Medical students’ migration intentions: risk factor and challenge for the healthcare system in Kyrgyzstan

Physician migration challenges healthcare systems in developing countries. The “Irish paradox” phenomenon, where doctor shortages persist despite numerous medical graduates, is emerging in Kyrgyzstan (KR). Limited research on this exists in Central Asia. The study explores medical students' migration intentions, offering insights for regional and global health authorities. A cross-sectional study surveyed 526 final-year medical students in KR. We analyzed demographic characteristics, intentions to work abroad, future professional preferences, and “Pull and Push” factors for migrations that might influence students’ decision to migrate. 86.1 % expressed willingness to emigrate. Intention to migrate was categorized by certainty of migration: 12.5 % “leave KR”, 14.5 % “highly likely to leave KR”, and 59.1 % “might leave KR”. 13.9 % decided to stay in KR. The significant predictors of migration were marriage and rural living; the main migration destinations were Russia (41.5 %), Kazakhstan (18.8 %), and the EU (11.5 %). Pull and push factors significantly differed among groups. The main limitations of the study arose from the nature of the observational study. The study results are alarming, uncovering the potential scale of physican migration in Central Asia. The majority of medical graduates in KR plan to migrate, posing a threat to healthcare sustainability. The presence of the "Irish paradox" amplifies the pressure on these processes in the country and should be considered in the development of migration policy. Monitoring students' intentions provides timely information for adjusting migration programs promptly, and the combined score of Pull and Push factors might serve as an express test to address the challenge more effectively. Migration programs should be developed jointly with the Russian Federation, as the main destination and give priority to professional development in the group with low migration intentions.