Brain Drain Research Articles

Predictive Model for Medical Assistance

Medical tourism has emerged as a prominent global healthcare phenomenon, driven by various factors such as cost differentials, quality of care, and accessibility. The first aspect of medical tourism is the transnational use of healthcare services, which is frequently driven by financial savings and shortened wait times. Patients from high-income nations frequently go to less expensive locations for elective surgery, while people from low-income nations may look overseas for cutting-edge medical care due to a lack of local healthcare infrastructure. Patients who choose medical tourism locations do so because of the high quality of the care they receive. Patients are enticed to particular locations by accredited healthcare facilities and highly trained medical personnel. However, maintaining uniform quality across many healthcare systems is still difficult. The economic impact on the countries of origin and destination makes up the third aspect of medical tourism. Through higher healthcare sector income, tourism-related activities, and job creation, medical tourism can promote economic growth in destination nations. On the other hand, source nations could experience issues with the distribution of healthcare resources and the "brain drain" of medical specialists. The relevance of ethical considerations in medical travel cannot be overstated. To preserve the credibility of medical tourism, issues relating to informed consent, patient safety, and the equal distribution of healthcare resources must be properly addressed. The COVID-19 pandemic's effects on international travel and healthcare systems are just a few of the aspects that are taken into account in this abstract while discussing the future of medical tourism. It emphasises the necessity of international cooperation to create uniform policies, rules, and moral frameworks that guarantee the safety of patients taking part in medical tourism.

Reverse mentoring – a useful tool for integrating into the system and making a change

Introduction: Reverse mentoring is useful for closing the generational gap,improving inclusion, and developing skills. Here, a junior team membermentors a senior team member. The scheme run by the Future LeadersProgram is open to International Medical Graduates (IMGs) in Yorkshireand Humber. The aim is to close the differential attainment gap byencouraging Equality, Diversity, and Inclusion (EDI) conversations.Method: Matching is done by MentorNet®. Mentor training consists ofhandbook, induction, and supervision meetings. We planned for threevirtual meetings within 6 months.• Session 1 – Aims and lived experience.• Session 2 – What does it take to feel safe, valued, and accepted?• Session 3: Setting up IMGs to succeed and the impact of the first placementon their careers.Discussion: Reverse mentoring is beyond sharing bad experiences as itcreates avenues for reflection and insights on how to better integrate intothe system.We do not need to have a bad experience before we advocate for EDIin our workplace. Sharing positive experiences is a powerful tool.Pairing Nigerian Junior doctors in the UK with senior doctors inNigeria would reduce the impact of ‘brain drain’ and be a positive toolfor exchanging knowledge and skills with the Nigerian workforce.’

BRIDGING THE SKILL GAP BETWEEN THE ACADEMIA AND INDUSTRY: A STUDY ON

Education is a crucial component of our lives. In addition to teaching morals and virtues that make students better global citizens, education also helps students become technically proficient so they may compete in the outside world. The ever-evolving landscape of industry demands a workforce equipped with adaptable and relevant skills, yet the traditional model of academia often struggles to keep pace with these dynamic requirements. This paper explores the multifaceted challenge of bridging the gap between academia and industry in terms of skill development. This paper concludes by advocating for a holistic approach that involves stakeholders from academia, industry, and government, fostering a culture of continuous learning, and redefining the metrics of success to encompass not only academic achievements but also practical skills and industry readiness. Skill development is indispensable part of education system to bridge the skill gap between industry and academia which is also confirmed by p- values for seven opinions by Chi Square test are 0.02, 0.0245, 0.0232, 0.0134, 0.0134, 0.0134, 0.00342 and 0.0245 conducted at LPU campus. For statistical Analysis, I have used ORIGIN 2019 Software. Through these concerted efforts, the gap between academia and industry can be narrowed, ensuring a more seamless transition for graduates into the workforce and enhancing the overall economic vitality and innovation ecosystem. The study also provides a roadmap of utilizing Learning Factories as an integral part for the Indian technical academic system. Key Words: skill development, academia, skill gap, brain drain, Industry

Brain Drain: A Cross-Sectional Study Evaluating Migration Intentions of Neurosurgery Trainees in Pakistan.

