Factors affecting the migration intention in medical students in Shiraz; south of Iran: a cross sectional study

The increasing emigration of human resources, particularly healthcare workers, poses a significant challenge to achieving the sustainable development goal of equitable healthcare access. This study aimed to assess the migration intentions among medical students at Shiraz University of Medical Sciences and to identify the factors that drive or hinder their propensity to emigrate.

This cross-sectional study employed stratified random sampling. Data were collected anonymously through a researcher-designed questionnaire completed by 403 medical students. The questionnaire's validity and reliability were established within this study. It comprised three sections: demographics, quantitative and qualitative questions regarding migration intentions, and factors influencing these intentions. Data analysis included bivariate and multivariate methods, with linear regression applied to identify significant predictors.

Among the participants, 70.7% expressed an intention to emigrate, with an average migration propensity score of 5.70 ± 2.32 (out of 10). Significant positive associations were found between migration intentions and variables such as pre-university education region, father's education level, prior international travel experience, presence of relatives abroad (including degree of kinship), English language proficiency, possession of foreign language certificates, knowledge of additional languages, number of published papers, online communication with individuals living abroad, and access to migration information sources. Multivariate linear regression highlighted privileged pre-university education regions, having close relatives abroad, English language skills, and access to migration information as significant predictors. Among the five categories of migration drivers (personal, economic, social, political, and structural), personal factors-including aspirations for a better life, gaining experience, family welfare, work-life balance, and family satisfaction-were the predominant motivators (29.8%). Conversely, personal barriers such as family dependence, feelings of alienation, language difficulties, and family dissatisfaction were the main obstacles (42.7%).

Enhancing overall welfare, improving work-life balance, increasing salaries, promoting physicians' social dignity, and strengthening job security are essential strategies to reduce the intention to emigrate and retain skilled healthcare professionals.