Understanding the drivers of brain drain: A study of migration intention among medical students in Nigeria

Ededa EM; Garba JA; Peter LO; Ajala EO; Ugwu FO; Ejeh EA; Akpan CJ; Beede MC; Onyeama RK; Shagbaor JU; Fatukasi SP; Hassan RM; Yusuf M; Yanmida G; Paul F; Musa HS; Daniel AA; Emeagui MK; Ayodele HA; Ologbonyo T; Ismail HO; Baba KD

doi:10.61386/imj.v19i4.1380

Authors

Ededa EM Bayero University, Kano, Nigeria
Garba JA Bayero University, Kano, Nigeria
Peter LO University of Nigeria, Nsukka, Nigeria
Ajala EO Igbinedion University, Okada, Nigeria
Ugwu FO Federal University of Health Sciences, Otukpo, Nigeria
Ejeh EA Benue State University, Makurdi, Nigeria
Akpan CJ University of Nigeria, Nsukka, Nigeria
Beede MC University of Abuja, Abuja, Nigeria
Onyeama RK University of Uyo, Uyo, Nigeria
Shagbaor JU Benue State University, Makurdi, Nigeria
Fatukasi SP Igbinedion University, Okada, Nigeria
Hassan RM Federal University, Birnin Kebbi, Nigeria
Yusuf M Lagos State University, Lagos, Nigeria
Yanmida G Bayero University, Kano, Nigeria
Paul F Kaduna State University, Kaduna, Nigeria
Musa HS Bayero University, Kano, Nigeria
Daniel AA Bayero University, Kano, Nigeria
Emeagui MK Federal University of Health Sciences, Azare, Bauchi, Nigeria
Ayodele HA Lagos State University, Lagos, Nigeria
Ologbonyo T Federal University of Health Sciences, Azare, Bauchi, Nigeria
Ismail HO Maitama Sule University, Kano Nigeria
Baba KD Maitama Sule University, Kano Nigeria

DOI:

https://doi.org/10.61386/imj.v19i4.1380

Keywords:

Physician migration, migration intention, medical students, health workforce, brain drain, retention strategies, licensure pathways

Abstract

Context: Health workforce migration from low- and middle-income countries remains a major global health challenge. Nigeria, one of the largest contributors to the global medical workforce, faces increasing loss of physicians.

Objective: This study examined the prevalence and determinants of migration intention among Nigerian medical students.

Materials and Methods: A descriptive cross-sectional study was conducted among 1,299 medical students in Kano State, Nigeria, using a semi-structured, self-administered online questionnaire. Statistical analysis was done using IBM SPSS v27. Binary logistic regression identified independent predictors of migration at p < 0.05.

Results: Eight hundred and thirty respondents (63.9%) intended to practice medicine abroad. The most preferred destinations were the United States (375;45.2%), Canada (369;44.5%), and the United Kingdom (363;43.7%). Interest in international practice was high (mean 3.98 ± 0.74), while awareness of licensure pathways was relatively low (mean 2.35 ± 0.96). Major drivers included better remuneration and improved medical infrastructure. Financial constraints (807;62.1%) was the leading barrier. Migration intention was significantly associated with motivation for studying medicine (p = 0.004), participation in international programs (p < 0.001), and prior exploration of certification processes (p < 0.001). Independent predictors of migration intention included higher interest in international practice (AOR = 2.59; 95% CI: 2.1–3.1) and greater awareness of licensure pathways (AOR = 2.34; 95% CI: 2.0–2.8).

Conclusion: A substantial proportion of Nigerian medical students intend to migrate, reflecting systemic push factors and pull dynamics. Early, targeted retention strategies within medical training and health system reforms are urgently needed to mitigate future workforce losses.