1. The Ethical Dimensions of International
Student Recruitment and International
Research Cooperation
Professor Lesleyanne Hawthorne
International Association of Universities
Vilnius - 2010 International Conference
24-26 June 2010

2. Decision to Study Internationally:
Stage 1 of a Global Career Trajectory?
Key drivers (sending and receiving countries):
1. Demography
2. Capacity-building
3. Addressing workforce maldistribution and under-supply
4. Domestic skills base versus knowledge economy needs
5. Compensation for out-migration
Case studies:
‘Indigenisation’ of Gulf State and select African workforces

3. Declining Fertility Rates by Select Country
2.2: Mexico
2.1: US
1.9: France
1.8: Norway, Australia, UK
1.7: Netherlands
1.5: Canada1.5
1.4: Switzerland
1.3: Germany, Italy, Spain, Czech Republic, Japan
1.1: Republic of Korea
0.9: City of Shanghai (recent Asian fertility declines….)
Japan: Set to experience a 70% population reduction in 40
years, with more than 40% of citizens aged 65 years or over
Canada: Scale of reliance on skilled migration
Source: Health At A Glance 2007 – OECD Indicators (2008), OECD, Paris; Matsutani, M
(2008), ‘Radical Immigration Plans Under Discussion’, The Japan Times, 19 June,
Tokyo

4. Top 10 Global Destinations for International
Students by 2008
(Higher/ Vocational Education)
Destination Country International Students Enrolled in
Higher/ Vocational Education
1. US 623,805 (2008)
2. Australia 389,373 (2008)
3. UK 389,330 (2008)
4. France 260,596 (2008)
5. Germany 246,369 (2007)
6. China 223,499 (2008)
7. Japan 123,829 (2008)
8. Canada 113,996 (2007)
9. Singapore 86,000 (2007)
10. Malaysia 72,000 (2008)
11. South Korea 63,952 (2008)
12. New Zealand 39,942 (2007)
Source: Compiled from data provided in International Student Mobility: Status Report 2009, V Lasanowski, The
Observatory on Borderless Higher Education, UK, June 2009

5. FOCUS 1: International Student Demand for
Biomedical Training
1. Source countries:
Prioritisation by field - medicine
Scale of government sponsorship
Global destinations
Risks – return?
Outcomes on return - bonded service/ skills transfer?
Malaysia medical student case study:
Private versus public international flows (Bumiputra policy)
Length of service on qualification
Medical practice location

6. International Student Demand for
Biomedical Training: The Ethical Context….
2. Receiving countries:
Differential selection procedures (eg public versus private students)
Academic readiness (‘need’ versus ‘merit’)
Access and progression (English ability/ academic transition)
Student motivation (retention)
Source country opportunity (migration)
Case studies:
Botswana student repatriation (eg from Ireland)
Select Gulf States’ scholarship student preparedness (eg New
Zealand)
Retention (eg private medical students in Australia)

7. International Student Demand for
Biomedical Training: The Ethical Context….
3. Third country opportunity:
Student motivation for international study
Global choices
The issue of ‘individual agency’
Private versus sponsored student choices
Case study:
Singaporean recruitment of private Malaysian medical students
qualifying in Australia
Pathways to internship and permanent resident status

8. Select Ethical Challenges –
International Medical Student Recruitment
Major immigrant-receiving countries:
Canada
Australia
UK
Issues:
Better to recruit and use international students?
Better to import fully-qualified migrant professionals?
Risk of skills wastage
Greater loss to countries which fully-resourced their training

9. EXAMPLE: Australia’s Level of Reliance on Migrant
Professionals by Field (2001 & 2006)
Compared to Canada (2001)
Occupation 2006 2001
% Overseas-Born % Overseas-Born
In Australia In Australia
(cf Canada)
Engineering 52% 48% (50%)
Computing 57% 48% (51%)
Medicine 45% 46% (35%)
Science 37% (36%)
Commerce/ business 40% 36% (27%)
Architecture 36% (49%)
Accountancy 44% 36% (35%)
Arts/ humanities 31% (24%)
Nursing 25% 24% (23%)
Teaching 25% 20% (15%)
Source: 2001 and 2006 Census data analysis, Australia and Canada; The Impact of Economic Selection
Policy on Labour Market Outcomes for Degree-Qualified Migrants in Canada and Australia, L
Hawthorne, Institute for Research on Public Policy, Vol 14 No 5, 2008, Ottawa

10. Australia’s Policy Transformation 1999+:
Selection Criteria Favouring International Students
g g ion
stin nin ect
te ee sel
age l scr dent
ngu ntia l stu and
La d e a
e ation al dem
Cr rn A
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Int upa tion RALI
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CANADA

11. International Student Response to Skilled
Migration Opportunity by 2004
18,000
15,000
Other occupations
12,000
Tradespersons
9,000
6,000 Professionals
3,000
Managers
0
Offshore Onshore

