Career intentions of final year medical students in Uganda after graduating: the burden of brain drain

Abstract

BackgroundUganda has severe shortage of human resources for health despite the heavy disease burden. The country has one of the highest fertility, and population growth rates in the world and is in dire need of trained health workers. The current doctor: patient ratio of 1:15000 is inadequate and this is further constrained by trained health workers leaving the country while others abandon the health sector. The aim of the study was to determine the career intentions of the final year medical students to leave the county and health field after graduating and the associated factors.MethodsWe conducted a cross-sectional study among 251 final year medical students from Makerere, Mbarara, Gulu and Kampala International Universities. We enrolled all the eligible final year medical students. The study was conducted using face-to-face questionnaires in each university. We determined the demographics, reasons for leaving the country and health sector and the intended destinations of medical students who planned to leave the country. Data was entered in Epidata then exported and analyzed in stata 12.ResultsOf the 251 students enrolled in the study, 28(11.2 %) wanted to leave the health sector, with Mbarara University of Science and Technology (MUST) having the highest percentage, 16.7 % and Kampala International University (KIU) the least, 7.7 %. Of the 28 who intended to leave the health sector, 82.1 % wanted to join the business sector, 10.7 % agriculture, and 7.1 % politics. Reasons given for the intent to leave were; lack of equipment and supplies in hospitals, over whelming patient numbers, very risky working environment, low payment to doctors, and political reasons. Overall, 112 (44.6 %) of the participants wanted to leave the country with 30.3 % intending to migrate to United States of America (USA), 11.9 % to United Kingdom (UK), 11.0 % to South Africa among others. Some of the reasons given were; doctors are paid a high salary abroad, safe working environment, and desire to continue academics. Age was associated with intention to leave the country (OR = 1.64; 95 % CI: 1.00 – 4.82).ConclusionsIn a country in dire need of health workers, the study showed high proportion of trainee health workers planning to abandon their professions or emigrate from Uganda after training.

Intention to immigration and its relationship with workload and healthy work environment in nurses

“…The results of present study showed that with increasing workload and reducing healthy work environment, the intention to immigration increases among nurses. Our study is consistent with similar studies in other countries that have identi ed high workload as one of the factors associated with nurses' intention to immigration (Lee and Moon, 2013;Kizito et al, 2015;Garner et al, 2015). In addition, a Inappropriate healthy work environment is one of the effective factors in maintaining nurses, and Inappropriate healthy work environment is one of the reasons related to the migration of nurses (Freeman et al, 2012;Dywili et al, 2013;Scruth et al, 2018;Hall et al, 2019;).…”

Factors affecting intent to immigration among Iranian health workers in 2016

“…Reasons related to the work environment were the most frequent cause of migration in the context of migration of human resources in the health sector. Lack of equipment and facilities in hospitals, high numbers of patients, high-risk environment, safety at work ( 21 ); job satisfaction, better working environment abroad, better management abroad, pressure of colleagues in the country of origin, high working hours and heavy workload, job position ( 22 ); improvement of workplace status ( 23 ); the status of current job satisfaction ( 24 ); poor employment conditions in the country of origin ( 25 ) and to advance career and job status ( 26 ) were all reasons related to occupational factors mentioned in various studies as reasons for migration among workers in health resources. Therefore, to keep employees in the country, work environments must be taken into special consideration.…”

“…Moreover, these factors were completely beyond the control of the health system, and related to society at the macro level. In a study conducted in Uganda on migration of physicians, it was found that one reason for inclination to migrate among medical students was political considerations ( 21 ). A study in Pakistan on medical students, revealed that discrimination and religious reasons caused migration ( 20 ).…”

Medical “Brain Drain” and Health Care Worker Shortages: How Should International Training Programs Respond?

“…A number of studies have quantified factors that propel physician migration from source countries: access to better training opportunities, higher salaries, need to escape political instability and corruption, poor quality of facilities and equipment, and plans for raising children [5][6][7][8]. Conversely, factors that influence physician retention in the destination countries include strong and robust health systems and political stability, which tend to facilitate improved lifestyles and opportunities for physicians and their families.…”