Intent To Migrate Among Specialist Trainees - A Qualitative Study

Objectives: This study aims to assess the intent and reasons for wanting to migrate among specialist trainees (resident doctors) in a teaching hospital in Nigeria- a low middle income country.
Methods: Qualitative focus group discussions were conducted among 4 groups of specialist trainees comprised of 32 doctors; from various departments in the hospital until data saturation using a question guide. Data was collected using semi-structured interviews which were audio recorded and transcribed verbatim. The data was analysed thematically by highlighting, collating and categorising key statements into general and subthemes.
Results: Majority of the respondents interviewed were males 56%. A vast majority of the specialist trainees interviewed, 94% had the intention of emigrating from Nigeria. Evident themes which emerged as decision to migrate were poor financial remuneration, insecurity, lack of job satisfaction, lack of amenities and facilities. First country of choice of migration was the United Kingdom followed closely by United States of America and Canada. The choice of the United Kingdom was mostly because of the perceived ease of medical accreditation process required to work.
Push factors for migration include low pay, insecurity due to kidnapping, the presence of terrorist groups such as Boko Haram; and conflict between doctors and non-doctors in the Nigerian health sector. Pull factors include better pay, job satisfaction, financial security and professionalism of healthcare workers.
Conclusions: Migration of doctors from low- or middle-income countries to high income countries is a global threat which can result in inequalities in healthcare delivery in low- and middle-income countries. Efforts should be put in place at the global and local levels to address this brain drain and foster the retention of doctors in their countries of citizenship.