Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2024

Open Access 01-12-2024 | Research

Turnover intention of foreign trained physicians in German rehabilitation facilities—a quantitative study

Authors: Eva Jansen, Johanna Schmidt, Manuela Marquardt

Published in: BMC Health Services Research | Issue 1/2024

Login to get access

Abstract

Background

Germany’s medical specialist shortage is an acute challenge, especially in the rehabilitation segment. One countermeasure is to recruit foreign trained physicians (FTP), but the high turnover of FTP is a burden on the departments that train them and integrate them professionally. Preliminary research showed that currently one in three physician positions in German Pension Insurance (DRV) contract facilities is filled by FTP.​This paper examines factors related to turnover intention of FTP in German rehabilitative departments.

Methodology

In spring 2022, we surveyed FTP across all inpatient and outpatient rehabilitation departments under the German Pension Insurance, using a two-stage cross-sectional approach. We conducted an online survey of FTP and developed a specialized questionnaire that captured sociodemographic, occupation related and professional biographical data, turnover intention, satisfaction, difficulties with professional integration and departmental structural characteristics. To analyze retention within the rehabilitation field, we used a measure of turnover intention, taking into account the direction of potential turnover, residency requirements and considerations of returning to the rehabilitation field. The data was evaluated in a subgroup analysis comparing FTP with and without turnover intention using Fisher’s exact tests.

Results

The sample includes n = 145 FTP, 119 stating no turnover intention and 27 with turnover intention. More than half of FTP with turnover intention wished to move to an acute care hospital. FTP with turnover intention are comparatively younger and came to Germany and were employed in the rehabilitation departments more recently, indicating an earlier career stage. Besides, career-related and regional factors show the strongest relation to turnover intention.

Discussion and conclusion

The results reveal a group of “established FTP” whose professional integration has been successfully completed. FTP with turnover intention are comparatively younger, career-oriented physicians for whom work in a rehabilitative facility is a career springboard to gain a foothold in acute care clinics. A limitation is that FTP with turnover intention are difficult to reach and may be underrepresented in our sample.
Appendix
Available only for authorised users
Footnotes
1
Temporary license granted to non-EU physicians which is typically valid for up to 2 years, during which these doctors are expected to fulfill specific requirements necessary for obtaining their full medical licensure (“Approbation”).
 
