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

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Nigeria, one of the largest contributors to the global medical workforce, faces increasing loss of future physicians. This study examined the determinants of migration intention among Nigerian medical students. Methods: A 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: 63.9% of respondents intended to practice medicine abroad. The most preferred destinations were the United States (45.2%), Canada (44.5%), and the United Kingdom (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 (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 global pull dynamics. Early, targeted retention strategies within medical training and broader health system reforms are urgently needed to mitigate future workforce losses. Clinical trial number: Not applicable Physician migration migration intention medical students health workforce brain drain retention strategies licensure pathways 1. Background Nigeria continues to face a critical shortage of healthcare workers, largely driven by the migration of trained physicians to high-income countries. This is reflected in the fact that although over 80,000 doctors are registered with the Medical and Dental Council of Nigeria (MDCN), fewer than 50% are currently practicing within the country [1]. This depletion of human resources has significantly strained the quality and accessibility of healthcare services, adversely affecting both patients and the remaining workforce [2]. Many citizens are compelled to seek care in expensive private facilities or face poor outcomes in under-resourced public hospitals, contributing to unfavorable health indices, including Nigeria’s disproportionately high maternal mortality burden [3]. Despite this shortage, the desire to emigrate remains high among Nigerian doctors. Previous studies show that 74.4% of doctors intend to specialize abroad, compared to only 13.9% who plan to remain in Nigeria [4]. Importantly, migration intentions often develop early, during undergraduate training. Medical students are increasingly exposed to both the challenges of local practice and opportunities abroad, shaping their career aspirations [2]. Studies have demonstrated that many students already consider international practice as a primary career goal even before graduation [4]. Globally, the increasing mobility of healthcare professionals reflects broader trends in the globalization of healthcare. However, in Nigeria, systemic challenges—including poor remuneration, inadequate infrastructure, and limited postgraduate training opportunities—serve as strong push factors [8]. Conversely, pull factors such as better working conditions, advanced medical technology, structured residency programs, higher income, and improved quality of life attract students to high-income countries [9,10]. The perception that residency training abroad is better structured and more supportive further reinforces this trend [9]. Migration intentions among medical students are important early indicators of future workforce losses. Evidence suggests that up to 40% of Nigerian medical graduates migrate within 10 years of graduation, while as many as 88% of practicing doctors actively seek opportunities abroad [4]. Structural limitations within Nigeria’s healthcare system, including inadequate specialist training capacity, further drive this trend, particularly among students interested in procedure-intensive specialties [4]. The implications of this sustained migration are profound. Nigeria’s doctor-to-patient ratio remains critically low at approximately 1:9,083, far below the recommended 1:600 [11]. More broadly, Africa bears 24% of the global disease burden but accounts for only 2% of the global health workforce [14]. Continued emigration risks worsening health outcomes and undermining efforts toward Universal Health Coverage [1]. While existing studies have examined migration among practicing doctors, there is limited evidence on the patterns and determinants of migration intention among medical students in Northern Nigeria. Understanding these early intentions is essential for designing targeted retention strategies. This study therefore aims to assess migration intentions and their determinants among medical students, providing evidence to inform policy and workforce planning in Nigeria. 2. Methods 2.1 Study design This study adopted a descriptive cross-sectional design to assess the proportion of medical students in Kano State, Nigeria, who intend to practice medicine abroad, their preferred destination countries, and the factors influencing their migration intentions. 2.2 Study setting and participants The study was conducted among medical students from the two major accredited medical schools in Kano State: Bayero University and North West University. Bayero University, Kano, is a major public university in Nigeria with a College of Health Sciences, offering a six-year MBBS programme comprising preliminary, preclinical, and clinical phases. North West University, Kano, also hosts a College of Health Sciences and runs a similar medical curriculum structure. Both institutions provide structured medical training that progresses from foundational sciences to clinical rotations in affiliated teaching hospitals. The MBBS programme spans six years, beginning with a preliminary year focused on foundational sciences, followed by two preclinical years covering basic medical sciences, and concluding with three clinical years involving hospital-based training and rotations. Participation was limited to consenting undergraduate students enrolled in the Bachelor of Medicine, Bachelor of Surgery (MBBS) programme. 2.3 Sample size determination The minimum sample size for the study was determined using Cochran’s formula for estimating proportions: where Z = 1.96 (95% confidence level), p = 0.628 (proportion of migration intention from a previous study) [5], and d = 0.05 (margin of error). Since the study population was finite, the sample size was adjusted using the finite population correction formula: where N represents the estimated total number of medical students across both institutions (N ≈ 1,573). After applying the correction and adjusting for a 10% non-response rate, the minimum required sample size was obtained as approximately 324. To improve statistical precision and enhance representativeness, recruitment was extended beyond the minimum sample size. A total of 1,299 valid responses were ultimately obtained and included in the analysis. 2.4 Research instrument and data collection Data were collected using a self-administered, semi-structured questionnaire developed in English and distributed via Google Forms between July 2025 and January 2026. The instrument captured information on socio-demographic characteristics, migration intentions, interest in international medical practice, awareness of licensure requirements and processes, preferred destination countries, and perceived barriers to practicing medicine abroad. The questionnaire was adapted from a previously validated instrument used by Adeniran et al. [5] to assess migration intention among undergraduate medical students. Minor modifications were made to suit the study context and the final version was validated for face, content and construct by a public health expert. 2.5 Data analysis Data were analyzed using IBM SPSS Statistics v27. Descriptive statistics, including means, frequencies, and percentages, were used to summarize 3. Results 3.1 Socio-demographic characteristics of respondents The socio-demographic characteristics of respondents are presented in Table 1. The respondents had a mean age of 21.63 ± 3 years, with the majority (64.1%) aged 18–22 years. Females constituted a slight majority (51.4%). Most participants were Muslims (88.2%), and the predominant ethnic group was Hausa (47.3%). Slightly more than half of the respondents were in their clinical years (51.1%), and the majority were enrolled at Bayero University Kano (69%). Table 1 Socio-demographic characteristics of respondents (n=1,299) Variable Frequency (n) Percent (%) Age <18 years 54 4.2 18-22 years 833 64.1 23-27 years 359 27.6 ≥28 53 4.1 Gender Female 668 51.4 Male 631 48.6 Religion Islam 1,146 88.2 Christianity 153 11.8 Ethnicity Hausa 615 47.3 Fulani 237 18.2 Igbira 126 9.7 Others 321 24.7 Year of Study Pre-clinicals 636 48.9 Clinicals 663 51.1 School NWU 403 31.0 BUK 896 69.0 Key: BUK - Bayero University Kano; NWU - North West University 3.2 Migration intention and career-related characteristics of respondents Table 2 shows the migration intention and career-related characteristics of the study participants. A majority of respondents (63.9%) expressed an intention to migrate and practice medicine abroad. Despite this high level of interest, preparedness for international practice was limited: only 31.9% had explored certification pathways, and 46.9% were aware of visa and immigration requirements. The primary motivation for studying medicine was personal interest and passion (74.5%), while external influences such as financial motives and family pressure were relatively less common. Table 2 Migration intention and career-related characteristics of respondents (n=1,299) Variable Frequency (n) Percent (%) Have you actively researched or considered options for practicing? Yes 830 63.9 No 469 36.1 Motivation for studying medicine Family Pressure 94 7.2 Money Curiosity & Passion for the medical profession Others 116 968 121 8.9 74.5 9.3 Have you participated in any international medical programs (e.g. conferences, electives, exchanges) Yes 197 15.1 No 1102 84.9 Are you aware of the visa and immigration requirements for working as a doctor abroad? Yes 609 46.9 No 690 53.1 Have you explored the certification process for practicing medicine in any specific foreign country? Yes 414 31.9 No 885 68.1 Do you personally know any Nigerian doctors currently practicing medicine overseas? Yes 900 69.3 No 399 30.7 Results are presented as frequencies and percentages 3.3 Preferred destination countries and drivers of migration Among respondents intending to migrate (Table 3), the most preferred destinations were the United States (45.2%), Canada (44.5%), and the United Kingdom (43.7%), with fewer selecting Australia (26.0%). Most respondents indicated flexibility to work in alternative countries if better opportunities were available. Key drivers of destination choice included better remuneration, access to advanced medical infrastructure, and improved work–life balance, while social and geographic factors were less influential. Table 3 Preferred destination countries and factors influencing migration choice (n=1,299) Variable Frequency (n) Percent (%) a Preferred countries UK 363 43.7 USA 375 45.2 Canada 369 44.5 Australia 216 26.0 Others 126 15.2 a Factors influencing choice of country Salary and benefits 635 76.5 Work life balance 531 64.0 Medical infrastructure and technology 616 74.2 Cultural factors 201 24.2 Proximity to Nigeria 60 7.2 Family or friends in the country 205 24.7 b Are you open to working in a country other than your preferred region if better opportunities arise Yes 793 95.5 No 37 4.5 a Factors influencing migration intention Higher salary 486 58.5 Better working conditions 577 69.5 Career advancement opportunities 510 61.4 Access to better medical technology 550 66.3 Personal reasons 232 28.0 a Multiple answers allowed; b n=830 (subset of participants intending to practice abroad) 3.4 Interest, awareness, and perceived barriers to international medical practice Results from Table 4 reveals that respondents demonstrated a high level of interest in international medical practice (mean score: 3.98 ± 0.74), with 65.8% expressing a desire to practice abroad and 85.6% perceiving better professional opportunities outside Nigeria. In contrast, awareness of licensure pathways was low (mean score: 2.35 ± 0.96), with only 19.3% familiar with required examinations such as USMLE or PLAB. Perceived barriers were moderate overall (mean score: 2.95 ± 0.69), with financial constraints identified as the most prominent challenge (62.1%). 