Abstract
ObjectiveTo explore migrant physicians’ conceptions about working in rural and remote areas in Sweden to understand what influences their motivation to work in these areas.Method and materialThe study employed a qualitative approach with semi-structured interviews with 24 migrant physicians. Transcripts were thematically analysed.ResultsConceptions were identified about foremost work content and tasks, and about living in rural and remote areas. Work content and tasks related to the health care systems, type of health care facility, duties, specialty, resources, patient population, colleagues, and professional development. Conceptions about living concerned geographical characteristics, people living in rural and remote areas, opportunities for travelling, family, leisure activities, social life, and language skills. Conceptions seemed to be influenced by individual, professional and societal aspects from both previous countries and Sweden. Conceptions and biographical aspects both appeared to affect motivation.DiscussionMotivation regarding working in rural and remote areas appeared to be influenced by conceptions of these areas. A specific type of place could be understood as being able to provide (or not) the external conditions needed for fulfilling needs and reaching goals, whether professional or personal, and as a tool for reaching or facilitating the achievement of these. Conceptions of an area can hence affect motivation and choices for where to work and live. However, biographical aspects also impact motivation. Our results indicate that positive rural experience in the recipient country might be a predictor for motivation.ConclusionProfessional and personal life and are intertwined. Conceptions about an area influence willingness to work there. Willingness is also affected by, and intertwined with, other aspects such as previous experiences, age, marital status and family circumstances.
Highlights
The absence of physicians in rural and remote areas is a global challenge [1,2,3,4,5,6,7,8,9]
We found that migrant physicians’ (MPs) who conceived of rural areas as having fewer opportunities for their children had a decreased motivation to work in such areas
Our results indicate that MPs with a positive experience of rural and remote areas in Sweden might be motivated to work in these areas
Summary
The absence of physicians in rural and remote areas is a global challenge [1,2,3,4,5,6,7,8,9]. Different initiatives have been undertaken to address the shortage of physicians in rural areas, including rural practice during medical education [8], financial incentives [8] or supporting physicians professional development in rural and remote areas via interventions [10]. Another strategy is to establish cooperation and networks among universities, governments and rural areas [11]. Regarding IMGs factors that have been identified affecting their attitudes towards working in rural areas include aspects related to their employment and career plans, and to the families in terms of spousal employment and schooling [5]. Educated health professionals tend to live and work in urban areas [5, 9, 12], as migrants in general do [13] even though the notion of ‘ruraloften carries idyllic and positive connotations, at least in the west of Europe [14,15,16]
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