Comparing the drivers of medical student emigration intention across two African nations.

Background: Sub‐Saharan Africa faces the highest relative need for health care workers in the world and the emigration of physicians significantly contributes to this deficit. Few studies have explored development of these patterns during medical education. This study investigates career aspirations...

Descripción completa

Detalles Bibliográficos
Publicado en:Medical Education Vol. 55; no. 10; pp. 1194 - 1205
Autores principales: Chaet, Alexis, Fessehaie, Nathaniel, Rajaguru, Praveen R., Alavi Jusabani, Mubashir, Randaoharison, Pierana, Samison, Luc, Anderson, Ursula, Ramanantoanina, Prisca, Zafimar, Mosa, Numfor, Anchi, Hardaker, W. Mack, Massawe, Honest, Pallangyo, Anthony, Temu, Rogers, Winterton, Matthew, Sheth, Neil P.
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Oct2021
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=152558491&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 152558491
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        03080110
        ESF
      jtl: Medical Education
      issn: 03080110
      maglogo: Y
    pubinfo:
      dt: Oct2021
      vid: 55
      iid: 10
      pid: 480
      pub: Wiley-Blackwell
      place: Malden, Massachusetts
    artinfo:
      ui:
        152558491
        150632185
        152558491
        152558491
        10.1111/medu.14562
        152558491
      ppf: 1194
      ppct: 11
      formats:
        fmt:
          @attributes:
            type: P
      tig:
        atl: Comparing the drivers of medical student emigration intention across two African nations.
      aug:
        au:
          Chaet, Alexis
          Fessehaie, Nathaniel
          Rajaguru, Praveen R.
          Alavi Jusabani, Mubashir
          Randaoharison, Pierana
          Samison, Luc
          Anderson, Ursula
          Ramanantoanina, Prisca
          Zafimar, Mosa
          Numfor, Anchi
          Hardaker, W. Mack
          Massawe, Honest
          Pallangyo, Anthony
          Temu, Rogers
          Winterton, Matthew
          Sheth, Neil P.
        affil: Perelman School of Medicine, University of Pennsylvania, Philadelphia PA,, USA
      sug:
        subj:
          Students, Medical Psychosocial Factors
          Students, Medical Psychosocial Factors
          Emigration and Immigration Psychosocial Factors
          Intention Evaluation
          Student Attitudes Evaluation
          Career Planning and Development
          Human
          Madagascar
          Tanzania
          Cross Sectional Studies
          Career Mobility, International
          Chi Square Test
          Fisher's Exact Test
          Descriptive Statistics
          Logistic Regression
          Content Analysis
          Student Satisfaction
          Internet Access
          Salaries and Fringe Benefits
          Faculty, Medical Labor Supply
          Access to Information
      ab: Background: Sub‐Saharan Africa faces the highest relative need for health care workers in the world and the emigration of physicians significantly contributes to this deficit. Few studies have explored development of these patterns during medical education. This study investigates career aspirations of medical students in two African nations with similar Human Development Indices, but distinct differences in training structure to better inform retention strategies. Methods: A cross‐sectional survey was administered in 2018 to medical students in Madagascar (University of Antananarivo, University of Mahajanga) and Tanzania (Kilimanjaro Christian Medical College, KCMC). Outcomes included emigration/career intentions, and factors influencing these decisions. Analysis utilised chi‐square and Fisher's exact tests (α < 0.05, two‐tailed) for statistical differences, logistic regression and qualitative content analysis of free text data. Results: A total of 439 students responded to the survey with a response rate of 12.9% from Antananarivo (n = 142/1097), 11.6% from Mahajanga (n = 43/370), and 60.0% from KCMC (n = 254/423). Significantly more Malagasy (49.7%, n = 90/181) than Tanzanian (25.2%, n = 54/214) students expressed emigration intent (P <.001). Malagasy students indicating research, possibility of working abroad, or work intensity as influencing career choice more frequently expressed a desire to emigrate. Satisfaction with computer/internet access was inversely correlated with a desire to work abroad. In comparison, Tanzanian students reporting income potential as influential in their career choice or attending a private high school were more likely to express a desire to work abroad. Qualitative content analysis of free text data demonstrated deficits in faculty availability, diversity of training locations and a particular emphasis on infrastructure challenges within Madagascar. Interpretation: A significant number of students desire to work abroad. Emigration interests are influenced by access to postgraduate training, infrastructure and opportunities in academia, which differ across countries. Efforts to retain physicians should consider these country and institution‐specific factors that influence medical student desire to emigrate. Fessehaie et al. reveal that drivers of student emigration differ across institutions, suggesting that efforts to retain physicians must be tailored to country and institution‐specific contexts.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N