Happiness in the Homeland: Satisfaction with Life And Its Correlation with Flourishing and Affect Balance in Foreign-Trained, Repatriated Physicians in Pakistan

Introduction International medical graduates (IMGs) constitute a significant proportion of the global physician workforce, with Pakistan as a leading source country. Despite many Pakistani physicians emigrating for training and employment, limited research exists on the well-being of those who return. This study aimed to assess satisfaction with life (SWL) in foreign-trained, repatriated Pakistani physicians and examine its associations with affect balance and flourishing. Methods A cross-sectional survey was conducted between April 2022 and November 2023, recruiting 109 repatriated physicians via purposive sampling. Data was collected using the Scale of Positive and Negative Emotions (SPANE), the Flourishing Scale, and the SWL Scale. Relationships among these variables were assessed using correlation analysis, and logistic regression was used to identify predictors of SWL. Results Of the 109 participants, 70.6% were male, 83.5% resided in Punjab, 68.8% had trained in the US/Canada, and 69.7% worked in the private sector. The mean age was 47.31 (SD=7.9) years, and 58.7% held dual nationality. Overall, 90.8% reported being satisfied with life. Men (p=0.03) and married individuals (p=0.04) demonstrated higher SWL, whereas participants from Sindh and Khyber Pakhtunkhwa scored lower (p=0.007). SWL correlated moderately with flourishing (r=0.488), positive emotions (r=0.391), and affect balance (r=0.327). Each one-unit increase in flourishing was associated with a 1.236-fold higher odds of SWL (p=0.005). Conclusions Foreign-trained, repatriated Pakistani physicians in this study exhibited high SWL, closely linked to flourishing and positive affect. The repatriated physicians may significantly contribute to healthcare systems in lower-middle-income countries. Future research should examine broader samples, include locally trained or expatriated comparison groups, and explore repatriation challenges to further elucidate factors that influence physician well-being.