Teaching assistants in Argentina have greater intentions to migrate abroad as physicians than other medical students
DOI:
https://doi.org/10.31053/1853.0605.v81.n2.42855Keywords:
medical education, faculty, human migrationAbstract
Introduction: The brain drain of physicians from lower-middle-income countries to high-income countries is a growing phenomenon that contributes to global health inequalities. Retention strategies are difficult to implement locally and to specifically target the population at risk of migrating. We hypothesize that medical students who are teaching assistants have greater intentions to migrate to practice Medicine abroad.
Methods: Medical students from Argentina were invited to an online survey of 22 multiple-choice questions based on the LIRHUS Network survey, previously used in Latin America.
Results: 2,301 medical students were enrolled. Most were young (23 [20-25] years old), single (90%), and female (79%). The majority studied at public universities (87%). The intention to migrate to practice Medicine abroad was more frequent among teaching assistants (36% vs 31%; χ2 = 4.4982; p = 0.0339). After adjusting for sex and age, being a teaching assistant was associated with the intention to migrate to practice Medicine abroad (OR = 1.26; 95% CI 1.02 - 1.55; p = 0.002).
Conclusions: Argentine teaching assistants have a greater risk of migrating to practice Medicine abroad. Given their high academic profile, these are valuable human resources trained using the public financing of low-middle-income countries. The loss of these resources could contribute to health inequalities. This is an easily identifiable and accessible subgroup toward which local retention policies could be directed.
Downloads
References
Mathews B, Malik M. Immigrant Physicians Fill a Critical Need in COVID-19 Response. J Hosp Med. 2020;15(8):505-506. doi:10.12788/jhm.3473
Mullan F. The Metrics of the Physician Brain Drain. New England Journal of Medicine. 2005;353(17):1810-1818. doi:10.1056/nejmsa050004
Tiwari V, Bhardwaj A, Sonani B, Mehta A. Urgent Issues Facing Immigrant Physicians in the United States in the COVID-19 Era. Ann Intern Med. 2020;173(10):838-839. doi:10.7326/m20-4103
Saluja S, Rudolfson N, Massenburg B, Meara J, Shrime M. The impact of physician migration on mortality in low and middle-income countries: an economic modelling study. BMJ Glob Health. 2020;5(1):e001535. doi:10.1136/bmjgh-2019-001535
Botezat A, Ramos R. Physicians’ brain drain - a gravity model of migration flows. Global Health. 2020;16(1). doi:10.1186/s12992-019-0536-0
Mills EJ, Kanters S, Hagopian A, Bansback N, Nachega J, Alberton M, Au-Yeung CG, Mtambo A, Bourgeault IL, Luboga S, Hogg RS, Ford N. The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis. BMJ. 2011 Nov 23;343:d7031. doi: 10.1136/bmj.d7031.
WHO Global Code of Practice on the International Recruitment of Health Personnel. Disponible en https://www.who.int/publications/i/item/wha68.32
Mayta-Tristán, P, Dulanto-Pizzorni, A. Prevalencia y factores asociados con la intención de Emigración en internos de Medicina de una universidad pública, Lima 2007. Rev Peru Med Exp Salud Publica. 2008; 25(3): 274 274-78.
Carrasco V, Lozano E, Velásquez E. Análisis actual y prospectivo de la oferta y demanda de médicos en el Perú 2005-2011. Acta Med Peru. 2008; 25(1): 22-29.
Dandavino M, Snell L, Wiseman J. Why medical students should learn how to teach. Med Teach. 2007;29(6):558-565. doi:10.1080/01421590701477449
Versteeg M, van Blankenstein F, Putter H, Steendijk P. Peer instruction improves comprehension and transfer of physiological concepts: a randomized comparison with self-explanation. Advances in Health Sciences Education. 2018;24(1):151-165. doi:10.1007/s10459-018-9858-6
Kurtz SM. Doctor-patient communication: principles and practices. Can J Neurol Sci. 2002;29 Suppl 2:S23-S29. doi:10.1017/s0317167100001906
Barrera, T., Cabana, N., Bourguet, M. E., Lacava, R., Baiocco, A. K., Angriman, F. ., Astorquizaga, L., Cruz, C. V., Politi, M. T.Ayudantías universitarias: influencia académica percibida en el desempeño en el examen de residencias médicas municipales. Revista del Hospital Italiano de Buenos Aires. 2021 Jun 30;41(2):61-9.