Background Pakistan has a significant proportion of medical graduates who intend to leave the country for better opportunities abroad, leading to a brain drain. However, the push and pull factors within neurosurgery remain unexplored, emphasizing the need for evaluation to enact policy changes. Materials and Methods We conducted a nationwide survey across 22 College of Physicians and Surgeons of Pakistan accredited neurosurgery training centers in all provinces of Pakistan. SPSS version 26 and STATA 15 were used for data analysis. Results We collected responses from 120 neurosurgery trainees across Pakistan. Trainees were categorized into two groups: those intending to leave (64%) and those intending to stay (36%) in Pakistan. A significant association was observed between the availability of fellowship training in the residents' hospital and the decision to leave or remain in Pakistan ( p = 0.034). About 67.5% of our respondents did not have any publication, and among the intention to leave group, a greater percentage had academic involvement, when compared with the stay group. A significant association ( p = 0.012) was also observed between the decision to leave or remain in Pakistan and the number of publications in nonindexed journals. Conclusion There remains a need for improvement in the standard of training provided by neurosurgery programs across the country. Our study found that disparities in research and academic exposure, as well as the lack of fellowship opportunities, may serve as stimuli for residents to leave Pakistan.

Nonprofit Human Resources: Crisis Impacts and Mitigation Strategies

This study empirically evaluates the relationships between the state and human service nonprofits’ human resources during a crisis. We employ qualitative content analysis to critically assess the experiences of 31 nonprofits that experienced the 2015 to 2017 Illinois Budget Impasse. We evaluated the nonprofits’ strategic human resource management implications through a resource dependency lens at three levels: micro-, meso-, and macro-. Human service nonprofits pull from a toolbox of strategies in surprising ways. Strategy choices were intrinsically linked to the impacts experienced by the individual workers (micro-) and organization (meso-). Micro-level impacts included additional emotional labor and reduced benefits, while meso-level impacts included loss of capacity and short-term planning changes. Finally, the sector-level impacts included a multipronged brain drain of the nonprofit human resource industry. The findings are helpful for nonprofit employees, managers, policy-makers, and anyone concerned about the delivery of social services by nonprofits during crises.

Abstract PO4-20-01: A PROSPECTIVE PILOT STUDY OF MAMMOGRAPHIC PREDICTION OF WOMEN’S RISK (M-POWER) IN NIGERIA

Abstract Background There have been no sustained efforts at stemming the rising incidence and mortality from breast cancer in sub-Saharan African countries like Nigeria. Mammography is the gold standard for breast cancer screening and is associated with improved survival particularly among women 50 to 69. Reports from various parts of Nigeria show very low mammography screening uptake. Causes include lack of geographical access, financial issues (less than 5% of the population is covered by the National Health Insurance Scheme), lack of awareness and the increasing expertise gap from the continued brain drain, despite the already low number of radiologists in the country. Given these obstacles, our long-term goal is to devise a rational basis for identifying mammographic risk categories so that this resource can be deployed cost-effectively. We propose to carry out a 5-year prospective mammographic study in Nigerian women and to use machine learning to develop a risk prediction algorithm, so that following a single screening mammogram, the appropriate frequency of subsequent mammograms can be determined. Our immediate goal is to examine the feasibility of performing such a study. To this end, we have initiated a cross-sectional pilot study that will recruit up to 2000 women in multiple urban centers in Nigeria. Objective: To explore feasibility of creating a digital mammography image database representative of the radiological features of the breast of Nigerian women. Objective: To explore feasibility of creating a database that can be used to inform a predictive mammographic risk model for breast cancer and identify the appropriate population that will benefit from breast cancer screening in Nigeria. Design This is a prospective, open-label, cross-sectional pilot study in 2000 eligible women in Nigeria and will include a single screening mammography examination. The mammography images will be read by the study radiologist. The Pilot phase will determine the feasibility and aid in the design of the of the Extension phase in which up to 20,000 participants will undergo yearly mammography examination for 5 years. Incident cases of breast cancer during the study period will permit the development of deep learning algorithms for predicting the risk of breast cancer in this population. Main Eligibility Criteria: Inclusion Criteria All consecutive women aged ≥40 years and < 65 years presenting for screening mammography at the participating institutions will be eligible. Signed study-specific written informed consent. Exclusion Criteria Complaint of a focal dominant lump or a bloody or clear nipple discharge. History of breast implants. Any woman who is pregnant or has reason to believe that she might be pregnant. Statistical Methods Analyses of continuous data will be summarized using descriptive statistics where the following parameters will be reported: Number of observations, Number of missing observations, Mean, Median, Standard deviation (SD), Minimum (Min), Maximum (Max) Categorical data will be presented with absolute and relative frequency (n and %). Present Accrual and Target accrual Two hundred ninety-six women have been enrolled and screening digital mammographic images using GE Digital mammography equipment have been obtained on all participants at 2 study sites in 2 cities in Southern Nigeria. The target accrual is 2000 participants over 12 months. Conclusion Our preliminary experience to date suggests the feasibility of proceeding with a larger prospective study to define mammographic risk groups in Nigerian women which will permit the rational allocation of resources for breast cancer prevention activities in this underserved population. Contact Information: Dr Toyin Shonukan at tshonukan@yemanjacancercare.org Citation Format: Oluwatoyin Shonukan, Hyelakumi Ibrahim, Esther Udoh, Wahab Egbeolu, Kanyinsola Oyeyinka, Jonas Haggstrom. A PROSPECTIVE PILOT STUDY OF MAMMOGRAPHIC PREDICTION OF WOMEN’S RISK (M-POWER) IN NIGERIA [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-20-01.

