Exploring Romanian Pharmacists' Migration Readiness Through the Push-Pull-Mooring Framework: A PLS-SEM Study

Background: The international migration of pharmaceutical professionals has implications for the availability of human resources and the sustainability of pharmaceutical services; however, the determinants of pharmacists' readiness for cross-border mobility remain insufficiently examined. This study examines the associations of professional factors, the importance assigned to migration-related benefits, and relocation-related barriers with Migration Readiness within the Push-Pull-Mooring (PPM) theoretical framework. Methods: Data were collected via an online questionnaire administered to a sample of 542 professionally active pharmacists in Romania and were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) with SmartPLS 4. The findings indicate that dissatisfaction with working conditions and remuneration is positively associated with both the Importance of Migration Benefits and Migration Readiness. Greater importance assigned to potential economic, professional, and personal migration-related benefits is, in turn, positively associated with Migration Readiness. Results: Among the mooring factors, Migration Mooring Barriers exhibit the strongest direct association with Migration Readiness, with a negative direction of the relationship; within this construct, family responsibilities and uncertainty regarding adjustment displayed the largest positive relative weights within the formative composite. By contrast, perceived institutional and professional deficits do not display significant associations with either perceived migration benefits or readiness to migrate. In addition, the internal cross-validated predictive assessment yielded positive Q² predict values for both endogenous constructs (Importance of Migration Benefits, IMB = 0.210; Migration Readiness, MR = 0.193). CVPAT indicated significantly lower predictive loss for the PLS-SEM model than for the indicator-mean and linear-model benchmarks, although the predictive advantage over the linear model was modest. These results support the internal predictive performance of the selected model for questionnaire responses within the analyzed sample. They do not establish the model's ability to predict subsequent migration or monitor workforce vulnerability over time. The model should therefore be regarded as a candidate framework for future longitudinal and externally validated workforce research. Conclusions: The findings provide exploratory support for examining pharmacists' Migration Readiness within the PPM framework. Because the instrument was author-developed or conceptually adapted from previous literature, measurement evaluation and refinement and structural-model testing were conducted within the same convenience sample, and the convergent validity of the formative composites was not established through redundancy analysis, the results require independent replication. The model should not be regarded as a validated workforce-monitoring, individual-prediction, or decision-support instrument.