3.5 Factors influencing migration intention Among respondents intending to migrate (Table 5), job security and long-term career prospects, as well as political stability in destination countries, were the most influential factors (mean scores: 3.7 ± 1.0 and 3.7 ± 1.14, respectively). In contrast, family or peer influence was less significant, with the majority of respondents indicating that it did not play a role in their decision to practice medicine abroad. Table 5 Factors influencing migration intention of respondents who intend to practice medicine overseas Variable SD n(%) D n(%) N n(%) A n(%) SA n(%) Mean ±SD Has family or peer influence played a role in your decision to practice medicine overseas 343 (41.3) 274 (33.0) 11 (1.33) 147 (17.71) 55 (6.63) 2.15 ±1.31 How much do job security and long-term career prospects influence decision to migrate 25 (3.0) 75 (9.0) 225 (27.1) 336 (40.5) 169 (20.4) 3.7 ±1 Does the political stability of a country impact your decision to practice medicine overseas 52 (6.27) 69 (8.3) 176 (21.2) 301 (36.3) 232 (28) 3.7 ±1.14 How much does mentorship from doctors abroad affect your decision 136 (16.4) 161 (19.4) 248 (29.9) 214 (25.8) 71 (8.6) 2.91 ±1.20 Gaps in Nigerian medical training influence my decision 20 (2.4) 55 (6.6) 263 (31.7) 317 (38.2) 175 (21.1) 3.69 ±0.96 Key: SD is Strongly Disagree, D is Disagree, N is Neutral, A is Agree, SA is Strongly Agree 3.6 Bivariate analysis of factors associated with migration intention Results from Table 6 reveals that motivation for studying medicine was associated with migration intention (p = 0.004), with higher proportions observed among students motivated by personal interest or financial reasons compared to those influenced by family or other factors. Participation in international medical programs was strongly associated with migration intention (p < 0.001), with a substantially higher proportion of exposed students intending to migrate. Similarly, prior exploration of overseas certification pathways was significantly associated with migration intention (p < 0.001), with markedly higher migration intent among those who had explored these processes. 3.7 Multivariable predictors of migration intention In the adjusted analysis (Table 7), motivation for studying medicine was independently associated with migration intention. Respondents motivated by curiosity and passion had higher odds of intending to migrate compared with those influenced by family pressure (AOR: 1.74; 95% CI: 1.1–2.8; p = 0.028), while motivations related to financial or other reasons were not significant. Participation in international medical programs was not independently associated with migration intention after adjustment. Higher levels of interest in international medical practice (AOR: 2.59; 95% CI: 2.1–3.1; p < 0.001) and greater awareness of licensure pathways (AOR: 2.34; 95% CI: 2.0–2.8; p < 0.001) were strong independent predictors of migration intention. Conversely, higher perceived barriers were associated with reduced likelihood of intending to migrate (AOR: 0.88; 95% CI: 0.7–1.1; p < 0.001). Table 4 Participants’ interest, awareness and perceived barriers towards international medical practice (n=1,299) Variable SD n (%) D n (%) N n (%) A n (%) SA n (%) Degree of interest in international medical practice (Mean ± SD = 3.98 ± 0.74) Are you interested in practicing medicine outside Nigeria after completing your studies 49 (3.8) 112 (8.6) 283 (21.3) 400 (30.8) 455 (35.0) Do you believe practicing abroad offers better professional opportunities than in Nigeria 24 (1.8) 23 (1.8) 140 (10.8) 458 (35.3) 654 (50.3) How important is international work experience in your career aspirations 27 (2.1) 83 (6.4) 335 (25.8) 572 (44.0) 281 (21.6) How likely are you to apply for international medical exchange programs if given the opportunity 29 (2.2) 84 (6.5) 220 (16.9) 476 (36.6) 490 (37.7) Degree of Awareness of international medical practice pathways (Mean ± SD =2.35±0.96) How familiar are you with the licensure exams required to practice medicine overseas (e.g. USMLE, PLAB) 315 (24.2) 309 (23.8) 424 (32.6) 186 (14.3) 65 (5.0) How knowledgeable are you about the residency or internship programs needed to practice medicine overseas 389 (29.9) 428 (32.9) 358 (27.6) 88 (6.8) 36 (2.8) Barriers influencing migration intention (Mean ± SD =2.95 ± 0.69) How significant do you perceive financial constraints (e.g., examination fees, visa application costs) in your pursuit of practicing medicine overseas 50 (3.8) 121 (9.3) 321 (24.7) 542 (41.7) 265 (20.4) How challenging do you find the licensing processes (e.g., examinations, credential verification) for practicing medicine overseas 43 (3.3) 153 (11.8) 528 (40.6) 452 (34.8) 104 (8.0) Do cultural differences (e.g., language, lifestyle, social norms) pose a barrier to your decision to practice overseas? 402 (30.9) 299 (23.0) 355 (27.30 187 (14.4) 55 (4.2) How much do concerns about adapting to a different healthcare system affect your decision to work abroad 274 (21.1) 365 (28.1) 482 (37.1) 138 (10.6) 39 (3.0) Key: SD is Strongly disagree, D is Disagree, N is Neutral, A is Agree, SA is Strongly agree Table 6 Bivariate analysis of factors associated with migration intention among respondents Variable Intention to migrate Statistics Yes N (%) No N (%) Age X 2 = 2.23 p = 0.526 <18 36 (66.7) 18 (33.3) 18-22 520 (62.4) 313 (37.6) 23-27 238 (66.3) 121 (33.7) ≥28 36 (67.9) 17 (32.1) Gender Female 433 (64.8) 235 (35.2) X 2 = 0.510 p = 0.475 Male 397 (62.9) 234 (37.1) Ethnicity Hausa 390 (63.4) 225 (36.6) X 2 = 0.512 p = 0.916 Fulani 154 (65.0) 83 (35.0) Igbira 78 (61.9) 48 (38.1) Others 208 (64.8) 113 (35.2) Year of Study Pre-Clinicals 396 (62.4) 239 (37.6) X 2 = 1.221 p = 0.269 Clinicals 433 (65.3) 230 (34.7) Motivation for studying medicine Family pressure 49 (52.1) 45 (47.9) X 2 = 13.265 p = 0.004 * Money 77 (66.4) 39 (33.6) Curiosity & Passion for the medical profession 639 (66.0) 329 (34.0) Others 65 (53.7) 56 (46.3) Have you participated in any international medical programs Yes 151 (77.0) 45 (23.0) X 2 = 17.360 p = <0.001 * No 678 (61.5) 424 (38.5) Have you explored the certification process for practicing medicine overseas Yes 368 (88.9) 46 (11.1) X 2 = 164.547 p = <0.001 * No 462 (52.2) 423 (47.8) * Statistically significant at p<0.05 Table 7 Multivariable logistic regression analysis of factors associated with migration intention Variable AOR 95% CI p-value Age <18 years Reference 18–22 years 0.96 0.50–1.90 0.91 23–27 years 1.11 0.50–2.30 0.774 ≥28 years 1.98 0.70–5.40 0.181 Gender Male Reference Female 1.21 0.90–1.60 0.16 Religion Islam Reference Christianity 0.76 0.60–1.00 0.053 Ethnicity Others Reference Fulani 0.91 0.60–1.40 0.655 Igbira 0.78 0.50–1.30 0.322 Hausa 0.94 0.70–1.30 0.732 Year of study Pre-clinical Reference Clinical 0.8 0.60–1.10 0.161 Motivation for studying medicine Family pressure Reference Money 1.51 0.80–2.90 0.212 Curiosity/passion 1.74 1.10–2.80 0.028 * Others 1.17 0.60–2.20 0.631 Participation in international programs No Reference Yes 1.53 1.00–2.30 0.45 a Perceived barriers 0.88 0.70–1.10 <0.001 * a Interest in international practice 2.59 2.10–3.10 <0.001 * a Awareness of licensure pathways 2.34 2.00–2.80 <0.001* a Composite scores for interest, awareness, and perceived barriers were treated as continuous variables in the regression analysis; * Statistically significant at p<0.05 4. Discussion The study found a high prevalence of migration intention among Nigerian medical students, with nearly two-thirds expressing a desire to practice medicine abroad. This reflects a continuing trend of medical workforce emigration and highlights concerns about the sustainability of the Nigerian healthcare system, consistent with previous studies [4,15]. Similar proportions have been reported among both medical students and doctors in training in Nigeria, where 74.4% of students preferred to specialize abroad and 74.2% of doctors undergoing training expressed migration intentions [4,15], suggesting that migration intention develops early and persists across different stages of medical training. Despite this strong intention, awareness of migration pathways such as licensure examinations and residency requirements was low, indicating a clear gap between aspiration and preparedness. This contrasts with findings among doctors in training, where a substantial proportion had already initiated migration plans [15], suggesting that while intention begins early, it becomes more structured and actionable with professional progression. This suggests that for many students, migration intention may be driven more by dissatisfaction with local training and practice conditions than by structured career planning [4]. Multivariate analysis showed that socio-demographic factors, including age, gender, ethnicity, religion, and year of study, were not significantly associated with migration intention. This indicates that migration intention cuts across diverse student subgroups and is not influenced by demographic or academic characteristics. Rather, it reflects broader systemic and professional concerns, supporting the view that migration in low- and middle-income countries is often driven by perceived professional risk and the search for better practice environments with improved medical infrastructure and technology [16,17]. The most preferred destination countries were the USA, Canada, and the UK, which is consistent with previous studies that similarly identified these countries as leading destinations for Nigerian medical trainees [4,15]. Key factors influencing destination choice included salary and benefits, medical infrastructure and technology, and work–life balance, while proximity to Nigeria was of minimal importance, further reinforcing the dominance of professional and economic considerations over geographic or social ties. Migration intention was further shaped by a combination of push and pull factors. The main pull factors included expectations