Gender Difference of Burnout in Physicians Working in Tertiary Care Hospital: A Cross-Sectional Study.

Burnout and emotional exhaustion are becoming common among health workers in the busy teaching hospitals due to increased workload and the dearth of human resource. This study aimed to determine the causes of burnout among doctors and across gender differences. This was a descriptive cross-sectional study conducted in the Fauji Foundation Hospital, Rawalpindi, Pakistan, from 1st July to 30th September 2022. Two hundred and forty-five randomly recruited doctors who filled out self-administered questionnaires were included in the study. Independent samples t-test was used for comparison of the mean emotional burnout score. Female doctors felt more emotionally drained, more fatigued, and more worn out from work than male doctors (p < 0.05). Overall emotional exhaustion was also higher in female doctors (p < 0.05). This situation was more serious during the COVID-19 pandemic. Gender-sensitive environments, workplace policies, and necessary interventions will save physicians' burnout and brain drain. Emotional burnout is greater in female doctors as compared to their male counterparts. This evidence not only calls for prevention and treatment but also certain service-related reforms to facilitate female physicians to balance out their work and family lives more effectively. Key Words: Physicians, Emotional exhaustion, Burnout, Gender difference, Pakistan.

Nurses' Awareness about Brain Drain and Its Determinants Factors at Main Mansoura University Hospital

Nurses' Awareness about Brain Drain and Its Determinants Factors at Main Mansoura University Hospital

RESEARCH OF STUDENTS' ORIENTATIONS REGARDING INTERNATIONAL MIGRATION

The purpose of the article is to identify and compare the essential characteristics of migration attitudes among Ukrainian and Polish students, and to outline trends in their development in the future. Methodology. The subjects of the research are students of various courses and specialties of the Lviv National Environmental University and the University of Life Sciences in Lublin (Poland). To collect empirical information, an online survey was conducted in October 2023, with 187 Ukrainian and 187 Polish students (n=374) participating. The questionnaire consisted of 10 questions, the results of which will be analysed in this study. The survey results showed that students of both higher education institutions have a rather positive attitude towards international migration processes, both women and men. Possible manifestations of student mobility can be seen as a fact that characterises the social role of modern students. Practical implications. The work is a study of young people's attitudes to migration, i.e., it is prospective, not retrospective. Such research can be extremely useful for the development of an effective socio-economic policy of the country. Since the research results reflect the moods of young people, they cannot claim to be highly predictive. However, a vision of what might happen if people's hypothetical aspirations were to become reality can be a powerful argument for politicians and statesmen in developing migration-related policies, both now and in the future. Value/Originality. Survey data from different age groups of students at two universities allow for a better understanding of their attitudes towards migration, immigration, and mobility and a comparison of these indicators in a peaceful country and in times of war. Possible manifestations of student mobility should be seen as a fact that characterises the social role of modern students. The problem, however, is that there are currently no effective mechanisms for managing these processes. There are also no mechanisms capable of ensuring the systemic effectiveness of communication links between different actors at the intercultural level, with the possibility of meeting their socio-cultural, professional and material needs in the process of socialisation of modern youth, as well as for the adequate reproduction of the intellectual potential of society as a whole. However, student emigration cannot be viewed exclusively from a negative perspective, as a "brain drain", although it is obvious that if students who study and work abroad do not return, the country loses part of its intellectual potential (Adamic, Dyachuk, 2023; Tokar, 2022). If to consider the return and emigration not as a purely territorial movement of students, but as a movement of intellectual resources, one can identify a positive trend: significant intellectual potential in the form of ideas, technologies and professional knowledge is returning to the country.

