Passing through – reasons why migrant doctors in Ireland plan to stay, return home or migrate onwards to new destination countries

Abstract

BackgroundInternational recruitment is a common strategy used by high-income countries to meet their medical workforce needs. Ireland, despite training sufficient doctors to meet its internal demand, continues to be heavily dependent on foreign-trained doctors, many of whom may migrate onwards to new destination countries. A cross-sectional study was conducted to measure and analyse the factors associated with the migratory intentions of foreign doctors in Ireland.MethodsA total of 366 non-European nationals registered as medical doctors in Ireland completed an online survey assessing their reasons for migrating to Ireland, their experiences whilst working and living in Ireland, and their future plans. Factors associated with future plans – whether to remain in Ireland, return home or migrate to a new destination country – were tested by bivariate and multivariate analyses, including discriminant analysis.ResultsOf the 345 foreign doctors who responded to the question regarding their future plans, 16 % of whom were Irish-trained, 30 % planned to remain in Ireland, 23 % planned to return home and 47 % to migrate onwards. Country of origin, personal and professional reasons for migrating, experiences of training and supervision, opportunities for career progression, type of employment contract, citizenship status, and satisfaction with life in Ireland were all factors statistically significantly associated with the three migratory outcomes.ConclusionReported plans may not result in enacted emigration. However, the findings support a growing body of evidence highlighting dissatisfaction with current career opportunities, contributing to the emigration of Irish doctors and onward migration of foreign doctors. Implementation of the WHO Global Code, which requires member states to train and retain their own health workforce, could also help reduce onward migration of foreign doctors to new destination countries. Ireland has initiated the provision of tailored postgraduate training to doctors from Pakistan, enabling these doctors to return home with improved skills of benefit to the source country.Electronic supplementary materialThe online version of this article (doi:10.1186/s12960-016-0121-z) contains supplementary material, which is available to authorized users.

The WHO Global Code: increasing relevance and effectiveness

“…Contrary to the Code's recommendation on equality, Tyrell et al found that physicians trained outside of Ireland were significantly less likely to experience career progression than those trained in Ireland [12]. Brugha et al [14] found that approximately half of foreign doctors intended to migrate onwards. Most of them pointed to a lack of career progression, with twothirds planning to return home having failed to gain entry in a post-graduate training scheme [14].…”

“…Tyrell et al [13] and Brugha et al [14] add important insight on the value of career progression for retaining health workers. Contrary to the Code's recommendation on equality, Tyrell et al found that physicians trained outside of Ireland were significantly less likely to experience career progression than those trained in Ireland [12].…”

“…Brugha et al [14] found that approximately half of foreign doctors intended to migrate onwards. Most of them pointed to a lack of career progression, with twothirds planning to return home having failed to gain entry in a post-graduate training scheme [14]. Both Tyrell et al and Brugha et al point to the need for close scrutiny on medical workforce policies [13,14].…”

“…Most of them pointed to a lack of career progression, with twothirds planning to return home having failed to gain entry in a post-graduate training scheme [14]. Both Tyrell et al and Brugha et al point to the need for close scrutiny on medical workforce policies [13,14]. Hitherto, Brugha et al note that the adoption of the Code did instigate such examination at the national level [14].…”

“…Both Tyrell et al and Brugha et al point to the need for close scrutiny on medical workforce policies [13,14]. Hitherto, Brugha et al note that the adoption of the Code did instigate such examination at the national level [14]. On another note, McAleese et al [15] warn that the longer health professionals remain abroad, the less likely are they to return to their home countries.…”