of higher salaries, improved working conditions, better work–life balance, advanced medical infrastructure, and increased career advancement opportunities. These findings are consistent with global trends in health workforce migration, where professionals seek environments offering both financial stability and modern healthcare systems [18,19]. This is particularly relevant within the African context, where documented shortages and maldistribution of health workers continue to drive outward migration pressures [18]. On the other hand, push factors included concerns about long-term career prospects and perceived gaps in the Nigerian medical training system. The influence of political stability and job security (both Mean = 3.7) further suggests that migration is driven not only by income considerations but also by the need for systemic stability. This is consistent with a previous study that reported that recurrent industrial actions and instability in the Nigerian healthcare system contribute to professional uncertainty [1]. Social influence appeared to play a limited role in migration decisions. Although exposure to doctors practicing abroad was relatively high (69.3%), family and peer influence had the lowest mean score (2.15), suggesting that migration intention is largely an individual, career-driven decision rather than one shaped by direct social pressure. This aligns with Toyin-Thomas et al. [17], who reported that modern migration drivers among healthcare workers in low- and middle-income countries are increasingly centered on career advancement and access to better technology rather than traditional social influences. Despite the high level of migration intention, several barriers to actual migration were identified. Financial constraints were the most significant obstacle, with over 60% of respondents indicating that limited resources could hinder migration plans. This aligns with evidence that migration costs represent a major barrier among individuals in Sub-Saharan Africa [20]. In contrast, cultural differences and concerns about adaptation to foreign healthcare systems were not considered major barriers by most respondents. Additionally, regression analysis indicated that perceived barriers significantly reduced the likelihood of migration intention, highlighting their moderating effect on migration decisions. This study has some limitations. It identified important predictors of migration such as interest in international medical practice and awareness of migration pathways; however, it did not deeply explore broader social, cultural, and institutional determinants shaping these intentions. Future studies should therefore adopt mixed-methods approaches, combining quantitative surveys with qualitative interviews or focus group discussions, to provide deeper insight into migration decision-making processes. Furthermore, research should evaluate the impact of policy interventions aimed at improving retention, including enhancements in residency training quality, working conditions, and career development pathways. Such evidence would be valuable in guiding strategies to strengthen Nigeria’s healthcare system and reduce the long-term impact of physician migration. 5. Conclusion This study demonstrates a high prevalence of migration intention among Nigerian medical students, underscoring the growing challenge of physician emigration within the Nigerian healthcare system. Migration intention was largely driven by interest in international medical practice, awareness of overseas training and licensure pathways, and key professional considerations such as better remuneration, improved working conditions, career advancement opportunities, and access to advanced medical technology. Financial constraints and licensure-related challenges emerged as important factors that may limit or delay actual migration. To address this trend, policymakers should prioritize sustainable retention strategies for future medical professionals. These include improving remuneration and working conditions for doctors, strengthening healthcare infrastructure, enhancing the quality and accessibility of postgraduate and residency training, and expanding structured career development opportunities. In addition, increasing transparency in medical career progression and introducing targeted financial support mechanisms such as loan schemes for medical students and early-career doctors may help reduce migration pressure and strengthen the long-term stability of the healthcare workforce. Abbreviations AOR – Adjusted Odds Ratio BUK – Bayero University Kano CI – Confidence Interval LMICs – Low- and Middle-Income Countries M.B.B.S – Bachelor of Medicine, Bachelor of Surgery MDCN – Medical and Dental Council of Nigeria NWU – North West University PLAB – Professional and Linguistic Assessments Board SD – Standard Deviation USMLE – United States Medical Licensing Examination USA – United States of America UK – United Kingdom WHO – World Health Organization Declarations Ethical approval and consent to participate The study adhered strictly to international ethical guidelines as enshrined in the Declaration of Helsinki. Ethical approval for this study was obtained from the Health Research Ethics Committee of the Kano State Ministry of Health (approval number: NHREC/17/03/2018). Participation in the study was voluntary, and informed consent was obtained electronically from all participants prior to data collection. Anonymity and confidentiality of respondents’ information were strictly maintained throughout the study. Consent for publication Not applicable Availability of data and materials The datasets supporting the conclusions of this article are included within the article (and its additional files). Competing interests The authors declare that they have no competing interests. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Authors’ contribution Ededa Emmanuel Matthew and Garba Joshua Adamu jointly contributed to the conceptualization of the study, development of the methodology, formal data analysis and interpretation, funding acquisition, project administration, and drafting of the original manuscript. Ajala Oladunsi Esther, Ugwu Felicia Oyare, and Ejeh Ene Ayomide contributed to manuscript review, critical revision, sub-committee coordination, and data oversight. Cydney John Akpan and Beede Miracle Chichetaram contributed to manuscript review, critical revision, and editorial support. Onyeama Royale Kelechi, Shagbaor Jeremiah Ushahemba, Fatukasi Sarah Pelumi, Yusuf Maryam, Emeagui Makuochukwu Kelvin, Hamzat Abdulmuiz Ayodele, Ologbonyo Temitope, and Hassan Oladipupo Ismail contributed to manuscript review. Rukayya Muhammad Hassan, Yanmida Gbenga, Paul Febian, Musa Hezekiah Sokolayam, Daniel Abraham Adebayo, and Khadija Dahira Baba contributed to data collection, data entry, and documentation. 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Polit Geogr. 2021;87:102350. doi:10.1016/j.polgeo.2021.102350 Additional Declarations No competing interests reported. Supplementary Files Braindraindataset.xlsx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9525189","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":629950318,"identity":"63def8c9-7c53-4426-aa57-90312982d452","order_by":0,"name":"Ededa Emmanuel Matthew","email":"","orcid":"","institution":"Bayero University","correspondingAuthor":false,"prefix":"","firstName":"Ededa","middleName":"Emmanuel","lastName":"Matthew","suffix":""},{"id":629950319,"identity":"f82313f6-2be2-4390-bd2f-03380fa54f6f","order_by":1,"name":"Garba Joshua Adamu","email":"","orcid":"","institution":"Bayero 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11:23:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9525189/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9525189/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108007746,"identity":"d143213e-e5a8-4c2a-b177-21535b11b1e1","added_by":"auto","created_at":"2026-04-28 13:01:41","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":549674,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9525189/v1/ce2e1d8e-b4f5-4d2d-a60f-391afef54bc1.pdf"},{"id":107975568,"identity":"37b381fd-e806-43c8-8bf7-20aa8e948eeb","added_by":"auto","created_at":"2026-04-28 07:35:55","extension":"xlsx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":620725,"visible":true,"origin":"","legend":"","description":"","filename":"Braindraindataset.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-9525189/v1/55fb0994a8bf7fc73a3e6ce4.xlsx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Understanding the drivers of brain drain: a study of migration intention among medical students in Nigeria","fulltext":[{"header":"1. Background","content":"\u003cp\u003eNigeria continues to face a critical shortage of healthcare workers, largely driven by the migration of trained physicians to high-income countries. This is reflected in the fact that although over 80,000 doctors are registered with the Medical and Dental Council of Nigeria (MDCN), fewer than 50% are currently practicing within the country [1]. This depletion of human resources has significantly strained the quality and accessibility of healthcare services, adversely affecting both patients and the remaining workforce [2]. Many citizens are compelled to seek care in expensive private facilities or face poor outcomes in under-resourced public hospitals, contributing to unfavorable health indices, including Nigeria’s disproportionately high maternal mortality burden [3].\u003c/p\u003e\n\u003cp\u003eDespite this shortage, the desire to emigrate remains high among Nigerian doctors. Previous studies show that 74.4% of doctors intend to specialize abroad, compared to only 13.9% who plan to remain in Nigeria [4]. Importantly, migration intentions often develop early, during undergraduate training. Medical students are increasingly exposed to both the challenges of local practice and opportunities abroad, shaping their career aspirations [2]. Studies have demonstrated that many students already consider international practice as a primary career goal even before graduation [4].\u003c/p\u003e\n\u003cp\u003eGlobally, the increasing mobility of healthcare professionals reflects broader trends in the globalization of healthcare. However, in Nigeria, systemic challenges—including poor remuneration, inadequate infrastructure, and limited postgraduate training opportunities—serve as strong push factors [8]. Conversely, pull factors such as better working conditions, advanced medical technology, structured residency programs, higher income, and improved quality of life attract students to high-income countries [9,10]. The perception that residency training abroad is better structured and more supportive further reinforces this trend [9].\u003c/p\u003e\n\u003cp\u003eMigration intentions among medical students are important early indicators of future workforce losses. Evidence suggests that up to 40% of Nigerian medical graduates migrate within 10 years of graduation, while as many as 88% of practicing doctors actively seek opportunities abroad [4]. Structural limitations within Nigeria’s healthcare system, including inadequate specialist training capacity, further drive this trend, particularly among students interested in procedure-intensive specialties [4].