Strengthening healthcare through family medicine training in The Gambia: The journey so far.

According to the World Health Organizations (WHO) family medicine forms the bedrock upon for accessible, affordable and equitable healthcare for any country. The need for family doctors is more acute for low income countries like The Gambia. More so that The Gambian health infrastructure is suboptimal and appropriate health personnel is low. This is worsened by brain drain leading to poor health indices. Despite these challenges and more, the department of Family Medicine was accredited for training in the Gambia with improved infrastructure (at the training centre), with 7 residents. Though there are still challenges there are also opportunities and strengths. There is therefore hope that the right personnel will be produced for an improved Gambian health system.

Navigating the Global Landscape: Dynamics and Impacts of Internationalization in Higher Education

The internationalization of higher education stands as a multifaceted phenomenon characterized by a myriad of driving forces, mechanisms, and consequential impacts. This paper seeks to elucidate the intricate nature of this global trend, exploring its diverse dimensions and evaluating its implications for institutions, stakeholders, and the broader socio-economic landscape. Central to the discourse on internationalization is the evolution of higher education in response to globalization. As the world becomes increasingly interconnected, institutions of higher learning face growing imperatives to engage in cross-border collaborations, foster cultural diversity, and prepare students for a globally interconnected workforce. The paper navigates through the underlying rationales propelling this transformation, shedding light on the economic, social, and academic motivations that drive institutions towards internationalization strategies. The mechanisms facilitating internationalization manifest through a spectrum of initiatives, including but not limited to student mobility programs, collaborative research ventures, cross-border partnerships, and curriculum internationalization. This paper delves into the efficacy of these strategies, evaluating their impact on enhancing academic quality, fostering intercultural competencies, and promoting knowledge exchange across borders. Furthermore, it examines the challenges and opportunities inherent in implementing these mechanisms, considering issues of equity, linguistic diversity, and varying academic standards across regions. A critical aspect of internationalization is its impact on stakeholders within higher education. Faculty members, administrators, and students experience a transformed academic landscape as they engage in global collaborations, navigate diverse cultural contexts, and adapt pedagogical approaches to accommodate internationalized curricula. This paper assesses the roles and experiences of these stakeholders, exploring how they contribute to and are affected by the internationalization agenda. While acknowledging the transformative potential of internationalization, this paper critically examines its limitations and ethical considerations. It addresses issues of cultural hegemony, power imbalances in global knowledge production, and the commodification of education. Moreover, it discusses the potential for unintended consequences, such as brain drain from developing countries and the commercialization of higher education. In conclusion, this paper synthesizes the complexities of internationalization in higher education, offering insights into its multifaceted nature, driving forces, operational mechanisms, and far-reaching implications. By providing a nuanced understanding of this phenomenon, it aims to inform policy discussions, guide institutional strategies, and stimulate further scholarly inquiry into the evolving landscape of higher education in a globalized world. Received: 25 December 2023 / Accepted: 25 February 2024 / Published: 23 April 2024

Access to care in Afghanistan after august 2021: a cross-sectional study exploring Afghans’ perspectives in 10 provinces

BackgroundThe Taliban takeover in August 2021 ended a decades-long conflict in Afghanistan. Yet, along with improved security, there have been collateral changes, such as the exacerbation of the economic crisis and brain drain. Although these changes have altered the lives of Afghans in many ways, it is unclear whether they have affected access to care. This study aimed to analyse Afghans’ access to care and how this access has changed after August 2021.MethodsThe study relied on the collaboration with the non-governmental organisation EMERGENCY, running a network of three hospitals and 41 First Aid Posts in 10 Afghan provinces. A 67-item questionnaire about access to care changes after August 2021 was developed and disseminated at EMERGENCY facilities. Ordinal logistic regression was used to evaluate whether access to care changes were associated with participants’ characteristics.ResultsIn total, 1807 valid responses were returned. Most respondents (54.34%) reported improved security when visiting healthcare facilities, while the ability to reach facilities has remained stable for the majority of them (50.28%). Care is less affordable for the majority of respondents (45.82%). Female respondents, those who are unmarried and not engaged, and patients in the Panjshir province were less likely to perceive improvements in access to care.ConclusionsFindings outline which dimensions of access to care need resource allocation. The inability to pay for care is the most relevant barrier to access care after August 2021 and must therefore be prioritised. Women and people from the Panjshir province may require ad hoc interventions to improve their access to care.

