A Phenominological Qualitative Study of Factors Influencing the Migration of South African Anaesthetists

Background: The anaesthetic workforce is a scarce resource in South Africa (SA), and the media frequently reports that anaesthetists are leaving the country in search of better opportunities in well-resourced countries. The aim of this study was to explore the factors influencing the migration intentions of South African anaesthetists. Methods: This study utilised a qualitative methodology in the form of virtual interviews. A total of 23 interviews were conducted on purposefully selected participants using a snowball approach. The interviews were transcribed and coded into emerging themes using MAXQDA version 2022. Thematic content analysis was subsequently performed. Results: The study found that all SA-based participants were considering emigrating, while those who had already emigrated had no plans to return to SA in the near future. Push factors prompted the consideration of emigration, and these were related to unsatisfactory living and working conditions in South Africa, such as a high level of crime and corruption, and the country's overall poor resources and infrastructure. Destination countries were chosen based on their pull factors such as better working conditions and opportunities for professional growth. These pull factors frequently outweighed South Africa's push factors and are therefore critical in the decision to emigrate. The main recommendations from the participants include facilitating collaboration between the public and private sectors, expanding the available sub-specialties in SA, and recognising fellowships in South African hospitals. The study participants were of the view that South African anaesthesiologists would be motivated to stay by a combination of patriotism and hope for the future. Conclusions and Policy Recommendations: The Anaesthetic workforce in South Africa is at critical risk and is unlikely to stabilise soon. Concerted efforts should be made by all concerned to explore ways of retaining the staff, considering the recommendations of the participants. Relevant key stakeholders in training and regulation of anaesthetics practice such as the Health Professions Council of South Africa, South African Society of Anaesthesiologists, and the Colleges of Medicine of South Africa should collaborate and prioritise mechanisms of monitoring emigration and intervening on modifiable professional and socio-political factors.