\u003c/p\u003e\n\u003cp\u003eThe implications of this sustained migration are profound. Nigeria’s doctor-to-patient ratio remains critically low at approximately 1:9,083, far below the recommended 1:600 [11]. More broadly, Africa bears 24% of the global disease burden but accounts for only 2% of the global health workforce [14]. Continued emigration risks worsening health outcomes and undermining efforts toward Universal Health Coverage [1].\u003c/p\u003e\n\u003cp\u003eWhile existing studies have examined migration among practicing doctors, there is limited evidence on the patterns and determinants of migration intention among medical students in Northern Nigeria. Understanding these early intentions is essential for designing targeted retention strategies. This study therefore aims to assess migration intentions and their determinants among medical students, providing evidence to inform policy and workforce planning in Nigeria.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cp\u003e\u003cstrong\u003e2.1 Study design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study adopted a descriptive cross-sectional design to assess the proportion of medical students in Kano State, Nigeria, who intend to practice medicine abroad, their preferred destination countries, and the factors influencing their migration intentions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2 Study setting and participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted among medical students from the two major accredited medical schools in Kano State: Bayero University and North West University. Bayero University, Kano, is a major public university in Nigeria with a College of Health Sciences, offering a six-year MBBS programme comprising preliminary, preclinical, and clinical phases. North West University, Kano, also hosts a College of Health Sciences and runs a similar medical curriculum structure. Both institutions provide structured medical training that progresses from foundational sciences to clinical rotations in affiliated teaching hospitals.\u003c/p\u003e\n\u003cp\u003eThe MBBS programme spans six years, beginning with a preliminary year focused on foundational sciences, followed by two preclinical years covering basic medical sciences, and concluding with three clinical years involving hospital-based training and rotations.\u003c/p\u003e\n\u003cp\u003eParticipation was limited to consenting undergraduate students enrolled in the Bachelor of Medicine, Bachelor of Surgery (MBBS) programme.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3 Sample size determination\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe minimum sample size for the study was determined using Cochran\u0026rsquo;s formula for estimating proportions:\u003c/p\u003e\n\u003cp\u003e\u003cimg width=\"107\" height=\"40\" src=\"data:image/png;base64,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\" v:shapes=\"_x0000_i1025\" alt=\"image\"\u003e\u003c/p\u003e\n\u003cp\u003ewhere Z = 1.96 (95% confidence level), p = 0.628 (proportion of migration intention from a previous study) [5], and d = 0.05 (margin of error).\u003c/p\u003e\n\u003cp\u003eSince the study population was finite, the sample size was adjusted using the finite population correction formula:\u003c/p\u003e\n\u003cp\u003e\u003cimg width=\"102\" height=\"50\" src=\"data:image/png;base64,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\" v:shapes=\"_x0000_i1025\" alt=\"image\"\u003e\u003c/p\u003e\n\u003cp\u003ewhere N represents the estimated total number of medical students across both institutions (N \u0026asymp; 1,573). After applying the correction and adjusting for a 10% non-response rate, the minimum required sample size was obtained as approximately 324. To improve statistical precision and enhance representativeness, recruitment was extended beyond the minimum sample size. A total of 1,299 valid responses were ultimately obtained and included in the analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.4 Research instrument and data collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were collected using a self-administered, semi-structured questionnaire developed in English and distributed via Google Forms between July 2025 and January 2026. The instrument captured information on socio-demographic characteristics, migration intentions, interest in international medical practice, awareness of licensure requirements and processes, preferred destination countries, and perceived barriers to practicing medicine abroad.\u003c/p\u003e\n\u003cp\u003eThe questionnaire was adapted from a previously validated instrument used by Adeniran et al. [5] to assess migration intention among undergraduate medical students. Minor modifications were made to suit the study context and the final version was validated for face, content and construct by a public health expert.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.5 Data analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were analyzed using IBM SPSS Statistics v27. Descriptive statistics, including means, frequencies, and percentages, were used to summarize\u0026nbsp;\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003e\u003cstrong\u003e3.1 Socio-demographic characteristics of respondents\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe socio-demographic characteristics of respondents are presented in Table 1. The respondents had a mean age of 21.63 ± 3 years, with the majority (64.1%) aged 18–22 years. Females constituted a slight majority (51.4%). Most participants were Muslims (88.2%), and the predominant ethnic group was Hausa (47.3%). Slightly more than half of the respondents were in their clinical years (51.1%), and the majority were enrolled at Bayero University Kano (69%).\u003c/p\u003e\n\u003cp\u003eTable 1 Socio-demographic characteristics of respondents (n=1,299)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003ePercent (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026lt;18 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18-22 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e833\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e64.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23-27 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e359\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e27.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e≥28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e668\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e51.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e631\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e48.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eReligion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eIslam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1,146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e88.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eChristianity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHausa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e615\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e47.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eFulani\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e237\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eIgbira\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e321\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eYear of Study\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePre-clinicals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e636\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e48.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eClinicals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e663\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e51.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eSchool\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNWU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e403\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e31.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBUK\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e896\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e69.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eKey: BUK - Bayero University Kano; NWU - North West University\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2 Migration intention and career-related characteristics of respondents\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 2 shows the migration intention and career-related characteristics of the study participants. A majority of respondents (63.9%) expressed an intention to migrate and practice medicine abroad. Despite this high level of interest, preparedness for international practice was limited: only 31.9% had explored certification pathways, and 46.9% were aware of visa and immigration requirements. The primary motivation for studying medicine was personal interest and passion (74.5%), while external influences such as financial motives and family pressure were relatively less common.\u003c/p\u003e\n\u003cp\u003eTable 2 Migration intention and career-related characteristics of respondents (n=1,299)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003ePercent (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eHave you actively researched or considered options for practicing?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e830\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e63.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e469\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e36.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eMotivation for studying medicine\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eFamily Pressure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMoney\u003c/p\u003e\n \u003cp\u003eCuriosity \u0026amp; Passion for the medical profession\u003c/p\u003e\n \u003cp\u003eOthers\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003cp\u003e968\u003c/p\u003e\n \u003cp\u003e121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003cp\u003e74.5\u003c/p\u003e\n \u003cp\u003e9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHave you participated in any international medical programs (e.g. conferences, electives, exchanges)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e197\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e84.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eAre you aware of the visa and immigration requirements for working as a doctor abroad?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e609\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e46.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e690\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e53.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHave you explored the certification process for practicing medicine in any specific foreign country?