Turnover intention of foreign trained physicians in German rehabilitation facilities

Germany's medical specialist shortage is an acute challenge, especially in the rehabilitation segment. One countermeasure is to recruit foreign trained physicians (FTP), but high turnover of FTP is a burden on the departments that train them and integrate them professionally. Preliminary research showed that currently one in three physician positions in German Pension Insurance (DRV) contract facilities is filled by FTP. This paper examines the turnover intention of FTP in German rehabilitative departments. In spring 2022, we conducted an online survey of FTP that captured sociodemographic and professional biographical data, turnover intention, satisfaction, difficulties with professional integration and structural characteristics. The data was evaluated in a subgroup analysis using chi-square tests. The sample includes n = 145 FTP, 119 stating no turnover intention and 27 with turnover intention. More than half of FTP with turnover intention wished to move to an acute care hospital. They are significantly (p < 0.05) younger, have worked in Germany and in the institutions for a shorter time, and have studied in more countries than FTP without turnover intention. The latter are proportionally more likely to have a German specialist title and management responsibilities. FTP with turnover intention are far less satisfied, particularly with career prospects and institution location. Structurally, FTP with turnover intention are proportionately more likely to be based in peripheral regions than conurbations, which are where all FTP without turnover intention are based. FTP with turnover intention have reported a much higher rate of discrimination by non-physician colleagues. KEY MESSAGES: • The results reveal a group of ‘established FTP’ whose professional integration has been successfully completed. • FTP with turnover intention are comparatively younger, career-oriented physicians for whom work in the rehabilitation facility is a career springboard to gain a foothold in acute care clinics.