Factors affecting the internal brain drain of Saudi healthcare professionals.

OBJECTIVE To investigate factors affecting the internal brain drain of healthcare professionals in the Kingdom of Saudi Arabia. METHODS A cross-sectional study was conducted using an anonymous self-administered online questionnaire sent to all Saudi students enrolled in healthcare profession programs in North America. The data was collected between January and March 2008 at the University of Illinois at Chicago, Chicago, Illinois, United States of America. Results were analyzed using logistic regression analyses. RESULTS A total of 377 completed questionnaires were returned. Results revealed that 71% of respondents intended to return to work within the 2 major urban cities Riyadh and Jeddah. Respondents who completed their undergraduate studies in a large city were more likely to work in the same city (odds ratio [OR]=3.2; p=0.000; 95% confidence interval [CI] = 2.0-5.2). Furthermore, 51% of the students were willing to work in a rural area for a 50% or more increase in their salary. Finally, men were more willing to work in a rural area for a financial incentive (OR=2.3; p=0.006, 95% CI = 1.3-4.3). CONCLUSION This study suggests that realistic financial incentives would probably not suffice to attract Saudi healthcare providers to rural areas. The provision of medical schools in smaller cities and rural areas is predicted to be a more effective method for improving the current maldistribution of healthcare providers.