The Global South subsidises healthcare in the Global North through the migration of doctors and nurses.

The UK is a good example. The National Health Service (NHS) faces a projected shortfall of up to , so recruiting thousands of international healthcare workers will be crucial. In recent years more than 50 per cent of new ?and in the NHS have been recruited from overseas, primarily ¨C and especially since Brexit ¨C .

The consequences for LMICs are dire. Nations such as Malawi and South Africa in training investments and have their healthcare systems weakened by the exodus of skilled professionals. The reduced access to healthcare that this creates undermines public health, productivity and economic stability in already under-resourced regions.

With the World Health Organization (WHO) predicting a global deficit of by 2030, this crisis necessitates urgent action. And higher education institutions, sitting at the pivotal intersection of training, research and policy formation, have a critical role to play.

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Their current approaches mainly focus on national interest, however. That is unsurprising when they face challenges of their own. In the UK, the outlines an ambitious goal of increasing domestic healthcare training by 50 per cent for doctors and 92 per cent for nurses. Yet in recent years, with financial barriers and limited placement opportunities cited as key issues.

Moreover, while there is support for expanding the educator workforce to meet rising demand, details around implementation are lacking. This is worrying because existing often face burnout and insufficient time for teaching responsibilities, exacerbating workforce attrition.

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These dual challenges ¨C strained education systems in high-income countries (HICs) and the loss of skilled professionals in LMICs ¨C underscore the urgent need for universities to adopt a more proactive and globally oriented approach.

Universities in HICs should prioritise the expansion of domestic healthcare training programmes while fostering partnerships with institutions in LMICs. The UK alone could need up to to train the necessary healthcare workforce, and it is far from unique ¨C countries across the world need to invest in expanding and establishing new medical schools and allied health divisions to train the health professionals needed to meet growing population and healthcare needs.

In doing so, universities can create mutually beneficial exchanges by sharing resources, expertise and curricula. Programmes that offer joint degrees or collaborative placements can ensure that training benefits both sending and receiving countries. For instance, bilateral agreements could be drawn up for healthcare students to undertake rotations internationally in both directions, with commitments to return with additional skills relevant to their local contexts. This model of mutually beneficial training has been undertaken by the? with its international ¡°medical training initiative¡±.

To discourage migration of graduates, healthcare curricula should . And as well as knowledge and practical expertise, students should also learn values; social accountability, global health ethics and sustainability should be embedded within curricula to encourage graduates to remain and work within their home countries.

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We must also address educator burnout and limited capacity. The number of educators must be expanded, and collaboration among them should be improved through interprofessional and multidisciplinary team education practices: that is, making creative use of existing educators from across the health professions, such as nurses and physiotherapists, to relieve the burden on mainstream teaching staff. And protected time ¨C and rewards ¨C for teaching need to be offered within health professions.

Collaborative training models, whereby LMIC healthcare professionals act as adjunct faculty in HIC institutions and vice versa, can both diversify perspectives and expand capacity without contributing to any brain drains. Such exchanges would not just help professionals from LMICs keep abreast of the latest techniques and treatments, they could also improve efficiency in HICs by teaching their staff how those in resource-constrained contexts manage to provide quality education with less.

Universities should also carry out more research and advocacy around the impact of healthcare migration and advocate for policies that foster global health equity. Research should focus not only on the economics of migration but also on its implications for education, skill transfer and long-term workforce sustainability. Universities can facilitate policy dialogues between LMIC and HIC stakeholders, fostering collaborative solutions, and they can promote ethical recruitment, reducing unidirectional hiring from the neediest ¡°¡± LMICs in particular.

In the end, though, prevention is better than cure. So HICs need to focus more strategically on improving retention of domestic graduates, lessening the need to recruit internationally. This would include addressing challenges such as poor pay and work conditions, discrimination, limited career progression and burnout. Universities and medical schools can model supportive and inclusive environments that value diversity and foster belonging for healthcare settings to adopt.

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The migration of healthcare workers is not solely a healthcare issue ¨C it is a global education challenge. Academics must rise to the occasion, leveraging their roles as educators, researchers and advocates to address the complexities of this crisis.

By expanding training capacity, fostering global collaborations and promoting ethical practices, universities can be at the forefront of creating sustainable solutions.

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is senior departmental lecturer in medical education at the University of Oxford.