医生的流动：对一群移民到德国的埃及医生的迁移因素的定性研究。
Doctors on the move: a qualitative study on the driving factors in a group of Egyptian physicians migrating to Germany.
机构信息
Dieter Scheffner Center for Medical Education and Educational Research, Dean's Office of Student Affairs, Charité - Universitätsmedizin Berlin, Free and Humboldt University Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany.
Medical Education Department, Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt.
出版信息
Global Health. 2019 Jan 7;15(1):2. doi: 10.1186/s12992-018-0434-x.
BACKGROUND
Migration of physicians has become a global phenomenon with significant implications for the healthcare delivery systems worldwide. The motivations and factors driving physician's migration are complex and continuously evolving. Purpose of this study is to explore the driving forces in a group of Egyptian physicians and final-years medical students preparing to migrate to Germany.
METHODS
A qualitative study was conducted based on social constructivism epistemology. In five focus group discussions, there participated a total 12 residents and 6 final-year medical students from 7 different training and workplace locations in Egypt. The participants provided information about their motivation and planning for migration. We applied a coding framework based on the concept of push/pull factors and barriers/facilitators for migration, and used Atlas.ti software for analysis.
RESULTS
The thematic analysis indicated that the migration within the study's participants results from a specific weighting of push and pull factors. Push factors are considered to be more important than pull factors. Factors related to professional development play a leading role. The route of migration towards Germany is mainly determined by the low hurdle registration and licensing requirements in this destination country compared to other countries. In some cases, Germany is regarded as a "transit country", a step on the road to other European countries. The intent, planning and preparation of migration is assisted considerably by the local formation of a community and culture of migration with multiple ways for information exchange, identity building and social support through face-to-face and online channels.
CONCLUSIONS
This study specifies - in a group of Egyptian physicians and final-year medical students - the perceived push and pull factors which influenced their intent to migrate to Germany. In addition to the general wealth gap, their particular route of migration is mainly determined by the requirements in licensing and registration procedures for foreign physicians in the potential destination country. The planning and preparation of a move is substantially facilitated by their joining a social network and a community of migrating physicians.
背景
医生移民已成为一种全球现象，对世界范围内的医疗保健系统产生了重大影响。推动医生移民的动机和因素复杂且不断演变。本研究旨在探讨一组准备移民德国的埃及医生和医学应届毕业生的驱动力。
方法
本研究基于社会建构主义认识论进行了定性研究。在五次焦点小组讨论中，来自埃及 7 个不同培训和工作场所的 12 名住院医师和 6 名医学应届毕业生参与其中。参与者提供了有关他们移民动机和计划的信息。我们应用了基于推拉因素和移民障碍/促进因素的编码框架，并使用 Atlas.ti 软件进行分析。
结果
主题分析表明，在研究参与者中，移民是由于推拉因素的特定权重所致。推动因素被认为比拉动因素更为重要。与专业发展相关的因素起着主导作用。移民到德国的途径主要是由于与其他国家相比，目的地国家的注册和许可要求门槛较低。在某些情况下，德国被视为“过境国”，是通往其他欧洲国家的一步。通过面对面和在线渠道，通过多种信息交流、身份构建和社会支持方式，当地移民社区和文化的形成极大地促进了移民的意图、规划和准备。
结论
本研究在一组埃及医生和医学应届毕业生中具体说明了影响他们移民德国意图的感知推拉因素。除了普遍的贫富差距外，他们特定的移民途径主要取决于潜在目的地国家对外国医生的许可和注册程序要求。通过加入移民医生的社交网络和社区，大大促进了移民的规划和准备。
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