Evidence map›Paper›PMID 42825867›Full record

SynthesisJournal of epidemiology and global health2026

Pushed, Pulled, and Moored: A Systematic Review and Meta-analysis of Migration Intentions Among Medical Trainees in the Arab Region.

Yusof Mohamed Omar, Mohamed Ashraf Elsaadany, Nour Edin Darwish, Yousuf Darwish, Lina Mohamed Omar, Mohamed Hossam Ghazy, Tasneem Deibes, Karim A Elsodany, Jamal Ahmad

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of epidemiology and global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Yusof Mohamed OmarFaculty of Medicine, Mansoura University, Mansoura, Egypt. yusofmohamed@std.mans.edu.eg.
Mohamed Ashraf ElsaadanyFaculty of Medicine, Cairo University, Cairo, Egypt.
Nour Edin DarwishFaculty of Medicine, Mansoura University, Mansoura, Egypt.
Yousuf DarwishFaculty of Medicine, Mansoura University, Mansoura, Egypt.
Lina Mohamed OmarFaculty of Medicine, Mansoura University, Mansoura, Egypt.
Mohamed Hossam GhazyFaculty of Medicine, Mansoura University, Mansoura, Egypt.
Tasneem DeibesFaculty of Medicine, Mansoura University, Mansoura, Egypt.
Karim A ElsodanyFaculty of Medicine, Mansoura University, Mansoura, Egypt.
Jamal AhmadCollege of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe Arab region is experiencing substantial outward migration amid persistent healthcare workforce shortages. However, reported prevalence estimates and reasons vary considerably across studies. Therefore, we aimed to estimate the pooled prevalence of migration intentions among medical trainees in the Arab region and summarize the reported drivers of migration using the Push-Pull-Mooring (PPM) framework.

methodsWe searched PubMed, Scopus, Embase, and Web of Science in April 2026, supplemented by backward and forward citation searching. Studies were eligible if they reported discrete prevalence estimates of migration intentions among medical students, interns, or residents in Arab countries. The pooled prevalence was calculated using a random-effects model with a generalized linear mixed model and logit transformation. Heterogeneity was primarily assessed using Tau². Risk of bias was assessed using the Newcastle-Ottawa Scale adapted for descriptive cross-sectional studies (NOS-xs2).

resultsThirty-one studies comprising 21,614 Arab medical trainees were included. The overall pooled prevalence of migration intention was 70.7% (95% CI: 63.2%-77.2%), with substantial heterogeneity (Tau² = 0.84). Subgroup analyses were not statistically significant except for region (p = 0.030), with the Nile Valley reporting the highest prevalence (74.3%; k = 14) and the Arabian Peninsula reporting the lowest (41.5%; k = 3). Prevalence was numerically highest among medical students (76.0%), followed by residents (65.4%) and interns (56.7%). By intention type, general migration intent was highest (74.1%), followed by training-related (71.5%) and work-related migration (61.9%). War and insecurity (k = 10), financial insecurity (k = 9), and poor working conditions (k = 7) were the most frequently reported push factors, while higher pay (k = 11), better training opportunities (k = 10), and career growth (k = 10) were the frequently reported pull factors. Family ties (k = 6) and patriotism (k = 5) were the frequently reported mooring influences.

conclusionsMore than two-thirds of medical trainees in the Arab region report intentions to migrate abroad, highlighting a major regional health workforce challenge. While intentions do not equate to actual migration behavior, the findings nevertheless support the need for health workforce policies that strengthen physician retention through investment in competitive remuneration, safe working environments, and high-quality local postgraduate training pathways while addressing broader sociopolitical drivers of migration.

Indexed as

Emigration and ImmigrationIntentionStudents, MedicalBrain DrainHumansInternship and ResidencyMiddle EastMiddle Eastern PeopleBrain drain; Arab world; Health workforceMedical studentsMeta-analysisMigration intentionPhysician migrationResidentsSystematic review

Identifiers

PMID42825867
PMCPMC13633222

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.