Medical Student Intentions to Move Abroad: A UK-Based Realist Evaluation

Area of Science:

• Medical Education
• Healthcare Workforce Planning
• International Migration Studies

Background:

• Medical student migration abroad can exacerbate domestic healthcare workforce shortages.
• Understanding factors influencing international relocation decisions is crucial for graduate retention.

Approach:

• Developed a programme theory using realist evaluation methodology.
• Combined literature review with 30 in-depth interviews of UK medical students.
• Generated actionable recommendations for stakeholders based on the theory.

Key Points:

• Identified five key contexts and six underlying mechanisms influencing students' decisions.
• Decision-making regarding international relocation is complex and multifaceted.
• Outcomes include a clear intention to move abroad or remain domestically.

Conclusions:

• Realist evaluation elucidates the interplay of contexts and mechanisms in graduate migration.
• Recommendations focus on enhancing domestic retention through curriculum, postgraduate opportunities, and social support.
• Evidence-based strategies can mitigate the impact of medical student emigration on national healthcare systems.