title: Passing through - reasons why migrant doctors in Ireland plan to stay, return home or migrate onwards to new destination countries.
abstract: International recruitment is a common strategy used by high-income countries to meet their medical workforce needs. Ireland, despite training sufficient doctors to meet its internal demand, continues to be heavily dependent on foreign-trained doctors, many of whom may migrate onwards to new destination countries. A cross-sectional study was conducted to measure and analyse the factors associated with the migratory intentions of foreign doctors in Ireland.
  
  
  
  A total of 366 non-European nationals registered as medical doctors in Ireland completed an online survey assessing their reasons for migrating to Ireland, their experiences whilst working and living in Ireland, and their future plans. Factors associated with future plans - whether to remain in Ireland, return home or migrate to a new destination country - were tested by bivariate and multivariate analyses, including discriminant analysis.
  
  
  
  Of the 345 foreign doctors who responded to the question regarding their future plans, 16 % of whom were Irish-trained, 30 % planned to remain in Ireland, 23 % planned to return home and 47 % to migrate onwards. Country of origin, personal and professional reasons for migrating, experiences of training and supervision, opportunities for career progression, type of employment contract, citizenship status, and satisfaction with life in Ireland were all factors statistically significantly associated with the three migratory outcomes.
  
  
  
  Reported plans may not result in enacted emigration. However, the findings support a growing body of evidence highlighting dissatisfaction with current career opportunities, contributing to the emigration of Irish doctors and onward migration of foreign doctors. Implementation of the WHO Global Code, which requires member states to train and retain their own health workforce, could also help reduce onward migration of foreign doctors to new destination countries. Ireland has initiated the provision of tailored postgraduate training to doctors from Pakistan, enabling these doctors to return home with improved skills of benefit to the source country.
authors.affiliation: Department of Epidemiology and Public Health Medicine, Royal College of Surgeons, Dublin, Ireland. rbrugha@rcsi.ie.
authors.forename: Ruairí
authors.initials: R
authors.lastname: Brugha
authors.affiliation: Department of Epidemiology and Public Health Medicine, Royal College of Surgeons, Dublin, Ireland.
authors.forename: Sara
authors.initials: S
authors.lastname: McAleese
authors.affiliation: Department of Epidemiology and Public Health Medicine, Royal College of Surgeons, Dublin, Ireland.
authors.forename: Pat
authors.initials: P
authors.lastname: Dicker
authors.affiliation: Centre for Health Policy and Management, Trinity College Dublin, Dublin, Ireland.
authors.forename: Ella
authors.initials: E
authors.lastname: Tyrrell
authors.affiliation: Centre for Health Policy and Management, Trinity College Dublin, Dublin, Ireland.
authors.forename: Steve
authors.initials: S
authors.lastname: Thomas
authors.affiliation: Centre for Health Policy and Management, Trinity College Dublin, Dublin, Ireland.
authors.forename: Charles
authors.initials: C
authors.lastname: Normand
authors.affiliation: Department of Epidemiology and Public Health Medicine, Royal College of Surgeons, Dublin, Ireland.
authors.forename: Niamh
authors.initials: N
authors.lastname: Humphries
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002322:Career Mobility; D003430:Cross-Sectional Studies; D004501:Education, Medical; D004641:Emigration and Immigration; D005260:Female; D005550:Foreign Medical Graduates; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D009042:Motivation; D015999:Multivariate Analysis; D010154:Pakistan; D010560:Personnel Selection; D011365:Professional Practice Location; D011795:Surveys and Questionnaires; D014171:Transients and Migrants; D014944:World Health Organization
keywords: Career progression; Foreign-trained doctors; Health workforce; Onward migration; WHO Global Code