Research article

Post-graduation migration intentions of students of Lebanese medical schools: a survey study

Elie A Akl^1,2 , Nancy Maroun³ , Stella Major⁴ , Claude Afif⁵ , Abir Abdo⁶ , Jacques Choucair⁷ , Mazen Sakr⁸ , Carl K Li² , Brydon JB Grant^1,2 and Holger J Schünemann⁹

¹Department of Medicine, University at buffalo, NY, USA

²Department of Social and Preventive Medicine, University at buffalo, NY, USA

³Department of Sociology, University at buffalo, NY, USA

⁴Division of Epidemiology, Public Health and Primary Care, Imperial College School of Medicine in London, UK

⁵Department of Medicine, University of Balamand, Beirut, Lebanon

⁶Department of Medicine, Lebanese University, Beirut, Lebanon

⁷Department of Medicine, Université Saint Joseph, Beirut, Lebanon

⁸Department of Medicine, Beirut Arab University, Beirut, Lebanon

⁹Dept. of Epidemiology & INFORMA, Italian National Cancer Institute Regina Elena, Rome, Italy

author email corresponding author email

BMC Public Health 2008, 8:191doi:10.1186/1471-2458-8-191

Published:	2 June 2008

Abstract

Background

The international migration of physicians is a global public health problem. Lebanon is a source country with the highest emigration factor in the Middle East and North Africa and the 7th highest in the World. Given that residency training abroad is a critical step in the migration of physicians, the objective of this study was to survey students of Lebanese medical schools about their intentions to train abroad and their post training plans.

Methods

Our target population consisted of all students of Lebanese medical schools in the pre-final and final years of medical school. We developed the survey questionnaire based on the results of a qualitative study assessing the intentions and motives for students of Lebanese medical schools to train abroad. The questionnaire inquired about student's demographic and educational characteristics, intention to train abroad, the chosen country of abroad training, and post-training intention of returning to Lebanon.

Results

Of 576 eligible students, 425 participated (73.8% response rate). 406 (95.5%) respondents intended to travel abroad either for specialty training (330 (77.6%)) or subspecialty training (76 (17.9%)). Intention to train abroad was associated with being single compared with being married. The top 4 destination countries were the US (301(74.1%)), France (49 (12.1%)), the United Kingdom (31 (7.6%)) and Canada (17 (4.2%)). One hundred and two (25.1%) respondents intended to return to Lebanon directly after finishing training abroad; 259 (63.8%) intended to return to Lebanon after working abroad temporarily for a varying number or years; 43 (10.6%) intended to never return to Lebanon. The intention to stay indefinitely abroad was associated male sex and having a 2^nd citizenship. It was inversely associated with being a student of one of the French affiliated medical schools and a plan to train in a surgical specialty.

Conclusion

An alarming percentage of students of Lebanese medical schools intend to migrate for post graduate training, mainly to the US. A minority intends to return directly to Lebanon after finishing training abroad.