Factors influencing Lebanese medical students' decisions to train abroad: Evaluation of a conceptual framework

Objective: To evaluate a conceptual framework portraying the factors underlying the intentions of medical students to train abroad. Methods: Eligible subjects were students in the prefinal and final years of medical studies in Lebanon. A survey questionnaire based on the conceptual framework inquired about demographic and educational characteristics, influencing factors, and intentions to train abroad. We assessed each of the factors for its frequency, distribution, and association with the intention to train abroad. Results: Of 576 eligible students, 425 (74%) participated. The frequency of the framework factors varied from 16% to 94% and was the highest for factors related to training and professional career. The factors independently associated with the intention to train abroad related to residency training, concern with professional career and political conditions. The intention to train abroad was also associated with thinking that the general public considers doctors trained abroad as more qualified (OR=6.3; 95% CI=1.2-33.2); receiving information about abroad training from doctors trained or training abroad (OR= 9.7; 95% CI=1.7-56.6); having relatives or friends living abroad (OR=6.9; 95% CI=1.4-35.7); and witnessing residents traveling to retrain abroad (OR=22.2; 95% CI=4.5-111.1). Conclusions: Issues related to residency training, concerns about future career, and political conditions are the main motivators for Lebanese medical students to train abroad. The proposed conceptual framework provides a useful tool, but requires further evaluation.