Physician migration and regional sustainable development: a case study of the Kabardino-Balkarian Republic

A.Kh. Dumanova, M.M. Kambiev

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Abstract. The migration of highly qualified medical personnel from peripheral regions to federal centers poses a significant threat to the sustainable development of Russian regions. Focusing on the KabardinoBalkarian Republic (KBR), the article examines key theoretical migration frameworks: “brain drain”, “brain circulation”, human capital theory, push-pull factors, network theories, as well as theories of endogenous migration and regional resilience. Based on the analysis of Rosstat statistical data for 2015–2023, the scale and dynamics of the outflow of persons with higher education and academic degrees, as well as its impact on the demographic sustainability of the region, are identified. Based on an analysis of Rosstat data for 2015–2023, this paper reveals the scale and dynamics of the brain drain of highly educated individuals and degree holders, showing its negative impact on regional demographic sustainability. The findings show that if current trends continue, they will lead to population aging, increased mortality, and a significant decline in the future quality of human capital. The study substantiates the necessity of shifting from the “brain drain” paradigm to the concept of managed “brain circulation”.
Aim. This paper aims to systematize key migration theories of highly qualified specialists within modern regional development models, adapting them to the KBR context; furthermore, it uses statistical data to evaluate the scale of this outflow and its long-term demographic impact on the republic.
Scientific novelty. For the first time, this study comprehensively applies modern migration theories to analyze the healthcare workforce in a specific North Caucasus region, supplementing it with a quantitative analysis of long-term migration trends (2015–2023) and their impact on regional sustainable development. The study identifies how “push-pull” factors operate specifically within a multi-ethnic, subsidized region of the Russian Federation, demonstrating a correlation between sharp spikes in migration loss and macroeconomic or geopolitical crises.

Results. Medical graduate migration from the KBR aligns with national centripetal trends, yet it is aggravated by regional imbalances, including the hyper-concentration of resources in Nalchik, underfunded material and technical infrastructure, and restricted career pathways. Statistical analysis confirms a steady negative net migration among individuals with higher education (ranging from –304 to –984 people annually) and a record outflow of Candidates of Sciences in 2023 (–12 people). Sharp spikes in migration loss (2015, 2018, and 2022) closely correlate with periods of economic and geopolitical crisis. The study demonstrates the relevance of classical models (such as push-pull, human capital, and network theories) in explaining this outflow; however, it also substantiates the necessity of shifting from the “brain drain” paradigm to the concept of managed “brain circulation” driven by strong kinship and community ties.
Conclusions. The paper demonstrates that the persistence of ongoing trends risks triggering a “development trap” in the KBR, characterized by population aging, rising mortality rates, and the degradation of regional human capital. The solution to the healthcare workforce shortage lies not in isolation but in enhancing the republic’s competitiveness as a professional environment. The formulated conclusions serve as a methodological basis for empirical research into the migration intentions of medical graduates and for developing regional policies to transform this outflow into managed circulation through alumni associations, telemedicine hubs, and return grant programs.

Keywords: physician migration, brain drain, brain circulation, human capital, regional sustainable development, demography, Kabardino-Balkarian Republic, medical personnel

For citation. Dumanova A.Kh., Kambiev M.M. Physician migration and regional sustainable development: a case study of the Kabardino-Balkarian Republic. News of the Kabardino-Balkarian Scientific Center of RAS. 2026. Vol. No. 3. Pp. 193–204. DOI: 10.35330/1991-6639-2026-28-3-193-204

©   Dumanova A.Kh., Kambiev M.M., 2026

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Information about the authors

Aminat Kh. Dumanova, Candidate of Economic Sciences, Senior Researcher, Department of Modeling of Socio-Economic Processes, Institute of Computer Science and Problems of Regional Management – branch of the Kabardino-Balkarian Scientific Center of the Russian Academy of Sciences;
37-a, I. Armand street, Nalchik, 360000, Russia;
dumanovanata@list.ru, ORCID: https://orcid.org/0000-0001-7365-9824, SPIN-code: 5464-8893
Mukhtar M. Kambiev, 6th year Student, (Group 1.6.44), Institute of Clinical Medicine, N.I. Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation (Pirogov University);
1, Ostrovityanova street, building 6, Moscow, 117513, Russia;
kambiev007mm@gmail.com, ORCID: https://orcid.org/0009-0005-9288-1363

Funding

The study was performed without external funding.