Abstract
BackgroundThe increasing migration of health professionals to affluent countries is not a recent phenomenon and has been addressed in literature. However the various facets of physician migration from Pakistan, the third leading source of International medical graduates has not been rigorously evaluated. The objective of the current study was to survey final year students and recent medical graduates in Lahore, Pakistan about their intentions to train abroad, their post training plans as well as to identify the factors responsible for their motivation for international migration.MethodA self administered structured questionnaire was developed to collect respondents' demographic and educational characteristics, intention to train abroad, their preferred destination & post training intentions of returning to Pakistan. Various influencing factors which impact on medical graduate's motivation to train abroad or stay in Pakistan were explored using a 10 point scale. SPSS software was used for data entry and analysis.ResultsOf the 400 eligible respondents, 275 responded (response rate 68.7%). One hundred and sixty six respondents (60.4%) intended to train abroad either for a specialty (54.9%) or a subspecialty (5.5%) The United States and United Kingdom were the most preferred destination. While 14.2% intended to return to Pakistan immediately after training, a significant percentage (10%) never intended to return to Pakistan or wished to stay abroad temporarily (37%). Professional excellence and establishing quickly in the competitive market were the most important goal to be achieved by the respondents for intention for postgraduate training abroad. The most common reasons cited for training abroad were the impact of residency training on future career (mean score 8.20 ± 2.3), financial conditions of doctors (mean score 7.97 ± 2.37) and job opportunities (mean score7.90 ± 2.34).ConclusionAn alarming percentage of medical graduates from Lahore, Pakistan intend to migrate for post graduate training, mainly to United States. A significant proportion wished to stay in the host country either temporarily or indefinitely. Impact of residency abroad on future career, financial conditions of doctors, job opportunities and better working conditions were some of the motivating factors behind the migration.
Highlights
The increasing migration of health professionals to affluent countries is not a recent phenomenon and has been addressed in literature
While 14.2% intended to return to Pakistan immediately after training, a significant percentage (10%) never intended to return to Pakistan or wished to stay abroad temporarily (37%)
The most common reasons cited for training abroad were the impact of residency training on future career, financial conditions of doctors and job opportunities
Summary
The increasing migration of health professionals to affluent countries is not a recent phenomenon and has been addressed in literature. The various facets of physician migration from Pakistan, the third leading source of International medical graduates has not been rigorously evaluated. Pakistan ranks 129th of the 174 nations on the Human Development Index, a measure of the achievement of a country in terms of health, longevity, education and standards of life”[5]. It is struggling with double burden of disease; an ongoing burden of infectious diseases and malnourishment while the cardiovascular disease, cancer etc are on the rise. People who can resume role of leaders to reform & stabilize the health system and drive changes in academics and research are lost putting enormous pressure on an already vulnerable healthcare system
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