Applying a typology of health worker migration to non-EU migrant doctors in Ireland

Human Resources for Health

Ruairí Brugha²  Charles Normand¹  Steve Thomas¹  Ella Tyrrell¹  Sara McAleese²  Niamh Humphries² 

[1] Centre for Health Policy and Management, Trinity College Dublin, Dublin, Ireland;Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, 123 St. Stephen’s Green, Dublin 2, Ireland

关键词: Health human resources for health;    Health workforce planning;    Medical workforce planning;    Migration typology;    Doctor migration;   

Others  :  1219650
DOI  :  10.1186/s12960-015-0042-2

 received in 2014-10-10, accepted in 2015-06-02,  发布年份 2015

【 摘 要 】

Background

Research on health worker migration in the Irish context has categorized migrant health workers by country or region of training (for example, non-EU nurses or doctors) or recruitment mechanism (for example, actively recruited nurses). This paper applies a new typology of health worker migrants – livelihood, career-oriented, backpacker, commuter, undocumented and returner migrants (European Observatory on Health Systems and Policies and WHO, vol. 2:129-152, 2014) – to the experiences of non-EU migrant doctors in Ireland and tests its utility for understanding health worker migration internationally.

Methods

The paper draws on quantitative survey (N = 366) and qualitative interview (N = 37) data collected from non-EU migrant doctors in Ireland between 2011 and 2013.

Results

Categorizing non-EU migrant doctors in Ireland according to the typology (European Observatory on Health Systems and Policies and WHO, vol. 2:129-152, 2014) offers insight into their differing motivations, particularly on arrival. Findings suggest that the career-oriented migrant is the most common type of doctor among non-EU migrant doctor respondents, accounting for 60 % (N = 220) of quantitative and 54 % (N = 20) of qualitative respondents. The authors propose a modification to the typology via the addition of two additional categories – the family migrant and the safety and security migrant.

Conclusions

Employing a typology of health worker migration can facilitate a more comprehensive understanding of the migrant medical workforce, a necessary prerequisite for the development of useful policy tools (European Observatory on Health Systems and Policies and WHO, vol. 2:129-152, 2014). The findings indicate that there is some fluidity between categories, as health worker motivations change over time. This indicates the potential for policy levers to influence migrant health worker decision-making, if they are sufficiently “tuned in” to migrant health worker motivation.

