A scoping review on medical students' international migration: trends, determinants, and implications for global health workforce planning.
Gerald Tze Zhen Ser, Zhi Sean Teng, Yady Zikry Yusni, Krisada Shen Yang Ooi, Zhi Yong Wong, Prashwin Singh Tejpal Singh, Wei-Han Hong
Abstract
Open AccessBACKGROUND: Physician migration is a known global phenomenon, with the migration intention of medical students serving as early indicators of the trends in workforce mobility. Understanding the factors influencing their decision to migrate is crucial in the planning of human resources for health in a country and the sustainability of a healthcare system, particularly in low- and middle-income countries (LMIC). This scoping review synthesises current available evidence on the trends, determinants, and implications of medical student international migration. METHODS: A systematic search was conducted on PubMed, Scopus, and Proquest from July 2013 to May 2025, following the PRISMA for Scoping Reviews framework. The selected articles included primary research investigating factors influencing migration intention among medical students. Articles were excluded if the study only explored on perception of migration. Included studies were assessed for quality according to Joanna Briggs Institute (JBI) Critical Appraisal tool, and extracted factors were reclassified and regrouped into domains of Academic and Personal Development, Economic and Working Conditions, and Social and Living Environment factors. RESULTS: 517 articles were screened, of which 33 articles were included, covering medical students from diverse geographical locations. Migration intentions were varied across regions, with studies from 6 countries each reporting that over 80% of sampled medical students intended to migrate. The most common push factors included income, working culture and environment, and career progression. The most frequently cited stay factors were family, financial, and patriotism. CONCLUSION: Migration intentions were widely reported among medical students across different regions, though the proportions varied by country. This serves as a predictor and could indicate the evolving global trend of physician migration in the years to come. Financial prospects, career opportunities, and working conditions play critical roles in determining the migration intentions of medical students. Targeted retention strategies should be implemented especially in resource-limited settings to address brain drain, although at the same time achieving balance in ethical recruitment practices in high-income countries. Future research is warranted to study the longitudinal trends of migration intention and assess the impact of policies on retention.