12. International Students as a Migration Resource All Sectors:
474,389 (October 2008) Rising to 620,000 (March 2010)
2008 Growth on YTD
Nationality Enrolments % of Total August 2007
China (38% migrate) 112,172 23.6% 18.8%
India (66% migrate) 80,291 16.9% 47.4%
Republic of Korea 31,667 6.7% 3.6%
Malaysia 20,449 4.3% 6.3%
Thailand 18,564 3.9% 9.8%
Hong Kong 16,827 3.5% -5.0%
Nepal 14,605 3.1% 101.8%
Indonesia 14,071 3.0% 4.1%
Vietnam 13,367 2.8% 62.7%
Brazil 12,493 2.6% 26.4%
Other Nationalities 139,883 29.5% 9.2%
Total Enrolments 474,389 100.0% 18.5%

13. International Medical Students and Australia’s
Migration ‘Critical Skills List’ (2009)
ASCO Number Occupation Shortages - Professional
2312-11 Anaesthetist
2381-11 Dentist
4315-11 Electronic Equipment Trades
2312-15 Emergency Medicine Specialist
2129-17 Engineer - Chemical
2124-11 Engineer - Civil
2125-11 Engineer - Electrical
2125-13 Engineer - Electronics
2126-11 Engineer - Mechanical
2127-11 Engineer - Mining
2126-13 Engineer - Production or Plant Engineer
4114-15 Aircraft Maintenance Engineer - Avionics
4114-11 Aircraft Maintenance Engineer - Mechanical
4431-13 Gasfitter
2311-11 General Medical Practitioner
2391-11 Medical Diagnostic Radiographer
2312-17 Obstetrician & Gynaecologist
2383-11 Occupational Therapist
2382-11 Pharmacist (Hospital)
2382-15 Pharmacist (Retail)
2385-11 Physiotherapist
2388-11 Podiatrist
2312-27 Psychiatrist
2122-11 Quantity Surveyor
2325-11 Registered Mental Health Nurse
2324-11 Registered Midwife
2323-11 Registered Nurse
2413-11 Secondary School Teacher
2312-79 Specialist Medical Practitioners NEC
2312-25 Specialist Physician

14. The Study-Migration Nexus: Outcomes for
International Medical Students in Australia
Potential resource:
Number (2009):
Around 3,000
Major sources:
Malaysia, Singapore, Canada, Botswana…
Sponsorship:
Around 30%
Ineligible for migration to Australia (ethical bar)
Retention:
Around 70%

15. Ethics and Global Policy Experimentation:
‘Two Step’ Student Migration
The growing OECD model (in the context of demographic shift):
1. Facilitating international student entry
2. Work rights during study
3. Certainty of access to stay on qualifying (with family)
4. Liberalisation of field of qualification and sector
5. (In select countries) Uncapped immigration categories
6. Global promotion (eg British Council, IDP Australia)
Finessing ‘the package’:
Fast-track access to permanent residence / citizenship

16. Comparator Countries: Canada’s Level of Reliance
on Foreign Health Professionals = 24,315 Skilled
Category Arrivals in 2008
Canada 2007 2008
Physicians:
Temporary 1,498 1,627
Permanent 1,137 1,444
Nurses:
Temporary 576 1,108
Permanent 665 853
Nurse Assistants/ Live-in Caregivers:
Temporary 13,746 12,864
Permanent 2,841 4,909
Pharmacists/
Allied Health:
Temporary 218 282
Permanent 692 710
Dentists:
Temporary 69 77
Permanent 210 250
Dental Technicians:
Temporary 84 92
Permanent 107 99
Source: Table prepared by L Hawthorne based on data purchased from Citizenship and
Immigration Canada August 2009

17. The Canadian Experience Class (September
2008+)
The new model:
1. Prioritises on-shore pathway:
Students/ temporary workers
2. Category:
Skilled class/ all disciplines
3. Numbers:
Uncapped
4. Selection criteria:
Tighter than for ‘standard’ skilled migrants (eg English/
French ability)

18. UK Dependence on Medical and Nursing
Migration
2000:
Around 250,000 health and care workers in the UK = foreign-
born (nearly six out of ten of foreign nationality)
Sixty per cent originated from countries outside the European
Economic Area (EEA)
38,560 foreign nurses
27,750 medical practitioners
27,710 care assistants
Five tier migration system:
Students – start at Tier 4
Progress to Tier 1 and 2

19. FOCUS 2: International Student Demand for
Biomedical Research Training - The Ethical Context
1. Source country priorities:
Capacity-building momentum
National development funding
Sponsorship
Demand: University sector, government sector, clinical
infrastructure
Case study:
Singapore: PhD qualified allied health professionals/ hospital
needs (eg Changi)/ expansion as global biotech and clinical hub

20. International Student Demand for Biomedical
Research Training: The Ethical Context (….)
2. Destination countries – capacity to deliver appropriate training?
Student selection (‘needs’ versus academic preparedness)
English ability
Priority fields (driven by home country needs or host country availability?)
Differential academic pathways compared to host countries
Training mode (onshore versus offshore, split programs)
Workplace demands in sponsorship contexts versus study context (skills
transferability?)
Indonesian case study:
Medical education in the context of ‘massification’
Prior training (eg internship access/ nursing clinical training)
Work-study pressures (given the necessity to contribute at home)
Ethical framework requirements: research projects

