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Table 4 Migration motives of international doctors and nurses to the UK

From: Migration motives and integration of international human resources of health in the United Kingdom: systematic review and meta-synthesis of qualitative studies using framework analysis

Macro-level driver International and national factors that exert influence across all international labour markets and also affect the health system dynamics [16, 20]
  Themes and descriptions Codes References to clarify the source of the codes
UK based Health system factors (these are factors related to the UK health systems including NHS) Active recruitment
Employment opportunities in the NHS
Safety and security of NHS
Established networks
Support offered for relocation/induction
Permit free training
Active recruitment [21, 25,26,27,28,29,30,31]
Employment opportunities in the NHS [26, 27, 32,33,34]
Safety and security of NHS [25, 26, 35, 37,38,39]
Established networks [29, 31]
Economic factors Ability to remit money
Strength of pound in global economy
[31, 33, 35, 39]
Political factors Bilateral agreement
UK referendum vote to leave EU
Safety for family/self, fleeing violence
Ease of obtaining right to remain
Ease of British Citizenship
Ease of movement to the UK from EU
Bilateral agreement [25, 29, 40]
Source country based Health system Unemployment
Underemployment
Poor salaries
Poor working conditions
Overproduction of nurses and doctors
Un/underemployment
Poor salaries [41]
Working conditions [27, 33]
Economic factors Global recession
Devaluation of money
Changes to remuneration
Remittance to home country
Global recession [30]
Devaluation of money [25]
Changes to remuneration [41]
Remittance to home country [38, 39, 42]
Social factors Corruption in everyday life Corruption in everyday life [26, 29, 33]
Political factors Immigration policies
Bilateral agreements
Colonial connections
Immigration policies
Bilateral agreements [8, 34]
Meso-level Professional-specific factors (e.g. education/training, job conditions) that frame perceived opportunities in a given occupational sector
UK Training opportunities Desire to gain postgraduate training
Desire to gain postgraduate qualification
Desire to learn the state of the art in the profession
Status of gaining UK qualifications and training
Training opportunities [26, 27, 32,33,34]
Employment opportunities Desire to experience working in a different environment Experience a different work environment [35, 50, 51]
Career progression opportunities Opportunities to gain clinical experience through short-term employment
Opportunity for research
Opportunity for networking
Opportunities to gain clinical experience through short term employment [43, 48]
Source country Training and employment opportunities Shortage of postgraduate training opportunities
Shortage of posts in a particular speciality/profession
Natural progression of training
[26, 49, 53]
Career progression opportunities Lack of promotion [30, 41, 49, 50, 53]
Micro-level Individual circumstances and attitudes through which macro- and meso-level drivers are viewed by individuals therefore influencing individuals’ migration decision
  Personal fulfilment Desire for life change
Adventure
Better quality of life
Desire for life change
Adventure [52]
Better quality of life [25, 29, 37, 40, 46, 48]
  Financial gain Financial gain for self
Financial gain for family
Financial gain for extended family
Desire to increase comparative income
Financial gain for self and family [26, 27, 29, 33, 35, 38, 42, 48, 55]
  Family factors Better quality of life for family
Better education for children
Desire to give children the cultural experience
Partners decision to work in the UK
Travel to the UK to marry
Travel to the UK to escape marriage
Better quality of life for family
Better education for children
Desire to give children the cultural experience [25]
Partners decision [35, 50, 51]
  Networks Access to social networks in the UK
Access to professional networks in the UK
Influenced by family mentor
Influenced by professional mentor
Access to networks and mentors [37, 38, 42, 51]
Role of mentor or mentoring [28]
  Language Knowledge of English language
Desire to improve English language
[25, 29, 39, 47, 48]
  Window of opportunity One off opportunity [25]
  Migrating stepping stone Working in the UK is seen as a potential stage in onward migration, primarily to the United States, Gulf countries and Australia [27]