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Ballard, Robinson and Laurence1 uncover some interesting factors that have made French GPs relocate to practice in London. As an English GP who moved from her London practice 4 years ago, I was particularly interested to see if I had any motives in common with those found in the study. I was unsurprised to see that personal factors remained the main driving force for the migration of these French GPs. This was also my main motivating force, as well as the issues that face GPs in the UK in the inner city. Furthermore, I currently work as a university faculty GP, in a teaching practice in innercity Hamilton, Ontario, Canada, where I see many doctors who have also migrated from their countries of origin. This population has moved for personal reasons also, but their stories tend to be that of persecution or hardship in their country of origin, and a desire to migrate to a better economic future for themselves and their families. Another factor pertinent to Canada, is that many Canadian-trained doctors also migrate, mainly to the US. It seems that the impetus for the migration of these doctors would mainly be financial — in the US the remuneration for GPs is very handsome indeed compared to the Canadian system.
I think that a follow-up study to address the issues of migrating GPs should look at why GPs specifically choose to leave the UK. Literature that exists in this area consists of a survey from 1990–19942 that concluded that areas with a high deprivation rate and with high needs had higher than average exodus rates of GPs (for example 7.8% in Kensington, Chelsea and Westminster). A more recent study of a qualitative nature might help to address the concerns of the GP recruitment and retention crisis that are highlighted by the authors in their introduction. After all, shouldn't we be trying to find out why GPs want to leave their places of professional origin, rather than finding out why other GPs want to come to the UK?