Abstract：
Many high-income countries are heavily dependent on internationally trained doctors to staff their healthcare workforce. Over one-third of doctors practising in the UK received their primary medical qualification abroad. Simultaneously, an average of around 2.1% of doctors leave the UK medical workforce annually to go overseas. The aim of this study was to identify the drivers and barriers of international migration of doctors to and from the UK.
A scoping review was conducted. We searched EMBASE, MEDLINE, CINAHL, ERIC and BEI in January 2020 (updated October 2021). Grey literature and citation searching were also carried out. Empirical studies reporting on the drivers and barriers to the international migration of doctors to and from the UK published in the English language from 2009 to present were included. The drivers and barriers were coded in NVivo 12 building on an existing framework.
40 studies were included. 62% were quantitative, 18% were qualitative, 15% were mixed-methods and 5% were literature reviews. Migration into and out of the UK is determined by a variety of macro- (global and national factors), meso- (profession led factors) and micro-level (personal factors). Interestingly, many of the key drivers of migration to the UK were also factors driving migration from the UK, including: poor working conditions, employment opportunities, better training and development opportunities, better quality of life, desire for a life change and financial reasons. The barriers included stricter immigration policies, the registration process and short-term job contracts.
Our research contributes to the literature by providing a comprehensive up-to-date review of the drivers and barriers of migration to and from the UK. The decision for a doctor to migrate is multi-layered and is a complex balance between push/pull at macro-/meso-/micro-levels. To sustain the UK\'s supply of overseas doctors, it is vital that migration policies take account of the drivers of migration particularly working conditions and active recruitment while addressing any potential barriers. Immigration policies to address the impact of Brexit and the COVID-19 pandemic on the migration of doctors to and from the UK will be particularly important in the immediate future. Trial registration PROSPERO CRD42020165748.
A scoping review was conducted. We searched EMBASE, MEDLINE, CINAHL, ERIC and BEI in January 2020 (updated October 2021). Grey literature and citation searching were also carried out. Empirical studies reporting on the drivers and barriers to the international migration of doctors to and from the UK published in the English language from 2009 to present were included. The drivers and barriers were coded in NVivo 12 building on an existing framework.
40 studies were included. 62% were quantitative, 18% were qualitative, 15% were mixed-methods and 5% were literature reviews. Migration into and out of the UK is determined by a variety of macro- (global and national factors), meso- (profession led factors) and micro-level (personal factors). Interestingly, many of the key drivers of migration to the UK were also factors driving migration from the UK, including: poor working conditions, employment opportunities, better training and development opportunities, better quality of life, desire for a life change and financial reasons. The barriers included stricter immigration policies, the registration process and short-term job contracts.
Our research contributes to the literature by providing a comprehensive up-to-date review of the drivers and barriers of migration to and from the UK. The decision for a doctor to migrate is multi-layered and is a complex balance between push/pull at macro-/meso-/micro-levels. To sustain the UK\'s supply of overseas doctors, it is vital that migration policies take account of the drivers of migration particularly working conditions and active recruitment while addressing any potential barriers. Immigration policies to address the impact of Brexit and the COVID-19 pandemic on the migration of doctors to and from the UK will be particularly important in the immediate future. Trial registration PROSPERO CRD42020165748.
摘要：
背景：许多高收入国家严重依赖经过国际培训的医生来配备医疗人员。在英国执业的医生中有超过三分之一在国外获得了基本医疗资格。同时,平均每年约有2.1％的医生离开英国的医疗队伍去海外。这项研究的目的是确定医生往返英国的国际移民的驱动因素和障碍。
方法：进行了范围审查。我们搜索了EMBASE,MEDLINE,CINAHL,ERIC和BEI于2020年1月（2021年10月更新）。还进行了灰色文献和引文搜索。包括2009年至今以英语发表的关于医生往返英国的国际移民的驱动因素和障碍的实证研究。在现有框架上的NVivo12中对驱动程序和障碍物进行了编码。
结果：纳入40项研究。62%是定量的，18%是定性的，15%为混合方法，5%为文献综述。移民进出英国是由各种宏观因素(全球和国家因素)决定的，中观(职业主导因素)和微观(个人因素)。有趣的是,移民到英国的许多关键驱动因素也是推动从英国移民的因素，包括:恶劣的工作条件，就业机会,更好的培训和发展机会，更好的生活质量，对生活变化和经济原因的渴望。障碍包括更严格的移民政策，注册过程和短期工作合同。
结论：我们的研究通过提供有关往返英国的驱动因素和障碍的全面最新综述，为文献做出了贡献。医生迁移的决定是多层的，并且是宏观/中观/微观层面的推/拉之间的复杂平衡。为了维持英国海外医生的供应，移民政策必须考虑到移民的驱动因素，特别是工作条件和积极招聘，同时解决任何潜在的障碍。解决英国退欧和COVID-19大流行对医生往返英国的影响的移民政策在不久的将来将尤为重要。试用注册PROSPEROCRD42020165748。
方法：进行了范围审查。
结果：纳入40项研究。
结论：我们的研究通过提供有关往返英国的驱动因素和障碍的全面最新综述，为文献做出了贡献。
