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      Perceptions of medical students regarding brain drain and its effects on Pakistan’s socio-medical conditions: A cross-sectional study

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          Abstract

          Background and Objective:

          The term “brain drain” refers to the exodus of educated or professional individuals to another nation, industry, or field, typically in search of a higher salary or living standard. Our objective was to look into the reasons why medical students leave after graduation, how it affects Pakistan’s socio-medical situation, and what may be done to address it.

          Methods:

          After receiving approval from the ethical committee, a cross-sectional survey was carried out among 420 undergraduate medical students of both genders at two different medical colleges in Pakistan for the current academic year 2021–2022. The core data was gathered via an organized questionnaire. The non-probability sampling method was employed to collect the sample. The data were analyzed with SPSS software.

          Result:

          Out of 420 medical students of both genders, 140 (33.3%) plan to leave Pakistan after graduation, while 280 (66.66%) want to pursue a career in Pakistan. Additionally, when asked about the amenities offered to Pakistani doctors throughout their training, the vast majority of medical students expressed satisfaction with living in Pakistan. However, among medical students who prefer to immigrate, the United States was at the top of their list. Although there are numerous reasons that affect doctors’ immigration choices, the majority of students think that poor pay and long working hours are the main ones that lead to poor patient management and inadequate training. This may be prevented by improving the pay and service structure.

          Conclusion:

          According to this survey, one in three medical students aspires to move overseas after graduation owing to a lack of resources and ineffective management, which has been adversely affecting Pakistan’s socio-medical situation. As a result, it is important for Pakistan’s health officials to launch campaigns to address the issues faced by medical students and physicians in order to prevent brain drain.

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          Most cited references10

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          The metrics of the physician brain drain.

          There has been substantial immigration of physicians to developed countries, much of it coming from lower-income countries. Although the recipient nations and the immigrating physicians benefit from this migration, less developed countries lose important health capabilities as a result of the loss of physicians. Data on the countries of origin, based on countries of medical education, of international medical graduates practicing in the United States, the United Kingdom, Canada, and Australia were obtained from sources in the respective countries and analyzed separately and in aggregate. With the use of World Health Organization data, I computed an emigration factor for the countries of origin of the immigrant physicians to provide a relative measure of the number of physicians lost by emigration. International medical graduates constitute between 23 and 28 percent of physicians in the United States, the United Kingdom, Canada, and Australia, and lower-income countries supply between 40 and 75 percent of these international medical graduates. India, the Philippines, and Pakistan are the leading sources of international medical graduates. The United Kingdom, Canada, and Australia draw a substantial number of physicians from South Africa, and the United States draws very heavily from the Philippines. Nine of the 20 countries with the highest emigration factors are in sub-Saharan Africa or the Caribbean. Reliance on international medical graduates in the United States, the United Kingdom, Canada, and Australia is reducing the supply of physicians in many lower-income countries. Copyright 2005 Massachusetts Medical Society.
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            Physician migration at its roots: a study on the factors contributing towards a career choice abroad among students at a medical school in Pakistan

            Background Physician migration, also known as “brain drain,” results from a combination of a gap in the supply and demand in developed countries and a lack of job satisfaction in developing countries. Many push and pull factors are responsible for this effect, with media and internet playing their parts. Large-scale physician migration can pose problems for both the donor and the recipient countries, with a resulting reinforcement in the economic divide between developed and developing countries. The main objectives of our study were to determine the prevalence of migration intentions in medical undergraduates, to elucidate the factors responsible and to analyze the attitudes and practices related to these intentions. Methods This was a cross-sectional, observational, questionnaire-based study, conducted at Dow Medical College of Dow University of Health Sciences, Karachi, between January, 2012 and May, 2012. A total of 323 students responded completely. The questionnaire consisted of 3 sections, and was aimed at collecting demographic details, determining students’ migratory intentions, evaluating reasons for and against migration and assessing attitudes and practices of students related to these intentions. Results Out of 323 respondents, 195 wanted to pursue their careers abroad, giving a prevalence rate of 60.4% in our sample. United States was the most frequently reported recipient country. The most common reasons given by students who wished to migrate, in descending order, were: lucrative salary abroad followed by quality of training, job satisfaction, better way of life, relatives, more opportunities, better working environment, terrorism in Pakistan, harassment of doctors in Pakistan, desire to settle abroad, more competition in Pakistan, better management, peer pressure, longer working hours in Pakistan, religious reasons, parent pressure, political reasons and favoritism in Pakistan. A considerable number of respondents had already started studying for licensing examinations, and were also planning of gaining clinical experience in their desired country of interest. Conclusion Physician migration is a serious condition that requires timely intervention from the concerned authorities. If considerable measures are not taken, serious consequences may follow, which may pose a threat to the healthcare system of the country.
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              Trade in health services

              In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services.
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                Author and article information

                Journal
                Pak J Med Sci
                Pak J Med Sci
                Pakistan Journal of Medical Sciences
                Professional Medical Publications (Pakistan )
                1682-024X
                1681-715X
                Mar-Apr 2023
                : 39
                : 2
                : 401-403
                Affiliations
                [1 ]Dr. Fizzah Nadir, MBBS., Punjab Medical College, Faisalabad, Pakistan
                [2 ]Dr. Hassan Sardar, MBBS., Punjab Medical College, Faisalabad, Pakistan
                [3 ]Dr. Husnain Ahmad, MBBS., Punjab Medical College, Faisalabad, Pakistan
                Author notes
                Correspondence: Dr. Hassan Sardar, Punjab Medical College, Faisalabad, Pakistan. Cell: 03037302474. Email: hasansardar61@ 123456gmail.com
                Article
                PJMS-39-401
                10.12669/pjms.39.2.7139
                10025733
                36950443
                e934afbf-abda-4bd7-836a-8e61b6d31419
                Copyright: © Pakistan Journal of Medical Sciences

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 September 2022
                : 15 December 2022
                : 07 January 2022
                Categories
                Original Article

                brain drain,immigration,medical students,pakistan socio-medical condition

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