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e414\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e31.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e885\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e68.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eDo you personally know any Nigerian doctors currently practicing medicine overseas?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e900\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e69.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e399\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eResults are presented as frequencies and percentages\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3\u0026nbsp;Preferred destination countries and drivers of migration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong respondents intending to migrate (Table 3), the most preferred destinations were the United States (45.2%), Canada (44.5%), and the United Kingdom (43.7%), with fewer selecting Australia (26.0%). Most respondents indicated flexibility to work in alternative countries if better opportunities were available. Key drivers of destination choice included better remuneration, access to advanced medical infrastructure, and improved work–life balance, while social and geographic factors were less influential.\u003c/p\u003e\n\u003cp\u003eTable 3 Preferred destination countries and factors influencing migration choice (n=1,299)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003cstrong\u003ePreferred countries\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eUK\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e363\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e43.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e375\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCanada\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e369\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e44.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eAustralia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003cstrong\u003eFactors influencing choice of country\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSalary and benefits\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e635\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e76.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWork life balance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e531\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e64.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMedical infrastructure and technology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e616\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e74.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCultural factors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eProximity to Nigeria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFamily or friends in the country\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e205\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003csup\u003eb\u003c/sup\u003e\u003c/strong\u003e\u003cstrong\u003eAre you open to working in a country other than your preferred region if better opportunities arise\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e793\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e95.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003cstrong\u003eFactors influencing migration intention\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHigher salary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e486\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e58.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBetter working conditions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e577\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e69.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCareer advancement opportunities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e510\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e61.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAccess to better medical technology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e550\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e66.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePersonal reasons\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e232\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003eMultiple answers allowed; \u003csup\u003eb\u003c/sup\u003en=830 (subset of participants intending to practice abroad)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.4\u0026nbsp;Interest, awareness, and perceived barriers to international medical practice\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResults from Table 4 reveals that respondents demonstrated a high level of interest in international medical practice (mean score: 3.98 ± 0.74), with 65.8% expressing a desire to practice abroad and 85.6% perceiving better professional opportunities outside Nigeria. In contrast, awareness of licensure pathways was low (mean score: 2.35 ± 0.96), with only 19.3% familiar with required examinations such as USMLE or PLAB. Perceived barriers were moderate overall (mean score: 2.95 ± 0.69), with financial constraints identified as the most prominent challenge (62.1%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.5\u0026nbsp;Factors influencing migration intention\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong respondents intending to migrate (Table 5), job security and long-term career prospects, as well as political stability in destination countries, were the most influential factors (mean scores: 3.7 ± 1.0 and 3.7 ± 1.14, respectively). In contrast, family or peer influence was less significant, with the majority of respondents indicating that it did not play a role in their decision to practice medicine abroad.\u003c/p\u003e\n\u003cp\u003eTable 5 Factors influencing migration intention of respondents who intend to practice medicine overseas\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSD n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eD\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eN\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eA\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSA\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e±SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHas family or peer influence played a role in your decision to practice medicine overseas\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e343\u003c/p\u003e\n \u003cp\u003e(41.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e274\u003c/p\u003e\n \u003cp\u003e(33.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003cp\u003e(1.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e147\u003c/p\u003e\n \u003cp\u003e(17.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003cp\u003e(6.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.15\u003c/p\u003e\n \u003cp\u003e±1.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHow much do job security and long-term career prospects influence decision to migrate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003cp\u003e(3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003cp\u003e(9.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e225\u003c/p\u003e\n \u003cp\u003e(27.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e336\u003c/p\u003e\n \u003cp\u003e(40.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e169\u003c/p\u003e\n \u003cp\u003e(20.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.7\u003c/p\u003e\n \u003cp\u003e±1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDoes the political stability of a country impact your decision to practice medicine overseas\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003cp\u003e(6.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003cp\u003e(8.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e176\u003c/p\u003e\n \u003cp\u003e(21.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e301\u003c/p\u003e\n \u003cp\u003e(36.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e232\u003c/p\u003e\n \u003cp\u003e(28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.7\u003c/p\u003e\n \u003cp\u003e±1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHow much does mentorship from doctors abroad affect your decision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003cp\u003e(16.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e161\u003c/p\u003e\n \u003cp\u003e(19.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e248\u003c/p\u003e\n \u003cp\u003e(29.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e214\u003c/p\u003e\n \u003cp\u003e(25.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003cp\u003e(8.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.91\u003c/p\u003e\n \u003cp\u003e±1.20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGaps in Nigerian medical training influence my decision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003cp\u003e(2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003cp\u003e(6.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e263\u003c/p\u003e\n \u003cp\u003e(31.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e317\u003c/p\u003e\n \u003cp\u003e(38.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e175\u003c/p\u003e\n \u003cp\u003e(21.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.69\u003c/p\u003e\n \u003cp\u003e±0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eKey: SD is Strongly Disagree, D is Disagree, N is Neutral, A is Agree, SA is Strongly Agree \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.6\u0026nbsp;Bivariate analysis of factors associated with migration intention\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResults from Table 6 reveals that motivation for studying medicine was associated with migration intention (p = 0.004), with higher proportions observed among students motivated by personal interest or financial reasons compared to those influenced by family or other factors. Participation in international medical programs was strongly associated with migration intention (p \u0026lt; 0.001), with a substantially higher proportion of exposed students intending to migrate. Similarly, prior exploration of overseas certification pathways was significantly associated with migration intention (p \u0026lt; 0.001), with markedly higher migration intent among those who had explored these processes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.7\u0026nbsp;Multivariable predictors of migration intention\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the adjusted analysis (Table 7), motivation for studying medicine was independently associated with migration intention. Respondents motivated by curiosity and passion had higher odds of intending to migrate compared with those influenced by family pressure (AOR: 1.74; 95% CI: 1.1–2.8; p = 0.028), while motivations related to financial or other reasons were not significant. Participation in international medical programs was not independently associated with migration intention after adjustment. Higher levels of interest in international medical practice (AOR: 2.59; 95% CI: 2.1–3.1; p \u0026lt; 0.001) and greater awareness of licensure pathways (AOR: 2.34; 95% CI: 2.0–2.8; p \u0026lt; 0.001) were strong independent predictors of migration intention. Conversely, higher perceived barriers were associated with reduced likelihood of intending to migrate (AOR: 0.88; 95% CI: 0.7–1.1; p \u0026lt; 0.001).