Maintaining resilience during medical migration: experiences of women family doctors around the world

Problem

In our globalised world the primary care workforce is increasingly mobile. It is also increasingly feminised. Given that some women appear to be leaving general practice at a young age, or struggle to sustain their careers as they originally intended, both factors may threaten the long-term viability of the workforce. To design systems to support women through medical migration and reduce workforce attrition, there is a need to understand how female GPs maintain their resilience through lifecycle transition events, including medical migration.

Approach

This study is a sub-analysis of data from a wider study of the experiences of female GPs during lifecycle transition events. Female GPs were recruited using purposive sampling via email lists and social media networks of the World Organisation of Family Doctors (WONCA). Twenty semi-structured qualitative interviews were carried out using Skype online technology with female GPs from all 7 WONCA regions (Asia Pacific, Africa, North America, Iberoamerica, Europe, South Asia and East Mediterranean). Interviews were transcribed and analysed using applied framework analysis. 11 interviews included doctors who had experienced medical migration (within and between countries) and these data were used for the sub-analysis.

Findings

Factors which influence women’s resilience through the transitional period of medical migration could be categorised into individual factors, organisational factors and systems factors. Some interviewees demonstrated characteristics of resilience by their ability to find others to support them, their ability to accept difficulties but also to find ways to learn from the experience, by taking control of situations where possible and through having clear aims that helped them through the process. When this translated into making positive choices with some advanced planning a more successful transition was likely. At an organisational level the transition was more successful if practical support was available and the new setting allowed women to work in the type of job they wanted. At a systems level the availability of professional networks, cultural and societal attitudes and country-specific legislation all played a role.

Consequences

There are similarities in the experiences of female GPs around the world, particularly regarding the psychological internal process of transition. Our findings demonstrate how the process can be supported through factors at individual, organisational and systems levels, and through this lessons can be drawn about how to support those women family doctors and their families who choose to migrate within and between countries.