Evaluation of the tendencies of migration abroad and their state of hopelessness of assistant physicians working in a university hospital

ABSTRACT EVALUATION OF THE TENDENCIES OF MIGRATION ABROAD AND THEIR STATE OF HOPELESSNESS OF ASSISTANT PHYSICIANS WORKING IN A UNIVERSITY HOSPITAL The concept of brain drain refers to the migration flow of highly educated and qualified individuals from developing countries to developed countries. One of the professional groups with the highest brain drain is health professionals. The issue of migration of physicians abroad, which has increased in recent years, has become an important issue that needs to be addressed and intervened by health managers. With this study, it is aimed to investigate the issue of physician migration and related factors that may cause brain drain, and to contribute to the literature by making evaluations on how sub-headings such as health policies, working conditions in the health sector and violence etc. affect physician migration and physicians' hopelessness. The population of this descriptive and cross-sectional study consisted of 534 assistant physicians who continued their medical speciality education at Fırat University Faculty of Medicine Hospital. The minimum sample size was determined as 223 by selecting 95% confidence interval and 5% margin of error. The participants were sent a questionnaire form prepared by reviewing the literature via Google Form and asked to fill it out voluntarily. In the first part of the questionnaire, questions questioning the sociodemographic characteristics of the participants, in the second part, questions questioning the factors thought to affect the migration status prepared from the literature, and in the third part, Beck Hopelessness Scale questions were used. The questionnaire was answered by 316 people in total. The data were recorded in the statistical package programme 22.0. Normality, Chi-Square, Mann-Whitney U, Kruskal-Wallis, Spearman Correlation tests were used in statistical analyses. Statistical significance was accepted as p<0,05. Among the assistant physicians who participated in the study, 59,2% were female, 56,0% were married, and the mean age was 30,61±4,15 years. 65,5% of the assistant physicians were working in internal medicine, 55,1% had 1-5 years of professional experience. 74,7% had been subjected to verbal/physical violence more than once. 25,3% stated that they had the intention to migrate abroad, 61,2% stated that they had started working to migrate. The most frequently preferred countries were Germany, the UK and Canada. 72,5% stated that they did not want to return to Turkey if they migrated or that they were undecided. The intention to migrate did not differ according to sociodemographic characteristics, but it differed significantly in those who were not satisfied with their speciality and income (p<0,05). Among the reasons for migration of assistant physicians; health policy in Turkey, working conditions, incidents of violence in health, decrease in purchasing power and future anxiety were the most common reasons. The mean Beck Hopelessness Scale (BHS) Total Score of assistant physicians was found to be 8,12±5,25 (min: 0, max: 20, median: 7). It was observed that assistant physicians with the intention to migrate had higher hopelessness scale score levels. A significant positive correlation was found between age, years of profession and hopelessness score. Hopelessness levels of physicians who were exposed to verbal or physical violence were found to be significantly higher. In conclusion; Considering that the number and quality of physicians in our country, which is far behind OECD (Organisation for Economic Co-Operation and Development) countries in terms of the number of physicians per thousand people, is vital for an effective and quality health service, it is very important to study the reasons for the migration of physicians, At the same time, it is thought that trying to understand the psychological aspect of migration in order to better address the individual aspect of the phenomenon of migration, which is a multifactorial concept, may shed light on the regulations related to health systems in the future and contribute to the literature by revealing the existing problems that may cause physicians to migrate and taking the necessary measures for this. Key words: Brain Drain, Physician Migration, Assistant Physician, Beck Hopelessness Scale