in Estonia (2012 experience) | Medium — needs residency reform first |
| Research grant programme for hospital physicians | ~GEL 3M | Effective for specialist retention; weak for GPs | Medium |
| Return migration incentive package | ~GEL 12M | Emerging evidence; Moldova return programme | Medium — depends on package design |
Sources: WHO Global Health Workforce Network 2023; PHIG policy review.[1,2,4]
Figure 2. Georgian Health Worker Emigration by Year and Salary Gap Trajectory 2019–2024
Conclusion
Georgia’s health worker emigration is growing at approximately 19% annually and will continue to grow unless the fundamental salary differential and career development gap are addressed. Mandatory service obligations and guilt-based retention campaigns will not work — the evidence from comparable settings is clear on this. What works is competitive salary supplementation for priority areas (rural and underserved settings, shortage specialties), accelerated career pathways for high performers, and a return migration incentive package that makes returning from abroad economically rational. PHIG recommends the Georgian government invest GEL 38 million annually in a coordinated retention and return programme — an amount equivalent to approximately 2.9% of the current health budget — with five-year outcomes defined and publicly tracked.
References
- Pkhakadze G. Health Worker Emigration from Georgia 2020–2025: Flows, Destinations and Policy Options. Tbilisi: PHIG; 2025.
- WHO. Health Workforce 2030: A Global Strategy for Human Resources for Health. Geneva: WHO; 2016.
- IOM Georgia. Health Worker Migration Survey 2024. Tbilisi: IOM; 2024.
- WHO. Retention of the Health Workforce in Rural and Remote Areas: A Systematic Review. Geneva: WHO; 2021.
- Geostat. Labour Migration Survey of Georgia 2024. Tbilisi: National Statistics Office; 2024.
Public Health Institute of Georgia
