Migration inflows to Bulgaria increased quickly in 2013: official data based on changes of permanent residence suggest that close to 19 000 persons immigrated in 2013, an increase by 32% over the level in 2012 (14 000). The migration outflow also rose, albeit less strongly – it approached 20 000 persons in 2013, up from 17 000 in 2012. These figures imply net emigration of 1 000 persons in 2013. Only in 2011, inflow and outflow had still stood at 5 000 and 10 000 persons, respectively, combining to a net emigration of 5 000 persons. However, figures based on changes of permanent residence might underestimate the true scale of migration flows. Incoming migrants in 2013 originated most frequently from Turkey, Syria and the Russian Federation. 70% of emigrants were younger than 35 years, and there is evidence that several hundred doctors and other highly trained medical staff have emigrated each year since 2010.