\u003c/p\u003e\u003cp\u003eTable 4 Participants\u0026rsquo; interest, awareness and perceived barriers towards international medical practice (n=1,299)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSD n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eD\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eA\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSA\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDegree of interest in international medical practice (Mean \u0026plusmn; SD = 3.98 \u0026plusmn; 0.74)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003eAre you interested in practicing medicine outside Nigeria after completing your studies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e49 (3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e112\u003c/p\u003e\n \u003cp\u003e(8.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e283\u003c/p\u003e\n \u003cp\u003e(21.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e400\u003c/p\u003e\n \u003cp\u003e(30.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e455\u003c/p\u003e\n \u003cp\u003e(35.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003eDo you believe practicing abroad offers better professional opportunities than in Nigeria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003cp\u003e(1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003cp\u003e(1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e140\u003c/p\u003e\n \u003cp\u003e(10.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e458\u003c/p\u003e\n \u003cp\u003e(35.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e654\u003c/p\u003e\n \u003cp\u003e(50.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003eHow important is international work experience in your career aspirations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003cp\u003e(2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003cp\u003e(6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e335\u003c/p\u003e\n \u003cp\u003e(25.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e572\u003c/p\u003e\n \u003cp\u003e(44.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e281\u003c/p\u003e\n \u003cp\u003e(21.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003eHow likely are you to apply for international medical exchange programs if given the opportunity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003cp\u003e(2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003cp\u003e(6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e220\u003c/p\u003e\n \u003cp\u003e(16.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e476\u003c/p\u003e\n \u003cp\u003e(36.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e490\u003c/p\u003e\n \u003cp\u003e(37.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDegree of Awareness of international medical practice pathways (Mean \u0026plusmn; SD =2.35\u0026plusmn;0.96)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003eHow familiar are you with the licensure exams required to practice medicine overseas (e.g. USMLE, PLAB)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e315\u003c/p\u003e\n \u003cp\u003e(24.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e309\u003c/p\u003e\n \u003cp\u003e(23.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e424\u003c/p\u003e\n \u003cp\u003e(32.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e186\u003c/p\u003e\n \u003cp\u003e(14.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003cp\u003e(5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003eHow knowledgeable are you about the residency or internship programs needed to practice medicine overseas\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e389\u003c/p\u003e\n \u003cp\u003e(29.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e428\u003c/p\u003e\n \u003cp\u003e(32.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e358\u003c/p\u003e\n \u003cp\u003e(27.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003cp\u003e(6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003cp\u003e(2.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBarriers influencing migration intention (Mean \u0026plusmn; SD =2.95 \u0026plusmn; 0.69)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003eHow significant do you perceive financial constraints (e.g., examination fees, visa application costs) in your pursuit of practicing medicine overseas\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003cp\u003e(3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e121\u003c/p\u003e\n \u003cp\u003e(9.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e321\u003c/p\u003e\n \u003cp\u003e(24.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e542\u003c/p\u003e\n \u003cp\u003e(41.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e265\u003c/p\u003e\n \u003cp\u003e(20.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003eHow challenging do you find the licensing processes (e.g., examinations, credential verification) for practicing medicine overseas\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003cp\u003e(3.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e153\u003c/p\u003e\n \u003cp\u003e(11.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e528\u003c/p\u003e\n \u003cp\u003e(40.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e452\u003c/p\u003e\n \u003cp\u003e(34.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003cp\u003e(8.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003eDo cultural differences (e.g., language, lifestyle, social norms) pose a barrier to your decision to practice overseas?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e402\u003c/p\u003e\n \u003cp\u003e(30.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e299\u003c/p\u003e\n \u003cp\u003e(23.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e355\u003c/p\u003e\n \u003cp\u003e(27.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e187\u003c/p\u003e\n \u003cp\u003e(14.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003cp\u003e(4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003eHow much do concerns about adapting to a different healthcare system affect your decision to work abroad\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e274\u003c/p\u003e\n \u003cp\u003e(21.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e365\u003c/p\u003e\n \u003cp\u003e(28.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e482\u003c/p\u003e\n \u003cp\u003e(37.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e138\u003c/p\u003e\n \u003cp\u003e(10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003cp\u003e(3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eKey: SD is Strongly disagree, D is Disagree, N is Neutral, A is Agree, SA is Strongly agree \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 6 Bivariate analysis of factors associated with migration intention among respondents\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntention to migrate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; Statistics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eN (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e = 2.23\u003c/p\u003e\n \u003cp\u003ep = 0.526\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u0026lt;18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e36 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e18 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e18-22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e520 (62.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e313 (37.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e23-27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e238 (66.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e121 (33.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u0026ge;28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e36 (67.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e17 (32.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e433 (64.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e235 (35.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e = 0.510\u003c/p\u003e\n \u003cp\u003ep = 0.475\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e397 (62.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e234 (37.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eHausa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e390 (63.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e225 (36.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e = 0.512\u003c/p\u003e\n \u003cp\u003ep = 0.916\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eFulani\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e154 (65.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e83 (35.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eIgbira\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e78 (61.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e48 (38.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e208 (64.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e113 (35.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYear of Study\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003ePre-Clinicals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e396 (62.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e239 (37.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e = 1.221\u003c/p\u003e\n \u003cp\u003ep = 0.269\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eClinicals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e433 (65.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e230 (34.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMotivation for studying medicine\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eFamily pressure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e49 (52.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e45 (47.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e = 13.265\u003c/p\u003e\n \u003cp\u003ep = 0.004\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eMoney\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e77 (66.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e39 (33.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eCuriosity \u0026amp; Passion for the medical profession\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e639 (66.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e329 (34.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e65 (53.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e56 (46.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHave you participated in any international medical programs\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e151 (77.