期刊论文详细信息
Human Resources for Health
Ireland’s medical brain drain: migration intentions of Irish medical students
Diarmuid O’Donovan5  Fidelma Dunne1  Siun O’Flynn2  Richard Arnett3  Martina Hennessy6  Jason Last4  Deirdre McGrath7  Deirdre Goggin5  David S Evans5  Kevin Kitt1  Pishoy Gouda1 
[1] National University of Ireland, Galway, Ireland;University College Cork, Cork, Ireland;Royal College of Surgeons in Ireland, Dublin, Ireland;University College Dublin, Dublin, Ireland;Department of Public Health, Merlin Park Hospital, HSE West, Galway, Ireland;Trinity College Dublin, Dublin, Ireland;University of Limerick, Limerick, Ireland
关键词: Human resources;    Emigration and immigration;    Medical students;   
Others  :  1139188
DOI  :  10.1186/s12960-015-0003-9
 received in 2014-03-19, accepted in 2015-02-23,  发布年份 2015
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【 摘 要 】

Background

To provide the optimum level of healthcare, it is important that the supply of well-trained doctors meets the demand. However, despite many initiatives, Ireland continues to have a shortfall of physicians, which has been projected to persist. Our study aimed to investigate the migration intentions of Irish medical students and identify the factors that influence their decisions in order to design appropriate interventions to sustain the supply of trained doctors in order to maintain a viable medical system.

Methods

An online cross-sectional survey was undertaken of all Irish medical students studying in the Republic of Ireland. The survey included nominal, ordinal, and scale items to determine migration intentions, factors influencing their decisions, and understanding of the Irish healthcare system.

Results

A total of 2 273 medical students responded (37% response rate), of whom 1 519 were classified as Irish medical students (having completed secondary school in Ireland). Of these, 88% indicated they were either definitely migrating or contemplating migrating following graduation or completion of the pre-registration intern year. Forty percent expressed an intention of returning to Ireland within 5 years. The factors most influencing their decision to leave were career opportunities (85%), working conditions (83%), and lifestyle (80%).

Conclusion

The migration intentions expressed in this study predict an immediate and severe threat to the sustainability of the Irish healthcare service. Urgent interventions such as providing information about career options and specialty training pathways are required. These must begin in the undergraduate phase and continue in postgraduate training and are needed to retain medical school graduates.