Problems and Countermeasures of Faculty Construction in Private Colleges and Universities

Private higher education has developed into an important part of China’s higher education, and its development history can be described as a mixture of opportunities and challenges, achievements and confusion. The construction of private higher education faculty is faced with the challenges of serious brain drain, imbalance of talent structure, and low professional identity. Improving regulations and systems, completing supporting policies; standardising internal management, perfecting the guarantee system; strengthening the training of teachers and improving professionalism can effectively enhance the overall development of private higher education and achieve sustainable development.

Brain drain among Sri Lankan psychiatrists

Brain drain among Sri Lankan psychiatrists

The Importance of Higher Education Quality for Mobility Intentions. Evidence from a Western Balkan Country

ABSTRACT The Western Balkan region confronts a pronounced brain drain phenomenon, as its highly educated youth seek enhanced opportunities abroad. Grounded in the Social Cognitive Theory, this paper explores the decision-making process of Macedonian youngsters and scrutinizes how personal, social, and educational factors shape their mobility intentions. The findings driven from a survey encompassing 1150 university students, obtained through descriptive analysis using Python 3.7 and Partial Least Squares Structural Equation Modeling via a high-level SEM tool for R, reveal valuable insights that describe the complex interplay of students’ expectations, subjective norms, higher education quality, and professors’ availability, crucial elements in mitigating brain drain trends. The implications delineate explicit obstacles to developing higher education quality, accentuating the importance of tailoring university services to students’ needs in terms of a better understanding of the higher education system’s potential. The conclusions identify indicators that can assist in describing the youngsters’ mobility intentions, contribute to monitoring the brain drain process through higher education attributes, and highlight strategies for facilitating the system’s competitiveness.

Brain drain in pediatric anesthesiology: The geographic and demographic distribution of national origin among pediatric anesthesiologists in the United States.

American pediatric anesthesiologists have a long history of international volunteerism. However, the US healthcare system also benefits from the contributions of a large number of physicians who come from other nations to work within its borders. Despite this fact, little is known about the contribution of international medical graduates (IMG) to the pediatric anesthesiology subspecialty. To characterize the contribution of IMG to the field of pediatric anesthesiology in the United States, and to elucidate the geographic and demographic distribution of their national origins so as to understand the movement of skilled personnel between countries. Online physician directories of American children's hospitals were searched, and anesthesiologists were recorded for their national origin of medical education. International graduates were reported as a percentage of the pediatric anesthesiology workforce. Those attending medical colleges catering to American students ("offshore" medical schools) were analyzed separately from other IMGs. The cohort of non-offshore IMGs were analyzed for national and continental origins, and by national level of economic development. Of 1979 anesthesiologists analyzed, 397 attended medical school outside the United States, with 58 being from offshore schools. The remaining 338 represented 17.1% of the total pediatric anesthesiology workforce. They came from 58 countries on six continents. Of those, 65.1% attended medical school in low- and middle-income countries. International medical graduates, disproportionately from low- and middle-income countries, compose a large proportion of the US Pediatric Anesthesiology workforce. While these clinicians play a vital role in providing care for American children, the potential impacts of skilled physician loss on their nations of origin must also be considered.

Addressing brain drain through employee development: the interplay of organizational commitment, turnover intention, and individual differences in Lebanon’s health-care sector

