A workload of 100 hours per week—around 16 hours a day, six days a week—was enough to drive Mustafa Mohamed, a psychiatrist from Cairo, to consider emigrating. He explains that economic and psychological pressures have affected the quality of his work, which requires mental clarity and focus—things now hard to attain. “Doctors in Egypt have become people who work solely to survive and fund their education, forcing them to work in multiple hospitals or clinics simultaneously, impacting the quality of care,” he says.
After experiencing what he describes as burnout, Mustafa began exploring work opportunities abroad, where he is currently comparing job offers. Despite graduating ten years ago, progressing through both public and private sector roles, and even opening his own clinic that has since become a mental health center, he has not yet achieved a stable standard of living. “I need to work a certain number of hours to live comfortably, which is why I’m looking for opportunities outside Egypt,” he states.
According to the 2023 “Egypt in Numbers” report from the Central Agency for Public Mobilization and Statistics, there were 1,832 practicing psychiatrists in 2021, with 22 government hospitals and around 5,209 beds. The number of outpatients and emergency department visits in general and central hospitals specializing in psychiatry and neurology during that year reached about 259,458 citizens, with approximately 1,866 patients admitted.
In his discussion with Zawia3, Osama Abdelhay, head of the Egyptian Medical Syndicate, highlighted that the General Secretariat for Mental Health and Addiction Treatment is the entity responsible for detailed data on psychiatrists and their geographical distribution. While the Ministry of Health relies on the syndicate’s reports for its statistical bulletins, attempts to reach responsible authorities have yielded no responses thus far, as the ministry did not respond to our inquiries.
In an official statement by the Ministry of Health in July 2023, spokesperson Hossam Abdelghaffar noted that the number of mental health facilities in Egypt reached 223, with a total capacity of 11,628 beds, including 1,747 addiction treatment beds in government facilities and 4,508 in private institutions.
Zawia3 also reached out to Menan Abdelmaksoud, Secretary General of the General Secretariat for Mental Health and Addiction Treatment, but she declined to cooperate, citing the need for prior approval from the Ministry of Health. Despite attempts to reach Abdelghaffar again, we received no response by the time of this report’s publication.
In a related context, Abdelghaffar later clarified in a statement that the number of registered specialists and consultants in the National Council for Mental Health amounted to 849, in addition to 187 independent medical evaluators and 70 inspectors in regional mental health councils. This figure totals 1,106 psychiatrists providing mental health services nationwide.
The statement further indicated that 55,057 cases were admitted to mental health facilities last year, with 19,528 cases in government institutions and 35,529 in private institutions.
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Psychiatrists’ Health
Dr. Mustafa Mohamed, now in his thirties, recalls the period after his graduation when he worked 27 shifts a month, each lasting 24 hours. “I would go home only three days a week, and despite wanting to learn and earn a good salary to build a future and start a family, I have not been able to achieve that so far,” he says.
Mahmoud Ali, a psychiatry consultant from Asyut, had a similar experience before migrating to Australia four years ago. “I worked 24-hour shifts for only 86 EGP, and when the number of shifts exceeded ten per month, I received no additional pay,” he shares, explaining that he could not refuse these extra shifts to avoid penalties.
After migrating to Australia, Mahmoud’s situation changed drastically. “The difference is huge. In Australia, I am paid for every extra minute I work, and I earn at least 130 dollars (6,288 EGP) for a single phone consultation,” he says. He added that the treatment of doctors in Egypt cannot be compared to the situation abroad, describing the conditions for doctors in Egypt as akin to “servitude.”
In 1997, a presidential decree consolidated all mental health hospitals under unified management supervised by the General Secretariat for Mental Health and Addiction Treatment, covering hospitals such as Abbasiya, Helwan, and Khanka in Greater Cairo, as well as Al-Maamoura and Abbas Helmy in Alexandria, along with other hospitals in the Delta and Canal cities.
Mahmoud Fouad, Executive Director of the Egyptian Center for the Right to Medicine, comments on the migration of Egyptian psychiatrists. He states, “Psychiatrists, like their colleagues in other specialties, suffer from low wages and long hours without incentives.” He notes that the General Secretariat for Mental Health and Neurology, affiliated with Egypt’s Ministry of Health, has not considered improving these doctors’ standards through support, education, or development in their field to provide better patient care. Additionally, the absence of a specific budget for psychiatrists makes migration abroad the best option, with little likelihood of their return.
Fouad adds that psychiatry in Egypt suffers from a shortage of doctors, requiring ongoing studies to improve practitioners’ skills—a challenge given the high cost of education. He highlights that Gulf countries have capitalized on this gap by offering attractive packages to Egyptian psychiatrists, leading to a severe shortage of qualified staff in Egyptian hospitals.
