Emigration Plans after Graduation of Clinical Medical Students of Ebonyi State University Abakaliki, Nigeria: Implications for Policy

Abstract

Objective: To determine the emigration plans after graduation of clinical medical students of Ebonyi State University Abakaliki, Nigeria.

Methods: A descriptive cross‑sectional study design was used. All clinical medical students of the University willing to participate were included. Information was obtained using a pre‑tested self‑administered questionnaire. Outcome measure included proportion of students willing to emigrate and those willing to practice in rural areas after graduation.

Results: A total of 285 students participated in the study, (response rate, 92.5%). Majority, 93.3% intend to pursue specialist training after  graduation. Minor proportion, 13.9% intend to specialize in Nigeria, whereas 74.4% prefer to specialize outside Nigeria. Major reasons for preferring specialist training abroad included good equipment/facilities, 33.8%, better remuneration/quality of life, 27.8%; and improved skills, 18.7%.  Countries of interest for training outside Nigeria included Canada, 28.3%; United Kingdom, 23.2%; and the United States of America, 18.2%. Minor proportion, 17.2% intend to practice in rural area after graduation. Predictors of willingness to emigrate included being in 400 level class, (adjusted odds ratio (AOR) =2.0, 95% CI = 1.1–4.1), being single, AOR = 4.0, 95% CI = 1.2–13.3) and having decided on specialty of choice, (AOR = 2.6, 95% CI = 1.5–4.5). Predictors of willingness to serve in rural area included family residence in urban area, (AOR = 0.2, 95% CI = 0.2–0.8) and intention to specialize in Nigeria, (AOR = 3.7, 95% CI = 1.6–8.5).

Conclusions: Majority of students intend to pursue specialist training and prefer training abroad. Minor proportions were willing to specialize in Nigeria and serve in rural areas. The students may have perceived medical practice in Nigeria as serving in rural areas hence students willing to work in rural areas were more likely to specialize in Nigeria. This may adversely affect health service delivery in Nigeria if left unchecked. Nigerian authorities should ensure that medical graduates willing to practice in Nigeria are not deterred. Also, plans to encourage doctors to practice in Nigeria should receive desired attention.

Keywords: Abakaliki, Ebonyi state, emigration, medical students, Nigeria, rural medical practice