Factors Associated With Migration Intentions Among Talented Medical Students in Iran: Cultural, Educational, and...

Healthcare brain drain challenges health systems in developing countries, and Iran loses considerable medical talent annually. Bright Talents Committee medical students are pivotal to the national health system yet exhibit high emigration propensity. This study examined the cultural, educational, and social correlates of migration intention, alongside demographic differences.

In this descriptive-analytical cross-sectional study, 150 talented students (professional doctorate/postgraduate) from Iran's Region 4 were surveyed using validated tools: Neill's Educational Satisfaction Questionnaire, Pascarella and Terenzini's Institutional Integration Scale, and Seeman's Cultural Alienation Questionnaire. Migration intention was assessed via a 5-point Likert scale (Cronbach's α=0.85). Data were analyzed (SPSS 26) using Pearson correlations, t-tests/ANOVA, and multiple linear regression. Sample size was determined a priori by power analysis (medium effect, power=0.80, α=0.05). Inclusion criteria were registration in a Region 4 Bright Talents Committee program, current student status, and written informed consent; students with over six months of prior study or work abroad were excluded.

Migration intention was high (51.2% scoring ≥4; M=3.8/5, SD=0.9). Cultural factors were significantly associated with migration intention (r=0.367, p<0.001; unstandardized B=0.10, p=0.001; R²=0.14), whereas the bivariate associations for social (r=-0.166, p=0.050) and educational factors (r=-0.217, p=0.031) did not remain significant in the multivariable model (B=-0.04, p=0.409 and B=-0.01, p=0.592). Social factors differed by gender (p=0.032), cultural factors by marital status (p=0.041), and social factors and educational satisfaction by economic status (p<0.05 each). Age, GPA, and field/level of study showed no significant associations (p>0.05).

Cultural alienation was the strongest correlate of migration intentions, though the cross-sectional design precludes causal inference. The attenuation of educational and social associations in the multivariable model suggests substantial shared variance with cultural alienation. These findings highlight cultural belonging as a target for student support and retention policy, pending careful appraisal of specific interventions.