title: Why are you draining your brain? Factors underlying decisions of graduating Lebanese medical students to migrate.
abstract: 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.
authors.affiliation: Department of Medicine, State University of New York at Buffalo, ECMC CC-142, 462 Grider Street, Buffalo, NY 14215, USA. elieakl@buffalo.edu
authors.forename: Elie A
authors.initials: EA
authors.lastname: Akl
authors.forename: Nancy
authors.initials: N
authors.lastname: Maroun
authors.forename: Stella
authors.initials: S
authors.lastname: Major
authors.forename: Claude
authors.initials: C
authors.lastname: Afif
authors.forename: Bechara
authors.initials: B
authors.lastname: Chahoud
authors.forename: Jacques
authors.initials: J
authors.lastname: Choucair
authors.forename: Mazen
authors.initials: M
authors.lastname: Sakr
authors.forename: Holger J
authors.initials: HJ
authors.lastname: Schünemann
mesh_terms: D000328:Adult; D002321:Career Choice; D003466:Cultural Characteristics; D004465:Economic Competition; D004641:Emigration and Immigration / Q000706:statistics & numerical data* / Q000639:trends; D017144:Focus Groups; D005550:Foreign Medical Graduates / Q000191:economics / Q000523:psychology* / Q000706:statistics & numerical data; D019981:Health Care Sector / Q000639:trends; D006801:Humans; D007396:Internship and Residency; D007407:Interviews as Topic; D007861:Lebanon / Q000208:ethnology; D009042:Motivation; D011365:Professional Practice Location / Q000191:economics; D012945:Social Values; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data