【 授权许可】

   
2015 Humphries et al.

【 参考文献 】

• [1]Spinks N, Moore C. The changing workforce, workplace and nature of work: implications for health human resource management. Nurs Leadersh. 2007; 20(3):26-41.
• [2]Willis-Shattuck M, Bidwell P, Thomas S, Wyness L, Blauuw D, Ditlopo P. Motivation and retention of health workers in developing countries: a systematic review. BMC Hum Resour Heal. 2008; 8:247. BioMed Central Full Text
• [3]Geddie K. The transnational ties that bind: relationship considerations for graduating international science and engineering research students. Popul Space Place. 2013; 19:193-208.
• [4]Humphries N, Brugha R, McGee H. “I won’t be staying here for long”: a qualitative study on the retention of migrant nurses in Ireland. Hum Resour Health. 2009; 7:68. BioMed Central Full Text
• [5]Padarath A, Chamberlain C, McCoy D, Ntuli A, Rowson M, Loewenson R. Health personnel in Southern Africa: confronting maldistribution and brain drain. 2004.
• [6]Humphries N, Bidwell P, Tyrrell E, Brugha R, Thomas S, Normand C. “I am kind of in stalemate”. The experiences of non-EU migrant doctors in Ireland. Health Professional Mobility in a Changing Europe. 2014.
• [7]Miller Franco L, Bennett S, Kanfer R. Health sector reform and public sector health worker motivation: a conceptual framework. Soc Sci Med. 2002; 54:1255-66.
• [8]Oman KA, Moulds R, Usher K. Specialist training in Fiji: why do graduates migrate and why do they remain? A qualitative study. BMC Hum Resour Heal. 2009; 7:9. BioMed Central Full Text
• [9]Humphries N, Tyrrell E, McAleese S, Bidwell P, Thomas S, Normand C et al.. A cycle of brain gain, waste and drain - a qualitative study of non-EU migrant doctors in Ireland. BMC Hum Resour Heal. 2013; 11:63. BioMed Central Full Text
• [10]Humphries N, Brugha R, McGee H. Sending money home: a mixed-methods study of remittances sent by migrant nurses in Ireland. Hum Resour Health. 2009; 7:66. BioMed Central Full Text
• [11]Oikelome F, Healy G. Gender, migration and place of qualification of doctors in the UK: perceptions of inequality, morale and career aspiration. J Ethn Migr Stud. 2012; 39(4):557-77.
• [12]Aiken LH, Buchan J, Sochalski J, Nichols B, Powell M. Trends in international nurse migration. Heal Aff. 2004; 23:69-77.
• [13]Vujicic M, Zurn P, Diallo K, Adams O, Dal Poz MR. The role of wages in the migration of health care professionals from developing countries. Hum Resour Health. 2004; 2:3. BioMed Central Full Text
• [14]Buchan J, Jobanputra R, Gough P, Hutt R. Internationally recruited nurses in London: a survey of career paths and plans. Hum Resour Heal. 2006; 4:14. BioMed Central Full Text
• [15]Iredale R. The migration of professionals: theories and typologies. Int Migr. 2001; 39:7-26.
• [16]Glinos I, Buchan J. Health professionals crossing the European Union’s internal and external borders: a typology and health professional mobility and migration. In: Health professional mobility in a changing Europe: new dynamics, mobile individuals and policy responses. 2014.129-52.
• [17]Glinos I, Buchan J, Wismar M. Health professional mobility in a changing Europe: lessons and findings. Health professional mobility in a changing Europe: new dynamics, mobile individuals and policy responses. 2014.
• [18]Medical Council. Medical workforce intelligence report. A report on the Annual Registration Retention Survey 2013. Dublin; 2014.
• [19]O’Cathain A, Murphy E, Nicholl J. Why, and how, mixed methods research is undertaken in health services research in England: a mixed methods study. BMC Health Serv Res. 2007; 7:85. BioMed Central Full Text
• [20]O’Cathain A. Three techniques for integrating data in mixed methods studies. BMJ. 2010; 341:c4587.
• [21]Bartram D, Poros MV, Monforte P. Key concepts in migration. Sage, London; 2014.
• [22]Kingma M. Nurses on the move: a global overview. Health Serv Res. 2007; 42(3 Part II):1281-98.
• [23]Bidwell P. The dynamics of temporary migration: the experience of South African doctors working in Ireland. Volume PhD, Trinity College Dublin; 2013.
• [24]Woulfe J. South Africans to cover GP shortages. Irish Independent 2005.
• [25]Sharma A, Lambert T, Goldacre M. Why UK-trained doctors leave the UK: cross sectional survey of doctors in New Zealand. J R Soc Med. 2012; 105:25-34.
• [26]UNHCR welcomes draft bill that will let refugee doctors practise in Ireland. [http://www.unhcr.ie/news/irish-story/unhcr-welcomes-draft-bill-that-will-let-refugee-doctors-practise-in-ireland]. Accessed 16.06.14.
• [27]International Medical Graduate Training Initiative National Framework Adopted by the HSE & The Forum of Irish Postgraduate Medical Training Bodies IMG Training Initiative. 2014.
• [28]WHO applaud Ireland-Pakistan MOU 2014. 2014.
• [29]Humphries N, Brugha R, McGee H. Nurse migration and health workforce planning: Ireland as illustrative of international challenges. Health Policy (New York). 2012; 107:44-53.
• [30]Buchan J. Reviewing the benefits of health workforce stability. Hum Resour Health. 2010; 8:29. BioMed Central Full Text
• [31]Omaswa F. Health worker migration: perspectives from an African health worker. Realizing the right to health – Swiss human rights book. Clapham A, Robinson M, editors. Rüffer & Rub, Zurich; 2009.
• [32]Medical workforce intelligence report. A report on the Annual Registration Retention Survey 2012. Medical Council of Ireland, Dublin; 2013.