Conventional wisdom holds that the ‘brain drain’ of health professionals from Africa is deeply damaging to the continent. Recently, a group of North American and European neo-liberal economists has challenged this conventional wisdom, variously arguing that the negative impacts are highly exaggerated and the compensating benefits many. The benefits include various forms of “diaspora engagement” in which those who have left then engage through sending remittances, direct investment, knowledge and skills transfer, return migration and involvement in diaspora associations. This paper examines the case of South African physicians who have left South Africa. South Africa provides an ideal case for examining the conflicting viewpoints on the health brain drain given the significant loss of physicians the country has experienced over the past two decades. A 2000 global survey of the location of physicians found that as many as 7,363 South African-trained doctors (or 21% of the total number in practice) were living and practising abroad. In 2005, the OECD estimated that more than 13,000 South African trained physicians were working in OECD countries, of whom 7,718 were in the United Kingdom, 2,215 in the United States, 1,877 in Canada and 1,022 in New Zealand. More recent data from Canada indicates that there were 2,193 South African physicians in that country in 2009. The research reported in this paper, consists of a survey of 415 South African doctors in Canada conducted in 2009-10 (representing almost 20% of the total number working in Canada.)