title: Gone for good? An online survey of emigrant health professionals using Facebook as a recruitment tool.
abstract: Health professionals, particularly doctors, nurses and midwives, are in high demand worldwide. Therefore, it is important to assess the future plans and likelihood of return of emigrating health professionals. Nevertheless, health professionals are, by definition, a difficult population to track/survey. This exploratory study reports on the migration intentions of a sample of doctors, nurses and midwives who had emigrated from Ireland, a high-income country which has experienced particularly high outward and inward migration of health professionals since the year 2000.
  
  
  
  Health professionals who had emigrated from Ireland were identified via snowball sampling through Facebook and invited to complete a short online survey composed of closed and open response questions.
  
  
  
  A total of 388 health professionals (307 doctors, 73 nurses and 8 midwives) who had previously worked in Ireland completed the survey. While over half had originally intended to spend less than 5 years in their destination country at the time of emigration, these intentions changed over time, with the desire to remain abroad on a permanent basis increasing from 10 to 34 % of doctor respondents. Only a quarter of doctors and a half of nurses and midwives intended to return to practice in Ireland in the future.
  
  
  
  The longer health professionals remain abroad, the less likely they are to return to their home countries. Countries should focus on the implementation of retention strategies if the 'carousel' of brain drain is to be interrupted. This would allow source countries to benefit from their investments in training health professionals, rather than relying on international recruitment to meet health system staffing needs. Improved data collection systems are also needed to track the migratory patterns and changing intentions of health professionals. Meanwhile, social networking platforms offer alternative methods of filling this information gap.
authors.affiliation: Department of Epidemiology and Public Health Medicine, Royal College of Surgeons, Dublin, Ireland. mcaleese.sara@gmail.com.
authors.forename: Sara
authors.initials: S
authors.lastname: McAleese
authors.affiliation: Department of General Practice, Royal College of Surgeons, Dublin, Ireland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Clyne
authors.affiliation: School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
authors.forename: Anne
authors.initials: A
authors.lastname: Matthews
authors.affiliation: Department of Epidemiology and Public Health Medicine, Royal College of Surgeons, Dublin, Ireland.
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: Niamh
authors.initials: N
authors.lastname: Humphries
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003695:Delivery of Health Care; D054242:Emigrants and Immigrants; D004641:Emigration and Immigration; D005551:Foreign Professional Personnel; D006801:Humans; D033182:Intention; D007494:Ireland; D009721:Nurse Midwives; D009726:Nurses; D010560:Personnel Selection; D010820:Physicians; D011365:Professional Practice Location; D061108:Social Media; D011795:Surveys and Questionnaires; D014171:Transients and Migrants; D000078329:Workforce
keywords: Doctors; Emigration; Health workforce planning; Midwives; Nurses; Online survey