Increase in Resignations
In April 2022, the Egyptian Medical Syndicate released a report indicating a notable increase in doctors resigning and obtaining “free doctor” certification. In 2016, approximately 1,044 doctors resigned, with the number rising to 2,549 in 2017. By 2018, 2,612 doctors resigned, and in 2019, resignations further increased to about 3,507. In 2020, 2,968 doctors resigned, while in 2021, the number reached a high of 4,127, bringing the total resignations between 2019 and 2022 to 11,536 doctors. However, the report did not specify the number of psychiatrists within these figures.
Among these doctors was Marwa Abdel-Aal, a psychiatrist from Sharqia, who moved to England with her husband, also a doctor, a year and a half ago. She explains that the primary reason Egyptian doctors migrate is low wages, as salaries in government hospitals sometimes do not exceed 3,000 EGP per month, which is insufficient to live on. “This salary is completely inadequate given the current economic circumstances,” she says.
She added that there is a global demand for psychiatrists, which has opened up numerous opportunities abroad. She explained that working abroad means fewer hours and higher salaries, reducing the mental exhaustion doctors in Egypt endure due to the heavy caseloads. “In England, the salary is sufficient to live comfortably without stress. I work from 9 a.m. to 5 p.m. and don’t have to work in multiple places to cover my expenses,” she explains.
Similarly, Iman Ahmed (a pseudonym), a psychiatrist from Mansoura in Dakahlia, had to leave for England six years ago due to low pay and the difficulty of balancing her professional and personal life. “In Egypt, if you want a decent salary, you have to sacrifice part of your family life. That’s why I chose to leave,” she says.
Before leaving, she earned only 2,000 EGP per month despite holding a master’s degree. Iman decided to emigrate because of the high workload and the limited opportunities for doctors in rural areas. She explained that she could not travel to Cairo for scheduled training due to the distance and her responsibilities as a mother.
Under the 2021 amendments to the Patient Care Act, psychiatrists cannot practice without a license from the Ministry of Health, which requires meeting specific criteria, including holding an appropriate academic degree and passing academic and practical training.
Mahmoud Fouad, Executive Director of the Egyptian Center for the Right to Medicine, comments that the cost of training and diplomas for psychiatrists has become prohibitively high, pushing many to migrate. He stressed that migration has become the easiest option for doctors who cannot advance their skills in Egypt. “Doctors now seek migration as the only way to improve their living and professional conditions, resulting in an increasing shortage of available psychiatrists in Egypt,” he said, highlighting the scarcity of doctors remaining in the country.
Dr. Mahmoud Ali, who migrated to Australia, notes a significant difference in living standards and wages compared to Egypt. “In Australia, doctors are treated as consultants with a salary on par with ministers,” he says. Before migrating, he was exhausted from seeing up to 50 patients daily due to a shortage of psychiatrists in Egypt.
Marwa Abdel-Aal agrees, explaining that long working hours cause both mental and physical exhaustion for doctors, turning their lives into a machine for making money just to live with dignity. She points out that many recent graduates prefer to pursue higher education abroad, where they receive more support and recognition. “I left without completing my master’s degree in Egypt, choosing instead to obtain it in England,” Marwa says.
She adds that most institutions in England offer mental health services for mental health workers, including access to a therapist. She expresses concern that the migration of doctors to the Gulf and Europe will have long-term negative effects.
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Shortage of Psychiatrists
According to estimates by Professor Ahmed Okasha, a psychiatrist, Egypt has only one psychiatrist per 50,000 citizens, with approximately 2,000 psychiatrists working in public and private hospitals. This figure is extremely low relative to the population, indicating a substantial gap in mental health care provision.
Mahmoud Fouad, Executive Director of the Egyptian Center for the Right to Medicine, notes that Egyptian psychiatrists suffer from neglect and poor working conditions. As a former board member of Khanka Psychiatric and Neurological Hospital, Fouad explains that “doctors’ conditions were far from satisfactory,” citing a lack of modern treatments, inadequate training, and a shortage of essential drugs for patients.
Psychiatrist Mustafa Mohamed highlights the challenges doctors face in developing their skills. With training costs calculated in dollars, the price of courses has risen by at least five times. “My skills will deteriorate because I can’t keep up with medical advancements due to this rise in costs, and the only solution is to raise consultation fees, which could be a barrier for the patients I aim to help,” he states.
Although the decision to migrate was not easy for many psychiatrists, many were compelled to take this step to improve their financial and academic standing and seek better opportunities. While the government announces steps to support the mental health system in Egypt—such as opening 230 counseling offices in primary health centers across seven governorates and receiving over 30,000 consultation requests since April 2024—the challenges facing psychiatrists, who struggle with low wages and high living costs, have not received sufficient attention, according to the doctors we spoke with.