【 授权许可】

   
2015 Gouda et al.; licensee BioMed Central.

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【 参考文献 】
  • [1]Simoens S, Hurst J. The supply of physician services in OECD countries. 2006. http://www.oecd.org/health/health-systems/35987490.pdf
  • [2]Organisation for Economic Co-operation and Development, World Health Organization. International migration of health workers. International Migration of Health Workers. 2010:1–8. http://www.oecd.org/migration/mig/44783473.pdf
  • [3]Joyce CM, McNeil JJ, Stoelwinder JU: More doctors, but not enough: Australian medical workforce supply 2001–2012. Med J Austr 2006, 184:441.
  • [4]National Health Service: Investment and reform for NHS Staff – taking forward the NHS plan. 2001.
  • [5]Gorman DF, Brooks PM: On solutions to the shortage of doctors in Australia and New Zealand. Med J Aust 2009, 190:152-6.
  • [6]Department of Education Working Group on Undergraduate Medical Education and Training. Medical education in Ireland. A New Direction. 2006. p. 1–128. https://www.education.ie/en/Publications/Policy-Reports/Medical-Education-in-Ireland-A-New-Direction-Report-of-the-Working-Group-on-Undergraduate-Medical-Education-and-Training.pdf.
  • [7]Health Service Executive. Implementation of the Reform of the Intern Year: Second Interim Report on the implementation of recommendations of the National Committee report on the Intern Year. 2012. p. 1–72. https://www.imo.ie/i-am-a/student/intern-placement-2013/Second-Interim-Implementation-Report-April-2012.pdf.
  • [8]Department of Health and Children Working Group on Postgraduate Medical Education and Training Group: Preparing Ireland’s doctors to meet the health needs of the 21st Century. 2006.
  • [9]Bidwell P, Humphries N, Dicker P, Thomas S, Normand C, Brugha R: The national and international implications of a decade of doctor migration in the Irish context. Health Policy 2013, 110:29-38.
  • [10]Kelleher E, Brugha R: NCHD emigration crisis and the need for consultant-delivered care. Ir Med J 2013, 106(5):133-4.
  • [11]McGrath J: Health care Skills Monitoring Report. 2005.
  • [12]Bruce-Brand R, Broderick J, Ong J, O’Byrne J: Diagnosing the doctors’ departure: survey on sources of dissatisfaction among Irish junior doctors. Ir Med J 2012, 105:15-8.
  • [13]Irish Medical Council. Medical Workforce Intelligence Report. 2013. p. 1–106. http://www.medicalcouncil.ie/News-and-Publications/Publications/Annual-Reports-Statistics-/Medical-workforce-intelligence-report-.pdf.
  • [14]Irish Medical Organisation. 2011 Annual Report & Accounts. 2011. http://www.imo.ie/about-imo/annual-reports/IMO-Annual-Report-2011-Final.pdf.
  • [15]Burke C: Survey of final year medical students 2012: will we go or will we stay?. 2012.
  • [16]García-Pérez MA, Amaya C, Otero Á: Physicians’ migration in Europe: an overview of the current situation. BMC Health Serv Res 2007, 7:201. BioMed Central Full Text
  • [17]Mullan F: The metrics of the physician brain drain. N Engl J Med 2005, 353:1810-8.
  • [18]Moss PJ: Reasons for considering leaving UK medicine: questionnaire study of junior doctors’ comments. BMJ 2004, 329:1263.
  • [19]McGowan Y, Humphries N, Burke H, Conry M, Morgan K: Through doctors’ eyes: a qualitative study of hospital doctor perspectives on their working conditions. Br J Health Psychol 2013, 18:874-91.
  • [20]Regets M. Research and policy issues in high-skilled international migration: a perspective with data from the United States. IZA discussion paper 2001. http://ftp.iza.org/dp366.pdf 2001
  • [21]Health Service Executive: A guide to application and appointment to intern training in Ireland 2011 Part 1. 2011.
  • [22]World Health Organization. The World Health Report 2006: working together for health. 2006. http://www.who.int/whr/2006/whr06_en.pdf.
  • [23]Scheffler RM, Liu JX, Kinfu Y, Dal Poz MR: Forecasting the global shortage of physicians: an economic- and needs-based approach. Bull World Health Organ 2008, 86:516-23. http://www.who.int/bulletin/volumes/86/7/07-046474.pdf
  • [24]Ono T, Lafortune G, Schoenstein M: Health workforce planning in OECD countries: a review of 26 projection models from 18 countries. In OECD Health Working Papers, No. 62. OECD Publishing, France; 2013:8-11.
  • [25]Rao NR, Rao UK, Cooper RA: Indian medical students’ views on immigration for training and practice. Acad Med 2006, 81:185-8.
  • [26]Akl EA, Maroun N, Major S, Afif C, Abdo A, Choucair J, et al.: Post-graduation migration intentions of students of Lebanese medical schools: a survey study. BMC Public Health 2008, 8:191. BioMed Central Full Text
  • [27]Syed NA, Khimani F, Andrades M, Ali SK, Paul R: Reasons for migration among medical students from Karachi. Med Educ 2007, 42:61-68.2.
  • [28]Krajewski-Siuda K, Szromek A, Romaniuk P, Gericke CA, Szpak A, Kaczmarek K: Emigration preferences and plans among medical students in Poland. Hum Resour Health 2012, 10:8. BioMed Central Full Text
  • [29]George G, Reardon C. Preparing for export? Medical and nursing student migration intentions post-qualification in South Africa. Afr J Prim Health Care Fam Med. 2013;5. doi: 10.4102/phcfm.v5i1.483
  • [30]Goldacre MJ, Davidson JM, Lambert TW: Retention in the British National Health Service of medical graduates trained in Britain: cohort studies. BMJ 2009, 338:b1977-7.
  • [31]Hawthorne L, Hamilton J: International medical students and migration: the missing dimension in Australian workforce planning? Med J Austr 2010, 193:262.
  • [32]Irish Medical Organisation: IMO position paper on medical schools. 2006.
  • [33]McGrath P, Wong A, Holewa H: Canadian and Australian licensing policies of international medical graduates: a web-based comparison. Educ. Health 2011, 24:452.
  • [34]Centre for Workforce Intelligence: Shape of the medical workforce. 2012.
  • [35]Grayson MS, Newton DA, Thompson LF: Payback time: the associations of debt and income with medical student career choice. Med Educ 2012, 46:983-91.
  • [36]Lofters A, Slater M, Fumakia N, Thulien N: “Brain Drain” and “Brain Waste”: experience of international medical graduates in Ontario. Risk Manag Healthc Policy 2014, 7:81-9.
  • [37]Haugh C, Doyle B, O’Flynn S: Debt crisis ahead for Irish medical students. Ir Med J 2014, 107:185-6.
  • [38]Health Service Executive: NCHD Candidate Information Booklet. 2013.
  • [39]Amy R. Review Body on Doctors’ and Dentists’ Remuneration fortieth report 2012. 2012. http://books.google.com/books?hl=en&lr=&id=keyoC-OjisQC&oi=fnd&pg=PR6&dq=Review+Body+on+Doctors+and+Dentists+Remuneration+Forty+First+Report+2013&ots=CbRaZNfOUZ&sig=_oa1mDRKdEZyG9kvZWLVlKT1wpQ
  • [40]Australian Medical Association: Victorian Public Health Sector - Doctors in Training Multi-Enterprise Agreement 2008–2012. 2008.
  • [41]Dorsey ER, Jarjoura D, Rutecki GW: Influence of controllable lifestyle on recent trends in specialty choice by US medical students. JAMA 2003, 290:1173-8.
  • [42]Hallock JA, Mckinley DW, Boulet JR: Migration of doctors for undergraduate medical education. Med Teach 2007, 29:98-105.
  • [43]Yarger JB, James TA, Ashikaga T, Hayanga AJ, Takyi V, Lum Y, et al.: Characteristics in response rates for surveys administered to surgery residents. Surgery 2013, 154:38-45.
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