Comparative attitude and plans of the medical students and young Nepalese doctors

Seeking greener pastures: attitudes towards brain drain among turkish medical students

BACKGROUND

Medical brain drain is a critical issue for healthcare systems worldwide. This study investigated attitudes toward brain drain and influencing factors among medical students at Pamukkale University.

METHODS

A cross-sectional study was conducted with 1,129 students (80.8% response rate) during the 2021-2022 academic year. Data, including sociodemographics, views on studying/working abroad, and the 16-item Brain Drain Attitude Scale (BDAS), were collected via a structured online questionnaire. Descriptive statistics, the Mann‒Whitney U test, the Kruskal‒Wallis test, and multiple linear regression were used for analysis.

RESULTS

Over half (52.9%) of the students desired to work abroad, motivated by better working conditions (73.7%), higher salaries (57.8%), and social living conditions (66.8%). The BDAS score (mean = 61.26) indicated a moderate tendency toward brain drain. Key factors associated with higher brain drain attitude scores included financial constraints (B = 0.389, p = 0.001), independent living (B = 0.296, p < 0.001), initial reluctance to attend medical school (B = 0.598, p < 0.001), having friends or relatives abroad (B = 0.347, p < 0.001), considering exchange programs (B = 1.004, p < 0.001), and moderate foreign language proficiency (B = 0.300, p < 0.001).

CONCLUSION

A significant portion of Turkish medical students expressed a desire to work abroad, driven primarily by better working conditions, social living conditions, higher salaries, and excessive workloads in Türkiye. Financial constraints, independent living, dissatisfaction with medical school choices, and social networks with international experiences emerged as significant factors influencing attitudes toward brain drain.

Global Brain Drain: How Can the Maslow Theory of Motivation Improve Our Understanding of Physician Migration?

The migration of physicians from low-resource to high-resource settings is a prevalent global phenomenon that is insufficiently understood. Most low-income countries are severely understaffed with physicians, and the emigration of the already limited number of physicians to other countries can significantly reduce access to healthcare in the source country. Despite a growing interest in global capacity building in these countries by academic and non-governmental organizations in high-income countries, efforts to stem physician migration have been mostly unsuccessful. The authors reviewed the current literature for the motivational factors leading to physician migration in the context of Maslow’s hierarchy of human needs. Our study found that financial safety needs were major drivers of physician emigration. However, factors related to self-actualization such as the desire for professional development through training opportunities and research, were also major contributors. These findings highlight the multifactorial nature of physician motivations to emigrate from low-resource countries. Maslow’s Theory of Motivation may provide a useful framework for future studies evaluating the concerns of physicians in low-income countries and as a guide to incentivize retention.

Future career plans of Malawian medical students: a cross-sectional survey

BACKGROUND

Malawi has one of the lowest physician densities in the world, at 1.1 doctors per 100,000 population. Undergraduate training of doctors at the national medical school has increased considerably in recent years with donor support. However, qualified doctors continue to leave the public sector in order to work or train abroad. We explored the postgraduate plans of current medical students, and the extent to which this is influenced by their background.

METHODS

A self-administered questionnaire was developed after discussion with students and senior staff. This included questions on background characteristics, education before medical school, and future career plans. This was distributed to all medical and premedical students on campus over 1 week and collected by an independent researcher. One reminder visit was made to each class. Chi-squared tests were performed to investigate the relationship of student characteristics with future career plans.

RESULTS

One hundred and forty-nine students completed the questionnaire out of a student body of 312, a response rate of 48%. When questioned on their plans for after graduation, 49.0% of students plan to stay in Malawi. However, 38.9% plan to leave Malawi immediately. Medical students who completed a 'premedical' foundation year at the medical school were significantly more likely to have immediate plans to stay in Malawi compared to those who completed A-levels, an advanced school-leaving qualification (P = 0.037). Current premedical students were slightly more likely to have immediate plans to work or train in Malawi compared to medical students (P = 0.049). However, a trend test across all the years was not significant. When asked about future plans, nearly half of students intend to work or train outside Malawi.

CONCLUSIONS

The majority of respondents plan to leave Malawi in the future. The effectiveness of the substantial upscaling of medical education in Malawi may be diminished unless more medical students plan to work in Malawi after graduation.