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Eser E, Cil E, Sen Gundogan NE, Col M, Yildirim Ozturk EN, Thomas DT, Sunter AT, Arslan HN, Citil R, Onder Y, Picakciefe M, Dede B, Demirel C, Aydin N, Caglayan C, Aker AA, Borlu A, Durmus H, Can G, Siddikoglu E, Sumer EH, Uygun T, Alkoy S, Aktas Aycan K, Koruk İ, Kuzan R, Demir LS, Hacilar E, Sari H, Kilinc Z, Onal O, Dogan E, Emek M, Terzioglu R, Yapici G, Erdal D, Eser S, Ayhan Akman E, Kosan Z, Yilmaz S, Ayoglu FN, Acikgoz B, Musal B, Suner AF, Erdogan A, Cilburunoglu İ, Saygun M, Daymaz D, Arslantas D, Onsuz MF, Beyhun NE, Ustundag MG, Ekuklu G, Ozder Tas F, Abacigil F, Oncu S, Hıdıroğlu S, Ozaydin AN, Pirincci E, Bulut I, Tozun M, Eskiocak M, Gunel P, Torun SD, Yavuz M, Hasde M, Camur D, Gunes G, Kurt B, Guler Baysoy N, Bakirci N, Demir F, Catak B, Ozyurda F, Turan M. Push and Pull Factors of Why Medical Students Want to Leave Türkiye: A Countrywide Multicenter Study. Teach Learn Med 2023:1-13. [PMID: 37530502 DOI: 10.1080/10401334.2023.2229810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Phenomenon: Physician immigration from other countries is increasing as developed countries continue to be desirable destinations for physicians; however, the determinants of Turkish physicians' migration decisions are still unclear. Despite its wide coverage in the media and among physicians in Türkiye, and being the subject of much debate, there is insufficient data to justify this attention. With this study, we aimed to investigate the tendency of senior medical students in Türkiye to pursue their professional careers abroad and its related factors. Approach: This cross-sectional study involved 9881 senior medical students from 39 different medical schools in Türkiye in 2022. Besides participants' migration decision, we evaluated the push and pull factors related to working, social environment and lifestyle in Türkiye and abroad, medical school education inadequacy, and personal insufficiencies, as well as the socioeconomic variables that may affect the decision to migrate abroad. The analyses were carried out with a participation rate of at least 50%. Findings: Of the medical students, 70.7% had emigration intentions. Approximately 60% of those want to stay abroad permanently, and 61.5% of them took initiatives such as learning a foreign language abroad (54.5%) and taking relevant exams (18.9%). Those who wanted to work in the field of Research & Development were 1.37 (95% CI: 1.22-1.54) times more likely to emigrate. The push factor that was related to emigration intention was the "working conditions in the country" (OR: 1.89, 95% CI: 1.56-2.28) whereas the "social environment/lifestyle abroad" was the mere pull factor for the tendency of emigration (OR: 1.73, 95% CI: 1.45-2.06). In addition, the quality problem in medical schools also had a significant impact on students' decisions (OR: 2.20, 95% CI: 1.83-2.65). Insights: Although the percentage of those who want to emigrate "definitely" was at the same level as in the other developing countries, the tendency to migrate "permanently" was higher in Türkiye. Improving working conditions in the country and increasing the quality of medical faculties seem vital in preventing the migration of physicians.
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Affiliation(s)
- Erhan Eser
- Department of Public Health, Manisa Celal Bayar University, Manisa, Türkiye
| | - Elif Cil
- Department of Public Health, Manisa Celal Bayar University, Manisa, Türkiye
| | | | - Meltem Col
- Department of Public Health, Ankara University, Ankara, Türkiye
| | | | - David Terence Thomas
- Department of Pediatric Surgery, Maltepe University, Istanbul, Türkiye
- Department of Medical Education, Maltepe University, Istanbul, Türkiye
| | | | | | - Riza Citil
- Department of Public Health, Tokat Gaziosmanpaşa University, Tokat, Türkiye
| | - Yalcin Onder
- Department of Public Health, Tokat Gaziosmanpaşa University, Tokat, Türkiye
| | - Metin Picakciefe
- Department of Public Health, Mugla Sitki Kocman University, Mugla, Türkiye
| | - Bahadir Dede
- Department of Public Health, Mugla Sitki Kocman University, Mugla, Türkiye
| | - Can Demirel
- Department of Biophysics, Gaziantep University, Gaziantep, Türkiye
- Department of Medical Education, Gaziantep University, Gaziantep, Türkiye
| | - Neriman Aydin
- Department of Medical Education, Gaziantep University, Gaziantep, Türkiye
- Department of Public Health, Gaziantep University, Gaziantep, Türkiye
| | - Cigdem Caglayan
- Department of Public Health, Kocaeli University, Kocaeli, Türkiye
| | - Ahmet Alp Aker
- Department of Public Health, Kocaeli University, Kocaeli, Türkiye
| | - Arda Borlu
- Department of Public Health, Erciyes University, Kayseri, Türkiye
| | - Hasan Durmus
- Department of Public Health, Erciyes University, Kayseri, Türkiye
| | - Gunay Can
- Department of Public Health, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Esin Siddikoglu