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e45 (23.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e = 17.360\u003c/p\u003e\n \u003cp\u003ep = \u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e678 (61.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e424 (38.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHave you explored the certification process for practicing medicine overseas\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e368 (88.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e46 (11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e = 164.547\u003c/p\u003e\n \u003cp\u003ep = \u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 274px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e462 (52.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e423 (47.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003csup\u003e*\u003c/sup\u003e\u003c/strong\u003eStatistically significant at p\u0026lt;0.05\u003c/p\u003e\n\u003cp\u003eTable 7 Multivariable logistic regression analysis of factors associated with migration intention\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u0026lt;18 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e18\u0026ndash;22 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.50\u0026ndash;1.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e23\u0026ndash;27 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.50\u0026ndash;2.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.774\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u0026ge;28 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e1.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.70\u0026ndash;5.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.181\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.90\u0026ndash;1.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReligion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003eIslam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003eChristianity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.60\u0026ndash;1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.053\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003eFulani\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.60\u0026ndash;1.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.655\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003eIgbira\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.50\u0026ndash;1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.322\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003eHausa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.70\u0026ndash;1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.732\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYear of study\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003ePre-clinical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003eClinical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.60\u0026ndash;1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.161\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMotivation for studying medicine\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003eFamily pressure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003eMoney\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e1.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.80\u0026ndash;2.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.212\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003eCuriosity/passion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e1.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e1.10\u0026ndash;2.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.028\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.60\u0026ndash;2.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.631\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParticipation in international programs\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e1.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e1.00\u0026ndash;2.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e0.45\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003cstrong\u003ePerceived barriers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e0.70\u0026ndash;1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003cstrong\u003eInterest in international practice\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e2.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e2.10\u0026ndash;3.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003csup\u003ea\u003c/sup\u003e\u003cstrong\u003eAwareness of licensure pathways\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003e2.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16px;\"\u003e\n \u003cp\u003e2.00\u0026ndash;2.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e\u0026lt;0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003eComposite scores for interest, awareness, and perceived barriers were treated as continuous variables in the regression analysis; \u003csup\u003e*\u003c/sup\u003eStatistically significant at p\u0026lt;0.05\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThe study found a high prevalence of migration intention among Nigerian medical students, with nearly two-thirds expressing a desire to practice medicine abroad. This reflects a continuing trend of medical workforce emigration and highlights concerns about the sustainability of the Nigerian healthcare system, consistent with previous studies [4,15]. Similar proportions have been reported among both medical students and doctors in training in Nigeria, where 74.4% of students preferred to specialize abroad and 74.2% of doctors undergoing training expressed migration intentions [4,15], suggesting that migration intention develops early and persists across different stages of medical training. Despite this strong intention, awareness of migration pathways such as licensure examinations and residency requirements was low, indicating a clear gap between aspiration and preparedness. This contrasts with findings among doctors in training, where a substantial proportion had already initiated migration plans [15], suggesting that while intention begins early, it becomes more structured and actionable with professional progression. This suggests that for many students, migration intention may be driven more by dissatisfaction with local training and practice conditions than by structured career planning [4].\u003c/p\u003e\n\u003cp\u003eMultivariate analysis showed that socio-demographic factors, including age, gender, ethnicity, religion, and year of study, were not significantly associated with migration intention. This indicates that migration intention cuts across diverse student subgroups and is not influenced by demographic or academic characteristics. Rather, it reflects broader systemic and professional concerns, supporting the view that migration in low- and middle-income countries is often driven by perceived professional risk and the search for better practice environments with improved medical infrastructure and technology [16,17]. The most preferred destination countries were the USA, Canada, and the UK, which is consistent with previous studies that similarly identified these countries as leading destinations for Nigerian medical trainees [4,15]. Key factors influencing destination choice included salary and benefits, medical infrastructure and technology, and work–life balance, while proximity to Nigeria was of minimal importance, further reinforcing the dominance of professional and economic considerations over geographic or social ties.\u003c/p\u003e\n\u003cp\u003eMigration intention was further shaped by a combination of push and pull factors. The main pull factors included expectations of higher salaries, improved working conditions, better work–life balance, advanced medical infrastructure, and increased career advancement opportunities. These findings are consistent with global trends in health workforce migration, where professionals seek environments offering both financial stability and modern healthcare systems [18,19]. This is particularly relevant within the African context, where documented shortages and maldistribution of health workers continue to drive outward migration pressures [18]. On the other hand, push factors included concerns about long-term career prospects and perceived gaps in the Nigerian medical training system. The influence of political stability and job security (both Mean = 3.7) further suggests that migration is driven not only by income considerations but also by the need for systemic stability. This is consistent with a previous study that reported that recurrent industrial actions and instability in the Nigerian healthcare system contribute to professional uncertainty [1].\u003c/p\u003e\n\u003cp\u003eSocial influence appeared to play a limited role in migration decisions. Although exposure to doctors practicing abroad was relatively high (69.3%), family and peer influence had the lowest mean score (2.15), suggesting that migration intention is largely an individual, career-driven decision rather than one shaped by direct social pressure. This aligns with Toyin-Thomas et al. [17], who reported that modern migration drivers among healthcare workers in low- and middle-income countries are increasingly centered on career advancement and access to better technology rather than traditional social influences.\u003c/p\u003e\n\u003cp\u003eDespite the high level of migration intention, several barriers to actual migration were identified. Financial constraints were the most significant obstacle, with over 60% of respondents indicating that limited resources could hinder migration plans. This aligns with evidence that migration costs represent a major barrier among individuals in Sub-Saharan Africa [20]. In contrast, cultural differences and concerns about adaptation to foreign healthcare systems were not considered major barriers by most respondents. Additionally, regression analysis indicated that perceived barriers significantly reduced the likelihood of migration intention, highlighting their moderating effect on migration decisions.\u003c/p\u003e\n\u003cp\u003eThis study has some limitations. It identified important predictors of migration such as interest in international medical practice and awareness of migration pathways; however, it did not deeply explore broader social, cultural, and institutional determinants shaping these intentions. Future studies should therefore adopt mixed-methods approaches, combining quantitative surveys with qualitative interviews or focus group discussions, to provide deeper insight into migration decision-making processes. Furthermore, research should evaluate the impact of policy interventions aimed at improving retention, including enhancements in residency training quality, working conditions, and career development pathways. Such evidence would be valuable in guiding strategies to strengthen Nigeria’s healthcare system and reduce the long-term impact of physician migration.