Cargando…
Factors influencing trainee doctor emigration in a high income country: a mixed methods study
BACKGROUND: The Global Code of Practice on the International Recruitment of Health Personnel focuses particularly on migration of doctors from low- and middle-income countries. Less is understood about migration from high-income countries. Recession has impacted several European countries in recent...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5611654/ https://www.ncbi.nlm.nih.gov/pubmed/28942731 http://dx.doi.org/10.1186/s12960-017-0239-7 |
_version_ | 1783265993743663104 |
---|---|
author | Clarke, Nicholas Crowe, Sophie Humphries, Niamh Conroy, Ronan O’Hare, Simon Kavanagh, Paul Brugha, Ruairi |
author_facet | Clarke, Nicholas Crowe, Sophie Humphries, Niamh Conroy, Ronan O’Hare, Simon Kavanagh, Paul Brugha, Ruairi |
author_sort | Clarke, Nicholas |
collection | PubMed |
description | BACKGROUND: The Global Code of Practice on the International Recruitment of Health Personnel focuses particularly on migration of doctors from low- and middle-income countries. Less is understood about migration from high-income countries. Recession has impacted several European countries in recent years, and in some cases emigration has reached unprecedented levels. This study measures and explores the predictors of trainee doctor emigration from Ireland. METHODS: Using a partially mixed sequential dominant (quantitative) study design, a nationally representative sample of 893 trainee doctors was invited to complete an online survey. Of the 523 who responded (58.6% response rate), 423 were still in Ireland and responded to questions on factors influencing intention to practice medicine abroad and are the subjects of this study. Explanatory factors for intention to practice medicine in Ireland in the foreseeable future, the primary outcome, included demographic variables and experiences of working within the Irish health system. Associations were examined using univariable and multivariable logistic regression to estimate odds ratios for factors influencing the primary outcome. Qualitative interviews were conducted with 50 trainee doctors and analysed thematically, exploring issues associated with intention to practice medicine abroad. RESULTS: There were high levels of dissatisfaction among trainee doctors around working conditions, training and career progression opportunities in Ireland. However, most factors did not discriminate between intention to leave or stay. Factors that did predict intention to leave included dissatisfaction with one’s work-life balance (odds ratio (OR) 2.51; 95% confidence interval (CI) 1.53–4.10; P < 0.001); feeling that the quality of training in Ireland was poor (OR 1.82; 95% CI 1.09–3.05; P = 0.002) and leaving for family or personal reasons (OR 1.85; 95% CI 1.08–3.17; P = 0.027). Qualitative findings illustrated the stress of doing postgraduate training with inadequate supervision, lack of ring-fenced training time and pressures on personal and family life. CONCLUSIONS: Large-scale dissatisfaction with working, training and career opportunities point to systemic factors that need to be addressed by health workforce planners if Ireland is to retain and benefit from a motivated medical workforce, given trainees’ perceptions that there are better opportunities abroad. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12960-017-0239-7) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5611654 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-56116542017-10-11 Factors influencing trainee doctor emigration in a high income country: a mixed methods study Clarke, Nicholas Crowe, Sophie Humphries, Niamh Conroy, Ronan O’Hare, Simon Kavanagh, Paul Brugha, Ruairi Hum Resour Health Research BACKGROUND: The Global Code of Practice on the International Recruitment of Health Personnel focuses particularly on migration of doctors from low- and middle-income countries. Less is understood about migration from high-income countries. Recession has impacted several European countries in recent years, and in some cases emigration has reached unprecedented levels. This study measures and explores the predictors of trainee doctor emigration from Ireland. METHODS: Using a partially mixed sequential dominant (quantitative) study design, a nationally representative sample of 893 trainee doctors was invited to complete an online survey. Of the 523 who responded (58.6% response rate), 423 were still in Ireland and responded to questions on factors influencing intention to practice medicine abroad and are the subjects of this study. Explanatory factors for intention to practice medicine in Ireland in the foreseeable future, the primary outcome, included demographic variables and experiences of working within the Irish health system. Associations were examined using univariable and multivariable logistic regression to estimate odds ratios for factors influencing the primary outcome. Qualitative interviews were conducted with 50 trainee doctors and analysed thematically, exploring issues associated with intention to practice medicine abroad. RESULTS: There were high levels of dissatisfaction among trainee doctors around working conditions, training and career progression opportunities in Ireland. However, most factors did not discriminate between intention to leave or stay. Factors that did predict intention to leave included dissatisfaction with one’s work-life balance (odds ratio (OR) 2.51; 95% confidence interval (CI) 1.53–4.10; P < 0.001); feeling that the quality of training in Ireland was poor (OR 1.82; 95% CI 1.09–3.05; P = 0.002) and leaving for family or personal reasons (OR 1.85; 95% CI 1.08–3.17; P = 0.027). Qualitative findings illustrated the stress of doing postgraduate training with inadequate supervision, lack of ring-fenced training time and pressures on personal and family life. CONCLUSIONS: Large-scale dissatisfaction with working, training and career opportunities point to systemic factors that need to be addressed by health workforce planners if Ireland is to retain and benefit from a motivated medical workforce, given trainees’ perceptions that there are better opportunities abroad. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12960-017-0239-7) contains supplementary material, which is available to authorized users. BioMed Central 2017-09-25 /pmc/articles/PMC5611654/ /pubmed/28942731 http://dx.doi.org/10.1186/s12960-017-0239-7 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Clarke, Nicholas Crowe, Sophie Humphries, Niamh Conroy, Ronan O’Hare, Simon Kavanagh, Paul Brugha, Ruairi Factors influencing trainee doctor emigration in a high income country: a mixed methods study |
title | Factors influencing trainee doctor emigration in a high income country: a mixed methods study |
title_full | Factors influencing trainee doctor emigration in a high income country: a mixed methods study |
title_fullStr | Factors influencing trainee doctor emigration in a high income country: a mixed methods study |
title_full_unstemmed | Factors influencing trainee doctor emigration in a high income country: a mixed methods study |
title_short | Factors influencing trainee doctor emigration in a high income country: a mixed methods study |
title_sort | factors influencing trainee doctor emigration in a high income country: a mixed methods study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5611654/ https://www.ncbi.nlm.nih.gov/pubmed/28942731 http://dx.doi.org/10.1186/s12960-017-0239-7 |
work_keys_str_mv | AT clarkenicholas factorsinfluencingtraineedoctoremigrationinahighincomecountryamixedmethodsstudy AT crowesophie factorsinfluencingtraineedoctoremigrationinahighincomecountryamixedmethodsstudy AT humphriesniamh factorsinfluencingtraineedoctoremigrationinahighincomecountryamixedmethodsstudy AT conroyronan factorsinfluencingtraineedoctoremigrationinahighincomecountryamixedmethodsstudy AT oharesimon factorsinfluencingtraineedoctoremigrationinahighincomecountryamixedmethodsstudy AT kavanaghpaul factorsinfluencingtraineedoctoremigrationinahighincomecountryamixedmethodsstudy AT brugharuairi factorsinfluencingtraineedoctoremigrationinahighincomecountryamixedmethodsstudy |