- Department of Public Health, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Ergun Haldun Sumer
- Department of Public Health, Sivas Cumhuriyet University, Sivas, Türkiye
| | - Tunahan Uygun
- Department of Public Health, Sivas Cumhuriyet University, Sivas, Türkiye
| | - Seval Alkoy
- Department of Public Health, Bolu Abant İzzet Baysal University, Bolu, Türkiye
| | - Kubra Aktas Aycan
- Department of Public Health, Bolu Abant İzzet Baysal University, Bolu, Türkiye
| | - İbrahim Koruk
- Department of Public Health, Harran University, Sanliurfa, Türkiye
| | - Rustem Kuzan
- Department of Public Health, Harran University, Sanliurfa, Türkiye
| | - Lutfi Saltuk Demir
- Department of Public Health, Necmettin Erbakan University Meram, Konya, Türkiye
| | - Esra Hacilar
- Department of Public Health, Necmettin Erbakan University Meram, Konya, Türkiye
| | - Hidir Sari
- Department of Public Health, Dicle University, Diyarbakir, Türkiye
| | - Zehra Kilinc
- Department of Public Health, Dicle University, Diyarbakir, Türkiye
| | - Ozgur Onal
- Department of Public Health, Suleyman Demirel University, Isparta, Türkiye
| | - Edanur Dogan
- Department of Public Health, Suleyman Demirel University, Isparta, Türkiye
| | - Mestan Emek
- Department of Public Health, Akdeniz University, Antalya, Türkiye
| | - Rıdvan Terzioglu
- Department of Public Health, Akdeniz University, Antalya, Türkiye
| | - Gulcin Yapici
- Department of Public Health, Mersin University, Mersin, Türkiye
| | - Deniz Erdal
- Department of Public Health, Mersin University, Mersin, Türkiye
| | - Sultan Eser
- Department of Public Health, Balikesir University, Balikesir, Türkiye
| | - Emine Ayhan Akman
- Department of Public Health, Balikesir University, Balikesir, Türkiye
| | - Zahide Kosan
- Department of Public Health, Ataturk University, Erzurum, Türkiye
| | - Sinan Yilmaz
- Department of Public Health, Ataturk University, Erzurum, Türkiye
| | - Ferruh Niyazi Ayoglu
- Department of Public Health, Zonguldak Bulent Ecevit Universitesi, Zonguldak, Türkiye
| | - Bilgehan Acikgoz
- Department of Public Health, Zonguldak Bulent Ecevit Universitesi, Zonguldak, Türkiye
| | - Berna Musal
- Department of Medical Education, Dokuz Eylul University Izmir, Türkiye
| | | | - Aysegul Erdogan
- Department of Public Health, Kahramanmaras Sutcu Imam University, Kahramanmaras, Türkiye
| | - İdris Cilburunoglu
- Department of Public Health, Kahramanmaras Sutcu Imam University, Kahramanmaras, Türkiye
| | - Meral Saygun
- Department of Public Health, Kirikkale University, Kirikkale, Türkiye
| | - Didem Daymaz
- Department of Public Health, Kirikkale University, Kirikkale, Türkiye
| | - Didem Arslantas
- Department of Public Health, Eskisehir Osmangazi University, Eskisehir, Türkiye
| | | | | | | | - Galip Ekuklu
- Department of Public Health, Trakya University, Edirne, Türkiye
| | - Fulya Ozder Tas
- Department of Public Health, Trakya University, Edirne, Türkiye
| | - Filiz Abacigil
- Department of Public Health, Adnan Menderes University, Aydin, Türkiye
| | - Selcen Oncu
- Department of Medical Education, Adnan Menderes University, Aydin, Türkiye
| | - Seyhan Hıdıroğlu
- Department of Public Health, Marmara University, Istanbul, Türkiye
| | | | - Edibe Pirincci
- Department of Public Health, Firat University, Elazig, Türkiye
| | - Irem Bulut
- Department of Public Health, Firat University, Elazig, Türkiye
| | - Mustafa Tozun
- Department of Public Health, Izmir Katip Celebi University, Izmir, Türkiye
| | - Muzaffer Eskiocak
- Department of Public Health, SANKO University, Gaziantep, Türkiye
- Department of Medical Education, SANKO University, Gaziantep, Türkiye
| | - Pinar Gunel
- Department of Medical Education, SANKO University, Gaziantep, Türkiye
- Department of Biostatistics, SANKO University, Gaziantep, Türkiye
| | | | - Melike Yavuz
- Department of Public Health, Bahcesehir University, Istanbul, Türkiye
| | - Metin Hasde
- Department of Public Health, University of Health Sciences - Gulhane Faculty of Medicine, Ankara, Türkiye
| | - Derya Camur
- Department of Public Health, University of Health Sciences - Gulhane Faculty of Medicine, Ankara, Türkiye
| | - Gulsen Gunes
- Department of Public Health, Yuksek Ihtisas University, Ankara, Türkiye
| | - Burak Kurt
- Department of Public Health, Yuksek Ihtisas University, Ankara, Türkiye
| | | | - Nadi Bakirci
- Department of Public Health, Acibadem University, Istanbul, Türkiye
| | - Figen Demir
- Department of Public Health, Acibadem University, Istanbul, Türkiye
| | - Binali Catak
- Department of Public Health, Kafkas University, Kars, Türkiye
| | - Ferda Ozyurda
- Department of Public Health, TOBB University of Economics and Technology, Ankara, Türkiye
| | - Mustafa Turan
- Department of Medical Education, TOBB University of Economics and Technology University, Ankara, Türkiye
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