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eThis study demonstrates a high prevalence of migration intention among Nigerian medical students, underscoring the growing challenge of physician emigration within the Nigerian healthcare system. Migration intention was largely driven by interest in international medical practice, awareness of overseas training and licensure pathways, and key professional considerations such as better remuneration, improved working conditions, career advancement opportunities, and access to advanced medical technology. Financial constraints and licensure-related challenges emerged as important factors that may limit or delay actual migration.\u003c/p\u003e\n\u003cp\u003eTo address this trend, policymakers should prioritize sustainable retention strategies for future medical professionals. These include improving remuneration and working conditions for doctors, strengthening healthcare infrastructure, enhancing the quality and accessibility of postgraduate and residency training, and expanding structured career development opportunities. In addition, increasing transparency in medical career progression and introducing targeted financial support mechanisms such as loan schemes for medical students and early-career doctors may help reduce migration pressure and strengthen the long-term stability of the healthcare workforce.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAOR – Adjusted Odds Ratio\u003c/p\u003e\u003cp\u003eBUK – Bayero University Kano\u003c/p\u003e\u003cp\u003eCI – Confidence Interval\u003c/p\u003e\n\u003cp\u003eLMICs – Low- and Middle-Income Countries\u003c/p\u003e\u003cp\u003eM.B.B.S – Bachelor of Medicine, Bachelor of Surgery\u003c/p\u003e\u003cp\u003eMDCN – Medical and Dental Council of Nigeria\u003c/p\u003e\u003cp\u003eNWU – North West University\u003c/p\u003e\u003cp\u003ePLAB – Professional and Linguistic Assessments Board\u003c/p\u003e\u003cp\u003eSD – Standard Deviation\u003c/p\u003e\u003cp\u003eUSMLE – United States Medical Licensing Examination\u003c/p\u003e\u003cp\u003eUSA – United States of America\u003c/p\u003e\u003cp\u003eUK – United Kingdom\u003c/p\u003e\u003cp\u003eWHO – World Health Organization\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study adhered strictly to international ethical guidelines as enshrined in the Declaration of Helsinki. Ethical approval for this study was obtained from the Health Research Ethics Committee of the Kano State Ministry of Health (approval number: NHREC/17/03/2018). Participation in the study was voluntary, and informed consent was obtained electronically from all participants prior to data collection. Anonymity and confidentiality of respondents’ information were strictly maintained throughout the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets supporting the conclusions of this article are included within the article (and its additional files).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEdeda Emmanuel Matthew and Garba Joshua Adamu jointly contributed to the conceptualization of the study, development of the methodology, formal data analysis and interpretation, funding acquisition, project administration, and drafting of the original manuscript. Ajala Oladunsi Esther, Ugwu Felicia Oyare, and Ejeh Ene Ayomide contributed to manuscript review, critical revision, sub-committee coordination, and data oversight. Cydney John Akpan and Beede Miracle Chichetaram contributed to manuscript review, critical revision, and editorial support. Onyeama Royale Kelechi, Shagbaor Jeremiah Ushahemba, Fatukasi Sarah Pelumi, Yusuf Maryam, Emeagui Makuochukwu Kelvin, Hamzat Abdulmuiz Ayodele, Ologbonyo Temitope, and Hassan Oladipupo Ismail contributed to manuscript review. Rukayya Muhammad Hassan, Yanmida Gbenga, Paul Febian, Musa Hezekiah Sokolayam, Daniel Abraham Adebayo, and Khadija Dahira Baba contributed to data collection, data entry, and documentation. Luke Oche Peter revised the final manuscript. All authors read and approved the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eOnah C, Azuogu B, Ochie C, Akpa C, Okeke K, Okpunwa A. Physician emigration from Nigeria and the associated factors: implications for safeguarding the Nigerian health system. Hum Resour Health. 2022;20:85.\u003c/li\u003e\n\u003cli\u003eOjo T, Oladejo B, Afolabi B, Osungbade A, Anyanwu P, Shaibu-Ekha I. Why move abroad? Factors influencing migration intentions of final-year students of health-related disciplines in Nigeria. BMC Med Educ. 2023;23:742.\u003c/li\u003e\n\u003cli\u003eUmar A, Salihu H, Azuine R. Crisis of brain drain in Nigeria\u0026rsquo;s health sector: challenges, opportunities, and the path forward. Int J Matern Child Health AIDS. 2025;14:e011.\u003c/li\u003e\n\u003cli\u003eOssai E, Una A, Onyenakazi R, Nwonwu E. Emigration plans after graduation of clinical medical students of Ebonyi State University Abakaliki, Nigeria: implications for policy. Niger J Clin Pract. 2020;23(7):995\u0026ndash;1001.\u003c/li\u003e\n\u003cli\u003eAdeniran A, Ojo O, Oluwole E, Obodo-Iregbu U, Ogunbiyi B. Perception of medical training and migration intention among graduating medical students in Lagos, Nigeria. LASU J Med Sci. 2021;6(1).\u003c/li\u003e\n\u003cli\u003eOyedokun A, Akoki D, Adesola A, Fatola A, Oyoyo H, Adu S. Exploring the emigration intentions of Nigerian medical and nursing students: factors driving migration and implications for Nigeria\u0026rsquo;s healthcare system. BMC Med Educ. 2025;25:698.\u003c/li\u003e\n\u003cli\u003eSer G, Teng Z, Yusni Y. A scoping review on medical students\u0026rsquo; international migration: trends, determinants, and implications for global health workforce planning. Hum Resour Health. 2025;23:67.\u003c/li\u003e\n\u003cli\u003eAkafa T, Okeke A, Oreh A. Push and pull factors of emigration among physicians in Nigeria. Int J Emerg Multidiscip Biomed Clin Res. 2023;1(2):1\u0026ndash;12.\u003c/li\u003e\n\u003cli\u003eAluko J, Adebayo A, Ogunleye O. Perceptions of residency training and international career aspirations among Nigerian medical students: a nationwide pilot survey. BMC Med Educ. 2025;25(1):116.\u003c/li\u003e\n\u003cli\u003e Adebowale A, Atte O, Ayeni O. Awareness of international practice opportunities and migration intention among final-year medical students in a Nigerian university. Dev Ctry Stud. 2022;12(5):14\u0026ndash;22.\u003c/li\u003e\n\u003cli\u003e Aderinto N, Kokori E, Olatunji G. A call for reform in Nigerian medical doctors\u0026rsquo; work hours. Lancet. 2024;403(10428):726\u0026ndash;7.\u003c/li\u003e\n\u003cli\u003e World Health Organization. Global health workforce mobility: migration intentions among medical trainees in low- and middle-income countries. Geneva: WHO Press; 2020.\u003c/li\u003e\n\u003cli\u003e Ossai E, Una A, Onyenakazi R, Nwonwu E. Emigration plans after graduation of clinical medical students of ebonyi state university Abakaliki, Nigeria: Implications for policy. Niger J Clin Pract. 2020;23(7):995. doi:10.4103/njcp.njcp_705_19\u003c/li\u003e\n\u003cli\u003e World Health Organization. Health workforce migration and brain drain in sub-Saharan Africa. Geneva: WHO Press; 2023.\u003c/li\u003e\n\u003cli\u003e Akinwumi A, Solomon O, Ajayi P, Ogunleye T, Ilesanmi O, Ajayi A. Prevalence and pattern of migration intention of doctors undergoing training programmes in public tertiary hospitals in Ekiti State, Nigeria. Hum Resour Health. 2022;20:76.\u003c/li\u003e\n\u003cli\u003e Stark O, Levhari D. On migration and risk in LDCs. Econ Dev Cult Change. 1982;31(1):191\u0026ndash;6.\u003c/li\u003e\n\u003cli\u003e Toyin-Thomas P, Ikhurionan P, Omoyibo E, Iwegim C, Ukueku A, Okpere J. Drivers of health workers\u0026rsquo; migration, intention to migrate and non-migration from low/middle-income countries, 1970\u0026ndash;2022: a systematic review. BMJ Glob Health. 2023;8(5):e012338.\u003c/li\u003e\n\u003cli\u003e Ahmat A, Okoroafor S, Kazanga I, Asamani J, Millogo J, Illou M. The health workforce status in the WHO African Region: findings of a cross-sectional study. BMJ Glob Health. 2022;7(Suppl 1):e008317.\u003c/li\u003e\n\u003cli\u003e Omoleke I, Taleat B. Contemporary issues and challenges of health sector in Nigeria. Res J Health Sci. 2018;5(4):210\u0026ndash;6.\u003c/li\u003e\n\u003cli\u003e Recchi E, Deutschmann E, Gabrielli L, Kholmatova N. The global visa cost divide: How and why the price for travel permits varies worldwide. Polit Geogr. 2021;87:102350. doi:10.1016/j.polgeo.2021.102350\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Physician migration, migration intention, medical students, health workforce, brain drain, retention strategies, licensure pathways","lastPublishedDoi":"10.21203/rs.3.rs-9525189/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9525189/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Health workforce migration from low- and middle-income countries remains a major global health challenge, with implications for health system resilience. Nigeria, one of the largest contributors to the global medical workforce, faces increasing loss of future physicians. This study examined the determinants of migration intention among Nigerian medical students.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e A 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 \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e 63.9% of respondents intended to practice medicine abroad. The most preferred destinations were the United States (45.2%), Canada (44.5%), and the United Kingdom (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 (62.1%) was the leading barrier. Migration intention was significantly associated with motivation for studying medicine (p = 0.004), participation in international programs (p \u0026lt; 0.001), and prior exploration of certification processes (p \u0026lt; 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).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e A substantial proportion of Nigerian medical students intend to migrate, reflecting systemic push factors and global pull dynamics. Early, targeted retention strategies within medical training and broader health system reforms are urgently needed to mitigate future workforce losses.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number: \u003c/strong\u003eNot applicable\u003c/p\u003e","manuscriptTitle":"Understanding the drivers of brain drain: a study of migration intention among medical students in Nigeria","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-28 07:35:51","doi":"10.21203/rs.3.rs-9525189/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2d2c051c-259f-4357-8c8b-807c0976978e","owner":[],"postedDate":"April 28th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-28T10:11:08+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-28 07:35:51","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9525189","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9525189","identity":"rs-9525189","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}