Why do medical students seek for work abroad?

This article was exclusively written for the Sting by Mr. Cagri Orkun Kilic, a medical student at the University of Marmara Faculty of Medicine in Istanbul, Turkey and Ms Aleksandra Likońska, a medical student at the University of Lodz, Poland . Both are also affiliated to the International Federation of Medical Students Associations (IFMSA). However, the opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one. Article 13 of Universal Declaration of Human Rights states “Everyone has the right to freedom of movement and residence within the borders of each state.” When healthcare workers move from one country to another to work, there are two factors to consider: Those called “push factors” which incites one to leave one’s country, and “pull factors” which can attract one to another country. Push and pull factors usually exist as opposite pairs such as low financial compensation in one country, and relatively high financial compensations in another country. Here we would like to elaborate the most common reasons why medical students leave their home country to work elsewhere. Medical students voluntarily dedicate their youth and free time to explore art of healing human body and it seems rightful to demand equitable salary for their work, which includes personal, financial and moral responsibilities. In many countries salaries for young doctors neither ensure enough livelihood nor is the reflection of the workload and responsibility. Moreover, young doctors, who know that specialty is essential for their future career very often agree to lower payments or emigrate. Graduation is not enough – in most countries to become an independent doctor specialty is required. Specialty course is a paid position at hospital and trainees are called residents. Residents learn by working, are gradually given more advanced procedures to perform, initially under supervision, later on their own. Average time of specialty course is 4-6 years. In Europe there is noticeably alarming trend of increasing number of medical students, but without parallel increase of specialty places. Emigration is inevitable when students don’t have possibility to continue their medical career in country they trained in. This policy that originally put forward to solve the problem of lacking doctors, instead aggravated it. Poor quality of postgraduate studies is also a drive for leaving homeland. Specialty course should be a time of gradual transition from mostly theoretical knowledge gained at university to fully individual medical practice. Regrettably, very often this process is disturbed: lack of supervisors, work overload brings overwhelming duties such as additional shifts. Humans seek to move out of a place where they feel insecure, as shown by the recent refugee situation in Europe. Economic and political instability and minority issues of a country are important pushing factors for medical students to seek new countries to settle and work. Disruptions in a country’s management and civil turmoil affect healthcare rapidly as deterioration of societal well-being leads to overuse of hospitals. Together with a sense of insecurity, political and economical instability is the recipe for medical student emigration. WHO suggests that heavy workload is a reason for healthcare workers migration. Medicine is a non-stop profession as people will always suffer from health problems and require treatment. The need for doctors in medical facilities are 24/7 and shifts and working hours are decided by special labor contracts. Demand for doctors’ work is high and with some poor management of human resources, doctors face inhumane working hours even around Europe. While the movement of medical students is a human right, on the other hand migration of doctors deepen the problem of lacking medical professionals in unprivileged areas. By understanding all factors behind doctors’ migration, IFMSA believes that solutions to such a complex problem may be found when worked together with governments, medical schools and other non-governmental organisations. About the authors Aleksandra Likońska is 5th year medical student at Medical University of Lodz, Poland, currently Standing Committee on Medical Education Regional Assistant for Europe 2016-17, International Federation of Medical Students’ Associations (IFMSA). Medical education enthusiast and researcher. Advocator for better medical universities’ curricula. Guide for medical students that want to be a change leaders in their countries. Member of Student Taskforce during An International Association For Medical Education AMEE Conference in Glasgow and Barcelona. Cagri Orkun Kilic is a 6th year medical student at University of Marmara Faculty of Medicine in Istanbul, Turkey. He worked as National Officer of Medical Education for Turkish Medical Students Association (TurkMSIC) 2013-2014 and as Medical Education Director for European Medical Students Association (EMSA) 2015-2016. He also worked for two years as one of the coordinators of Student Taskforce during An International Association For Medical Education AMEE Conferences in 2016 and 2017.