The Relationship between Job Dissatisfaction and the Desire to Migrate among Medical Staff of Hamadan University of Medical Sciences, Hamadan, Iran, in 2024

BRIEF TEXT

Background and Objective

Medical staff migration is recognized as a global health workforce crisis, especially in developing countries [1]. … [2]. Iran, as one of the countries with a young population, has had an upward trend in the outflow of academically educated people in recent years. Job dissatisfaction in the country of origin plays a major role in medical staff migration [3, 4]; therefore, this study aimed to determine the level of job dissatisfaction in medical staff with a tendency to migrate. ... [5-12].

Materials and Methods

This cross-sectional study was conducted in 2024 with the participation of 540 medical staff of Hamadan University of Medical Sciences, Hamadan, Iran, who were selected by convenience sampling. The research instrument was the Minnesota Job Satisfaction Questionnaire [13-16]. The data were analyzed using SPSS software (version 20). The normal distribution of the data was examined using the t-student and Mann-Whitney tests. Finally, analysis of variance and Pearson and Spearman correlation tests were performed at a significance level of 0.05.

Results

Of the total participants, 328 people were female (60.7%) and 212 people were male (39.3%), and their mean age was 30.96 ± 6.9 years (Table 1). 156 people (28.9%) of the medical staff did not have a desire to migrate, while 291 people (54.4%) had a desire to migrate, 74 people (13.7%) were planning to migrate, and 16 people (3%) had taken practical steps to migrate. The mean job satisfaction score was 41.35 ± 11.4, and the lowest mean was related to the dimensions of the payment system and career advancement opportunities (Table 2).

No significant relationship was found between gender, age, and marital status and job satisfaction (Table 3).

The level of job satisfaction was reported as poor in 200 people (37.2%), average in 291 people (54.4%), and very good in 43 people (8.3%). Also, a statistically significant relationship was observed between occupation (P < 0.001), educational level (P < 0.001), and employment status (P < 0.001) and job satisfaction in healthcare professionals with a tendency to migrate (P < 0.05) (Table 4).

Discussion

The present study was conducted to determine the level of job dissatisfaction among the medical staff of the hospitals of Hamadan University of Medical Sciences, Hamadan, Iran. The findings showed that the lowest satisfaction was with the payment system, followed by advancement opportunities, and the highest average was related to the dimensions of satisfaction with the organizational atmosphere, type of job, satisfaction with the management style, and physical conditions, respectively.

Also, job satisfaction among the employed staff of Hamedan University of Medical Sciences who are inclined to migrate was 37.2% poor, 54.4% moderate, and 8.3% very good, which showed that the majority of these people have poor and moderate job satisfaction. The findings of this study are consistent with the results of Haqdoost et al. (2022); as they reported that more than half of the participants had a high and very high desire to migrate, and a significant portion even showed a desire to work in unspecialized and lower jobs abroad [9]. This high figure is a serious alarm for the country's health system, because the migration of elites and health professionals will have irreparable negative consequences for access to quality health services. In this regard, the study by Kamali et al. also showed moderate job satisfaction among nurses and reported a significant relationship between the desire to migrate and nurses' job satisfaction [17]. Also, Koosha et al. (2012) reported the highest average satisfaction in the dimension of individual factors affecting job satisfaction and the highest level of dissatisfaction in the dimension of environmental and welfare factors, which is consistent with the findings of the present study, especially in the dimension of the payment system [18]. In the study by Nouri Hekmat, economic factors were also identified as one of the most important causes affecting elite migration [12].

These results have also been confirmed in international studies. In a study that examined the relationship between satisfaction and intention to migrate among physicians in three university hospitals in Poland, physicians' income level was cited as the main reason for dissatisfaction and as a factor influencing the intention to migrate. Other factors, such as career advancement opportunities and characteristics related to the work environment, including relationships with colleagues, were effective in both levels of dissatisfaction and intention to migrate [13]. Thomas also showed that job dissatisfaction was the main reason for nurses' desire to migrate. As 87% of those who were dissatisfied with their jobs had a desire to migrate [19]. Oosthuizen et al. also showed that an unsuitable job situation, due to lack of career advancement opportunities, was the most important factor in the decision to migrate [20].

In general, economic issues are considered one of the main reasons for the migration of medical personnel. Issues, such as the incompatibility of wages with the inflation rate and living costs, the low value of the country's currency exchange rate compared to other countries, economic instability, and lack of hope for the country's economic future are among the reasons for the migration of specialists [21].

Also, no significant relationship was found between gender, age, and marital status and job satisfaction, which is in contradiction with the study by Kamali et al., in which a significant relationship was observed between age and marital status and job satisfaction [17], and some studies, such as Reid et al., showed a significant relationship between marital status and the desire to migrate. And the desire to migrate is higher in single people than in married people [23].

Another important finding of the present study was the existence of a significant relationship between job and job satisfaction, such that job satisfaction differed among doctors, paramedics, and then midwives and nurses. This result could be due to differences in responsibilities, salaries, advancement opportunities, and working conditions. The results of the study by Koosha et al. also reported a significant difference in job satisfaction among different job groups [18]. A significant relationship was also found between educational qualifications and job satisfaction, such that people with a doctorate had the highest job satisfaction, and satisfaction increased with increasing job rank, such that people with a bachelor's degree had the lowest job satisfaction.

Conclusion

A significant portion of the medical staff working in hospitals of Hamadan University of Medical Sciences tends to migrate, and job satisfaction in most of these individuals was assessed at a weak-to-moderate level. Analysis of job satisfaction dimensions showed that the payment system and professional development opportunities are the main sources of dissatisfaction. Developing comprehensive strategies focusing on optimizing the compensation system and promoting career growth paths is essential to prevent human resource attrition and manage the migration phenomenon.

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Table 1. Demographic Characteristics of Staff Working in Hospitals of Hamadan University of Medical Sciences, Hamadan, Iran

Table 2. Average Job Satisfaction and Its Dimensions in the Immigration-Prone Staff Employed at Hamadan University of Medical Sciences, Hamadan, Iran (n = 384)

Table 3. Average Job Satisfaction by Age, Gender, and Marital Status among Medical Staff Inclined to Migrate at Hamadan University of Medical Sciences, Hamadan, Iran

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Table 4. Frequency Distribution of Job Satisfaction of Staff Inclined to Migrate Working at Hamadan University of Medical Sciences, Hamadan, Iran, by Job, Educational Degree, Employment Status (n = 384)