Assessment of Brain Drain Attitudes and Determinants among Medical Students and Young Physicians

Background

Medical brain drain may threaten future health workforce capacity. This study aimed to determine migration willingness and brain drain attitudes among sixth-year medical students and resident physicians.

Methods

A cross-sectional study was conducted in September 2025 among final-year medical students and resident physicians at Gazi University Faculty of Medicine. Data were collected using online and face-to-face questionnaires assessing sociodemographic and professional characteristics, migration intention, and the 16-item Attitude Scale for Brain Drain (ASBD). Higher scores indicated stronger migration tendency (range: 16-80). Logistic regression was performed to identify factors associated with willingness to work abroad, and adjusted odds ratios (aOR) with 95% confidence intervals (CI) were reported (p < 0.05).

Results

Among 785 participants, 20.9% intended to work abroad and 30.2% were undecided. The most preferred destination countries were the United States (28.0%), Germany (26.2%), and the United Kingdom (22.6%). The mean ASBD score was 54.47±11.18. The main migration reasons were better working conditions (90.3%), economic conditions (82.4%), higher welfare level (81.2%), and safer working environment (80.6%). In logistic regression, willingness to work abroad was associated with male sex (aOR: 1.57, 95% CI: 1.02–2.41), having an acquaintance who had migrated abroad (aOR: 1.62, 95% CI: 1.01–2.58), and higher ASBD score (aOR: 1.20, 95% CI: 1.16–1.24).

Conclusions

One in five participants intended to work abroad, and nearly one in three were undecided. Migration willingness was independently associated with male sex, having an acquaintance who had migrated abroad, and higher ASBD scores. Improving working conditions, economic prospects, and workplace safety may be essential to retain young physicians.

Key messages

• One in five final-year medical students and resident physicians intended to work abroad, and nearly one in three were undecided, indicating a substantial risk for future physician workforce retention.

• Migration willingness was mainly driven by working conditions, economic prospects, welfare level, and workplace safety; policies targeting these areas may help reduce medical brain drain.