There Is No Place Like Home: A Meta-Ethnography Exploring The Experiences of International Medical Graduates Following Return Migration to Their Home Country

Abstract

Medical migration describes the movement of doctors across national boundaries and has historically followed a gradient from low- and middle-income countries (LMIC) to high-income countries (HIC), typically for training and income opportunities. Whilst the challenges of being an international medical graduate (IMG) are well-documented, not all doctors stay in their host country, and comparatively little is known about the experiences of those who return to their home country. Qualitative studies examining the experiences of IMGs returning to home countries were identified through database (Ovid, ProQuest, Medline, Scopus and EBSCOhost) and manual searching and were synthesised following a meta-ethnographic approach. A total of seven studies were included in the synthesis, published between 1975 and 2019, charting the experiences of 134 doctors returning to Africa, South America, Europe, Asia or Oceania. A total of 10 third-order constructs were identified that were developed into overarching third-order constructs: reflections on personal development, social and cultural connection to home countries and challenges associated with professional reintegration. Return migration in doctors has received little attention, indicating a need for further research in this area. The commonality of experiences in this review suggests that whilst family trumps finances in reasons to return, disillusionment with state healthcare systems in home countries encourages a drive to private practice and the wasted opportunity for valuable knowledge transfer. These findings can enable medical educators to better support IMGs considering and experiencing return migration, and inform policymakers seeking to optimise conditions for return migration as part of medical workforce planning.