21. International Student Demand for Biomedical
Research Training: The Ethical Context (….)
3. Suitability of PhD training models:
Case study: Malaysian split PhD program (UK, Australia)
2+2 years
Student selection (versus those awarded ‘full’ overseas PhD programs)
Reduced fees (but more complex supervision processes?)
Dual supervision (home/ abroad) – availability? adequately matched?
Potential challenges:
Student movement – beneficial?
Research infrastructure - in each country?
Work demands in-country - versus study priorities?
Supervisory process – potential complexity
Host institution - incentives?
Students – attraction to stay in more developed research infrastructure?

22. EXAMPLE: Return Home or Retention?
USA and International PhD Students
Overall international student numbers:
2006- 07: 582,984 ($US14.5 billion industry)
2008-09: 671,616
Top 5 sources: India, China, South Korea, Canada,
Japan
Growth: +16%, +10%, +10% (past 3 years)
Recent policy trends:
‘Claw-back’
New strategic initiatives: China, Morocco, Chile etc
‘Vigorous efforts at the national, state and campus
levels…’ including high level global promotional visits
Research incentive

23. Recruitment and Retention of International
PhD Students – USA
Doctoral student enrolments and retention:
World PhD student share (13.5% → 28.3% by 2003)
Fee access/ cross-subsidisation
China, India – 85-95% retention (at least 5 years)
Pathways into permanent residence (HIB+ Visa)
Case study: National Institutes of Health
The demand for lab scientists (‘backbone’)
Filling the gap – domestic PhD career trajectories
Sources: Science and Engineering Indicators 2008, National Science Foundation, February, Washington; Marginson, S & Van Der Wende, M (2007), Globalisation and Higher
Education, Education Working Paper No 8, Directorate for Education, OECD, Paris; International Students in the United States, Open Doors Report 2007, Institution of
International Education (IIE), 13 November 2007, Washington DC; ‘Foreign Scientists at the National Institutes of Health: Ramifications of US Immigration and Labor
Policies’, S Diaz-Briquets & C Cheny, International Migration Review Vol 37 No 2, Summer 2003; ‘Immigration in High-Skill Labour Markets: The Impact of Foreign
Students on the Earnings of Doctorates’, George J Borjas, Working Paper 12085, National Bureau of Economic Research, March 2006; ‘Stay Rates of ForeignDoctorate
Recipients From U.S. Universities: 2005’, Michael Finn, Oak Ridge, TN: Oak Ridge Institute for Science and Education, 2007; Open Doors Report (2009),
http://www.wystc.org/docs/blog/?p=943 (accessed June 2010)

24. Ethical Issue 1: Human Resource Use versus
Wastage
Ethically better to recruit mature skilled migrants, or train retain
students?
Case Study: Medical Outcomes for 1996-2001 Medical Migrants to Canada
and Australia
South Africa: 81% employed in Canada (81% in Australia) √
UK/Ireland: 48% employed in Canada (83% in Australia)
India: 19% employed in Canada (66% in Australia)
HK, Malaysia, Singapore: 31% employed in Canada (59% in Australia)
Eastern Europe: 8% employed in Canada (24% employed in Australia)
China: 4% employed in Canada (5% in Australia)
Source: The Impact of Economic Selection Policy on Labour Market Outcomes for Degree-Qualified Migrants in
Canada and Australia, L Hawthorne, Institute for Research on Public Policy, Vol 14 No 5, 2008, Ottawa

25. Ethical Issue 2: Individual Agency for Global
Medical and Health Workers – Limit? Impacts?
Ethically appropriate to limit global study/ mobility in select
fields?
Case Study: Nurses/ doctors in Africa:
Rural → urban
Public → private
Poor → rich
Unsafe → secure (disease, law and order)
Employment conditions → remuneration, quality of practice, training, workload,
facilities, promotion, health service quality etc
Living conditions
Family choice → children’s education, spouse career (etc)
Source: Working Together for Health – The World Health Report 2006, WHO, France

26. Ethical Issues 3 and 4: Academic Selection
and Progression/ Training Outcomes
What duty of care is owed by education provider countries?
Education challenges:
Student versus source country and host country motivations? (aligned
or conflicting)
Purpose and mode of selection? (sponsored cohorts versus private
students/ onshore versus split mode)
Relevance of study? (content and mode)
Readiness and support for study? (duty of care - academic and
language transition needs)
Ethical frameworks/ critical reasoning capacity/ use of sources
Certainty of academic progression? (if inadequately resourced)
Skills transferability on return? Infrastructure, incentives
Career trajectory challenges:
What is the obligation of provider countries?

27. Certainty - Scale of Future Global Demand:
Study and Career Trajectories in High Priority Fields
Traditional population structure Emerging population structure