Universidad Nacional de Rosario. Facultad de Ciencias Médicas. Proyecto “Reglamento de Concurso para Ingreso a 1er. año del Sistema de Formación de Postgrado de Especialidades Médicas”. Disponible en: https://fcm.unr.edu.ar/wp-content/uploads/2019/12/ReglamentoIngresoResidencias.pdf
Sistema Provincial De Salud De Tucumán. Dirección General De Recursos Humanos En Salud. Dirección De Formación Y Capacitación - Departamento De Residencias. Reglamento General Para Concurso De Residencias Del Sistema Provincial De Salud. Disponible en: http://msptucuman.gov.ar/wordpress/wp-content/uploads/2018/03/2018-Reglamento-de-Concursos-de-Residencias.pdf
Hernández-Negrín H, Negrín Jurajuria A, Cabrera Bermúdez Y, Zurbano Fernández J, Martínez Neira X. Movimiento de alumnos ayudantes: experiencia de una institución cubana. Educación Médica. 2018;19(2):115-119. doi:10.1016/j.edumed.2016.09.006
Mayta-Tristán P, Pereyra-Elías R, Montenegro-Idrogo JJ, Mejia CR, Inga-Berrospi F, Mezones-Holguín E; Red-LIRHUS (Grupo Colaborativo Latinoamericano para la Investigación en Recursos Humanos en Salud). Profile and professional expectations of medical students from 11 Latin American countries: the Red-LIRHUS project. BMC Res Notes. 2017 Apr 20;10(1):159. doi: 10.1186/s13104-017-2479-y.
Santiago-Ullero B, Valer-Villanueva S, Urrunaga-Pastor D, Benites-Zapata VA. Estrés percibido e intención de migrar al interior del país en médicos y enfermeros que residen en Lima: un análisis exploratorio de la encuesta nacional de satisfacción de usuarios en salud (Ensusalud), 2015 [Perceived stress and intention to migrate to the interior of peru among physicians and nurses who reside in Lima: exploratory analysis of the national survey of satisfaction of users in health, 2015]. Rev Peru Med Exp Salud Publica. 2017 Jul-Sep;34(3):404-413. Spanish. doi: 10.17843/rpmesp.2017.343.2822.
Glueck DH. Sample Size Calculations in Clinical Research 2nd edition by CHOW, S.-C., SHAO, J., and WANG, H. Biometrics. 2008;64(4):1307-1308. doi:10.1111/j.1541-0420.2008.01138_10.x.
Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996 Dec;49(12):1373-9. doi: 10.1016/s0895-4356(96)00236-3.
Rueda L. La mujer en las profesiones de la salud. Acta bioethica. 2006;12(2):177-83.
Suciu Ş, Popescu C, Ciumageanu M, Buzoianu A. Physician migration at its roots: a study on the emigration preferences and plans among medical students in Romania. Hum Resour Health. 2017;15(1). doi:10.1186/s12960-017-0181-8
Elie A Akl. Post-graduation migration intentions of students of Lebanese medical schools: a survey study. BMC Public Health. 2008, 8:191 doi:10.1186/1471-2458-8-191.
Valor de aranceles 2021 para estudiantes nuevos - Universidad de Chile. Uchile.cl. https://www.uchile.cl/portal/admision-y-matriculas/aranceles-y-credito/aranceles/4934/estudiantes-nuevos. Publicado 2021. Acceso Noviembre 28, 2021.
Universidad Nacional de Chile. Valor de aranceles 2021 para estudiantes nuevos. Disponible en: https://www.uchile.cl/portal/admision-y-matriculas/aranceles-y-credito/aranceles/4934/estudiantes-nuevos
Universidad Peruana Cayetana Heredia. Admisión. Disponible en: https://cayetano.edu.pe/admision
Organización Internacional para las Migraciones, Instituto Nacional de Estadística e Informática, Dirección General de Migraciones y Naturalización. Perú: Estadísticas de la migración internacional de peruanos, 1990-2007. Lima: OIM/INEI/DIGEMIN; 2008.
Chikanda, A. Skilled Health Professionals’ Migration and its Impact on Health Delivery in Zimbabwe, Journal of Ethnic and Migration Studies. 2006, 32:4, 667-680, doi: 10.1080/13691830600610064
Webb R, Valencia S. Human resources in public health and education in Peru. In: Cotlear D (ed). A new social contract for Peru. An agenda for improving education, health care, and the social safety net. Washington DC: World Bank; 2006. p. 191-244.
Attaran A, Walker RB. Shoppers drug mart or poachers drug mart?. Canadian Medical Association Journal. 2008 Jan 29;178(3):265-6. doi:10.1503/cmaj.071733
Houssay, BA; La emigración de científicos y técnicos de la Argentina. Prensa Médica Mexicana; XXXIII; 9-10; 1968; 362-369. Disponible en: https://ri.conicet.gov.ar/handle/11336/123100.
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Universidad Nacional de Córdoba
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The Faculty of Medical Sciences Journal (RFCM) subscribes to the Open Access policy and does not charge authors fees for publishing, nor does it charge readers fees for accessing published articles (APC).
