Why are you draining your brain? Factors underlying decisions of graduating Lebanese medical students to migrate

• Published in: Social science & medicine (1982) Vol. 64; no. 6; pp. 1278 - 1284
• Main Authors: Akl, Elie A., Maroun, Nancy, Major, Stella, Afif, Claude, Chahoud, Bechara, Choucair, Jacques, Sakr, Mazen, Schünemann, Holger J.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-03-2007; Elsevier; Pergamon Press Inc
• Series: Social Science & Medicine
• Subjects: Adult; Biological and medical sciences; Brain Drain; Career Choice; Cultural Characteristics; Decision making; Doctors; Economic Competition; Emigration; Emigration and Immigration - statistics & numerical data; Emigration and Immigration - trends; Focus Groups; Foreign Medical Graduates - economics; Foreign Medical Graduates - psychology; Foreign Medical Graduates - statistics & numerical data; Health Care Sector - trends; Health participants; Humans; Internship and Residency; Interviews as Topic; Labor Market; Labour market; Lebanese people; Lebanon; Lebanon - ethnology; Lebanon Middle east Brain drain Migration Physicians Medical students; Medical schools; Medical sciences; Medical Students; Middle East; Migration; Miscellaneous; Motivation; Physicians; Professional Practice Location - economics; Public health. Hygiene; Public health. Hygiene-occupational medicine; Social Values; Sociocultural Factors; Students; Students, Medical - psychology; Students, Medical - statistics & numerical data; Lebanon; Asia; Middle east; Lebanon; Medical students; Brain drain; Physicians; Migration; Middle east; Human; Health staff; Decision making; Central nervous system; Physician; Teaching; Medicine; Resident(student); Social aspect; Public health
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2006.10.021

In the context of a worldwide physician brain drain phenomenon, Lebanon has the highest emigration factor in the Middle East and North Africa. In this manuscript we aim to identify and develop a conceptual framework for the factors underlying the decisions of graduating Lebanese medical students to train abroad. We conducted two focus groups and seven semi-structured individual interviews with 23 students. In the deductive analysis (based on the push–pull theory), students reported push factors in Lebanon and pull factors abroad related to five dimensions. They focused predominantly on how training abroad provides them with a competitive advantage in an oversaturated Lebanese job market. An inductive analysis revealed the following emerging concepts: repel factors abroad and retain factors locally; societal expectations that students should train abroad; marketing of abroad training; and an established culture of migration. The marketing of abroad training and the culture of migration are prevalent in the academic institutions.