Determinants of Nigerian medical doctors' willingness to practice in foreign countries

Background: Despite the poor doctor–patient ratio in Nigeria, which is far below the World Health Organization's recommendation, Nigerian doctors are known to contribute a significant proportion of the medical workforce in other countries, especially in the United Kingdom (UK) and the United States of America (USA). Aim: This study aimed to assess Nigerian medical doctors' willingness to practice in foreign countries, as well as the possible push and pull factors contributing to this brain drain. Methodology: A cross-sectional survey was conducted, and 329 medical doctors were selected from a list of doctors who were attending the Annual Delegates Meeting of the Nigerian Medical Association, using a systematic random sampling technique. A semistructured self-administered questionnaire was used to obtain the information from the selected respondents. Results: All selected respondents agreed to participate in the study. The mean age of the participants was 41.4 ± 6.3 years, 85.9% of them being males and 75.7% being Christians. About 36% of the respondents had medical fellowship, 31.6% were resident doctors, and 16.4% had only an MBBS degree. The median duration of practice was 12 years, and the median monthly income was ₦420,000.000. About 72.9% of the respondents were willing to practice in foreign countries if given the opportunity, 29.2% of whom preferred the USA, 25.1% preferred the UK, and 15.7 preferred Australia. Among those not willing to practice in foreign countries, 48.3% preferred working in Nigeria despite all the challenges and 32.2% was due to family and other personal reasons. Among those willing to practice in foreign countries, about 66.3% was due to poor financial incentives/working environment, 46.5% due to insecurity, and 38% due to inter-professional rivalry in the health sector. The following factors were found to be independent (intrinsic) determinants of willingness to practice in a foreign country: Geopolitical zone of origin, highest educational qualifications, duration of practice, and average monthly income. Conclusion: It is a big threat to the Nigerian health system for the majority of its doctors to be willing to leave the country. Hence, the need for governments at all levels to, as a matter of urgency, address the factors responsible for this drive