The anatomy of a decision: exploring the push, pull, and personal factors of emigration intent among Turkish medical students

The migration intentions of medical students, often referred to as “brain drain,” pose a significant challenge to healthcare systems worldwide. This study aims to investigate the motivations for emigration, career preferences, and preparatory actions among medical students in Türkiye, a country experiencing significant physician outflow. A cross-sectional online survey was distributed to medical students across Türkiye. The final sample included 1134 participants from 20 different medical faculties. Data were collected on demographics, motivations for studying medicine, specialty preferences, language proficiency, international experience, and intentions and preparations for working abroad or domestically. Motivations for studying medicine and specialty preferences differed significantly by gender. Female students were more driven by altruism and preferred nonsurgical specialties, whereas male students prioritized financial prospects, prestige, and surgical fields. The key predictors for intending to work abroad included higher parental education, advanced foreign language proficiency (especially English), and prior international experience. A third of the students (33%) expressed a desire to work abroad after graduation, with Germany, the UK, and the US being the top destinations. The primary push factors for emigration were demanding working conditions (70.8%), violence against healthcare professionals (64.1%), and systemic problems within the healthcare system (55.8%). A striking finding was 74.2% of the students who planned to stay in Türkiye were also making preparations to leave, indicating a deep-seated lack of confidence in the domestic healthcare environment. A significant proportion of Turkish medical students intend to practice abroad, driven primarily by push factors related to working conditions and safety. The widespread preparatory activities, even among those stating an intention to stay, suggest that brain drain is a tangible risk. Retaining this future physician workforce requires urgent, systemic interventions addressing working conditions, safety from violence, and career opportunities, particularly in research and academic medicine.