Purpose The purpose of this study is to explore the influence of employee development programs on organizational commitment and its subsequent impact on employee turnover intention by considering individual differences for non-medical staff in a health-care institution in Lebanon. This study is relevant in understanding and addressing the brain drain phenomenon in the Lebanese health-care sector. Design/methodology/approach Correlational analysis and hierarchical regression were conducted to examine the relationships among employee development, organizational commitment and turnover intention. The study also made use of Process by Hayes to examine the existence of a moderated mediated relationship, which is the central point of this research. Findings Results indicate that when holding constant frequency of training, individuals high in commitment report a lesser intention to leave compared to those low in commitment. As a first-stage moderated mediation model is understood, this finding shows that the indirect effect of frequency of training on turnover intention through organizational commitment is moderated by individual differences. Originality/value The findings of this study, based on the human capital theory and social exchange theory, enhance our understanding of how employee development influences organizational commitment, predominantly in the context of Lebanon’s health-care sector grappling with brain drain. Additionally, by integrating both the self-determination theory and the expectancy theory, the study provides a new stance on how intrinsic motivational factors contribute to a better understanding of this complex relationship, especially considering the brain drain dilemma. This study addressed the gap in research studies that failed to explore the extent of the relationship between employee development and turnover intention by highlighting the importance of looking at the relationship as a moderated mediated type of relationship. The findings highlight the importance of organizations implementing the right development programs, as they yield higher levels of organizational commitment and subsequently decrease the intention to leave. This study is important for health-care organizations in Lebanon, suggesting a strategic approach to retain skilled professionals amidst ongoing migration challenges.

GOVERNMENT ARTIFICIAL INTELLIGENCE READINESS AND BRAIN DRAIN: INFLUENCING FACTORS AND SPATIAL EFFECTS IN THE EUROPEAN UNION MEMBER STATES

In the swiftly advancing field of Artificial Intelligence (AI), a field where every country aims to keep pace, significant disparities are observed in how different nations adopt AI. This study explores the deep, yet insufficiently studied, effects of AI on societal, economic, and environmental aspects. It particularly examines how brain drain influences governmental AI implementation capabilities, addressing a gap in existing literature. The study investigates the interplay between government AI implementation and brain drain, factoring in macroeconomic conditions, governance quality, educational levels, and R&amp;D efforts. Utilizing 2022 data from European Union countries, the research employs instrumental-variables regressions (2SLS and LIML) to counteract endogeneity and uses clustering methods for categorizing countries based on their government AI levels, alongside spatial analysis to detect cross-national spillovers and interactions. The findings reveal brain drain’s detrimental effect on governmental AI preparedness, highlight clustering tendencies, and identify spatial interdependencies. This paper underscores the need for strategic policy-making and institutional reforms to bolster government AI capabilities. It advocates for a paradigm shift in government frameworks post-New Public Management era, tailored to the new challenges posed by AI. The research, however, is limited to a single year and region, with constraints on data availability and indicator breadth.

Navigating brain drain in the Western Balkans

This article analyses the European Commission’s attitude vis-à-vis labour migration and brain drain in the Western Balkans. It uses Croatia’s post–EU accession experience as a focal point. Grappling with elevated migration rates and a decline in natality, the Western Balkan countries are an interesting region in terms of demographic change. Examining how much attention the Commission pays to brain drain, the article notes an increase since 2019; yet this focus appears disproportionately limited considering the potential repercussions for economic growth and social welfare in the countries experiencing it. The Commission’s predominantly negative view of brain drain emphasises that it is the nations affected that are responsible for avoiding it, thereby confirming that it is caused by a skills mismatch. The article recommends integrating brain-drain prevention measures into the enlargement process, and encourages the Commission to improve its focus on the matter in its annual candidate and potential candidate country progress reports.

Boomerang Entrepreneurs and the Declining Home City’s Place Image: Away on the Brain Drain Flow and Back on the Homesick Flow

Abstract Boomerang entrepreneurs (practicing and nascent entrepreneurs who return to their declining home cities after years away) may especially be an answer to the brain drain, suppressed innovation, and often tepid entrepreneurial ecosystem condition that plague declining cities such as U.S. Rust Belt cities. This conceptual article addresses how the declining home city’s place image might inform and promote a boomerang entrepreneur’s return migration and venturing decisions and with what implications for the place’s entrepreneurial ecosystem. Even given homesickness, this kind of return migration is unlikely unless prospective boomerang entrepreneurs revise their place images of their old hometowns. We conceptually develop and support propositions on the relationships between place image and brain drain, between affect and both place image revision and entrepreneurial intentions, and between place image revision and both return migration intentions and entrepreneurial opportunity recognition. We also discuss implications for microfoundations of entrepreneurial ecosystems in declining cities, place branding that can encourage boomerang entrepreneurs’ place image revision and return migration to the declining home city, and related research data collection.