Literature
1.
2.
Kaduszkiewicz H, Teichert U, van den Bussche H. Ärztemangel in Der hausärztlichen Versorgung auf dem Lande und Im Öffentlichen Gesundheitsdienst. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz; 2018.
3.
Arentz C. Regionale Verteilung Von Ärzten in Deutschland und anderen ausgewählten OECD-Ländern. KölnWIP- Wissenschaftliches Institut der PKV; 2017.
4.
Jansen E, Marquardt M. Ärztlicher Fachkräftemangel in der Rehabilitation - Ergebnisse einer quantitativen Umfrage in deutschen Rehabilitationsfachabteilungen. Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin. 2023;in print.
5.
Robert Bosch Stiftung. Gesundheitszentren für Deutschland Wie ein Neustart in der Primärversorgung gelingen kann. Stuttgart; 2021.
6.
7.
Deutsche Rentenversicherung. Rahmenkonzept zur medizinischen Rehabilitation in der gesetzlichen Rentenversicherung. Vol. 4. 2009.
8.
9.
Gutenbrunner C, Liebl ME, Reisshauer A, Schwarzkopf SR, Korallus C, Ziegenthaler H, et al. Rethinking Rehabilitation Medicine - The Profile of the specialist in physical and Rehabilitation Medicine (PRM). Phys Medizin Rehabilitationsmedizin Kurortmedizin. 2014;24(2):62–74.CrossRef
10.
Demary V, Koppel O. Der Arbeitsmarkt für Humanmediziner Und Ärzte in Deutschland: Zuwanderung Verhindert Engpässe. IW-Trends—Vierteljahresschrift Zur Empirischen Wirtschaftsforschung. 2013;40(3):47–62.
11.
12.
Hänel P, Jansen E. Outpatient care: (not) a place to settle. Deutsches Arzteblatt Int. 2014;111(46).
13.
14.
15.
Bourgeault IL, Neiterman E, LeBrun J, Viers KWJ. Brain gain, Drain and Waste: the experiences of internationally educated Health professionals in Canada. Ottawa: University of Ottawa; 2010.
16.
Klingler C, Marckmann G. Difficulties experienced by migrant physicians working in German hospitals: a qualitative interview study. Hum Resour Health. 2016;4(1):57.CrossRef
17.
Klingler C, Ismail F, Marckmann G, Kuehlmeyer K. Medical professionalism of foreign-born and foreign-trained physicians under close scrutiny: a qualitative study with stakeholders in Germany. PLoS ONE. 2018.
18.
Michalski K, Farhan N, Motschall E, Vach W, Boeker M. Dealing with foreign cultural paradigms: a systematic review on intercultural challenges of international medical graduates. PLoS ONE. 2017.
19.
Jansen E, Schnepf T, Hänel P. Divergierende Berufliche Sozialisation Von migrierten Ärzten. Public Health Forum. 2015.
20.
Jansen E, Hänel P, Klingler C. Rehabilitation-specific challenges and advantages in the integration of migrant physicians in Germany: a multiperspective qualitative interview study in rehabilitative settings. Public Health. 2018.
21.
Hänel P, Fölske L, Muschalla B, Jansen E. Herausforderungen Und Chancen Der Sozialen Anbindung Von migrierten Ärztinnen Und Ärzten in Der stationären Rehabilitation. Praxis Klinische Verhaltensmedizin Und Rehabilitation. 2018;104:236–46.
22.
Udechukwu IIMB. Determining the probability that an employee will stay or leave the Organization: A Mathematical and Theoretical Model for organizations. Hum Resour Dev Rev. 2007;6(2):64–184.CrossRef
23.
Ngo-Henha PE. A review of existing turnover intention theories. Int J Econ Manage Eng. 2017;11(11).
24.
Tett RP, Meyer JP. Job satisfaction, organizational commitment, turnover intention, and turnover: path analyses based on meta-analytic findings. Pers Psychol. 1993;46(2):259–93.CrossRef
25.
Rahman W, Nas Z. Employee development and turnover intention: theory validation. Eur J Train Dev. 2013;37(6):564–79.CrossRef
26.
Bodla MA, Hameed A. Factors affecting employee turnover intentions: empirical evidence from Textile Sector of Pakistan. Int J Knowl Cult Change Management: Annual Rev. 2009;9(8).
27.
Winterton J. A conceptual model of labour turnover and retention. Hum Resource Dev Int. 2004;7(3):371–90.CrossRef
28.
Brook J, Aitken LM, Webb R, MacLaren J, Salmon D. Characteristics of successful interventions to reduce turnover and increase retention of early career nurses: a systematic review. Int J Nurs Stud. 2019;91:47–59.CrossRefPubMed
29.
Jansen E, Marquardt M. Retention and turnover intention of foreign-trained physicians (FTPs): a scoping review. Z Evid Fortbild Qual Gesundh Wesen. 2023.
30.
evasys GmbH. Evasys [Internet]. 2024. Available from: https://​evasys.​de.​
31.
Heponiemi T, Hietapakka L, Lehtoaro S, Aalto A-M. Foreign-born physicians’ perceptions of discrimination and stress in Finland: a cross-sectional questionnaire study. BMC Health Serv Res. 2018;18(418).
32.
Braun K-P, Shaar M, Gumz A, Shaar A, Pantenburg B, Deutsch S et al. Job satisfaction and intentions to leave of Foreign-National urologists Working at German hospitals: results of the cross-sectional EUTAKD Study. Urol Int. 2021.
33.
Brugha R, Clarke N, Hendrick L, Sweeney J. Doctor Retention: a cross-sectional study of how Ireland has been losing the battle. Int J Health Policy Manage. 2021;10(6):299–309.
34.
Becker R, Teney C. Understanding high-skilled intra-european migration patterns: the case of European physicians in Germany. J Ethnic Migration Stud. 2020;46(9):1737–55.CrossRef
35.
Eneroth M, Gustafsson Sendén M, Schenck Gustafsson K, Wall M, Fridner A. Threats or violence from patients was associated with turnover intention among foreign-born GPs - a comparison of four workplace factors associated with attitudes of wanting to quit one’s job as a GP. Scand J Prim Health Care. 2017;35(2):208–13.CrossRefPubMedPubMedCentral
36.
Byrne O-P, Conway E, McDermott AM, Matthews A, Prihodova L, Costello RW, et al. How the organisation of medical work shapes the everyday work experiences underpinning doctor migration trends: the case of Irish-trained emigrant doctors in Australia. Health Policy. 2021;125(4):467–73.CrossRefPubMed
37.
Marquardt M, Schmid J, Jansen E. Herausforderungen Und Chancen Bei Der Professionellen Integration Von Medizinerinnen und Medizinern Mit ausländischem Abschluss in Rehabilitationseinrichtungen—Eine Komparative Analyse Zweier Quantitativer Querschnittsbefragungen. Dtsch Rentenversicherung Z. 2023;2.
38.
Zhang X, Bian L, Bai X et al. The influence of job satisfaction, resilience and work engagement on turnover intention among village doctors in China: a cross-sectional study. BMC Health Serv Res. 2020;20(283).
39.
Fleming P, Sinnot M-L. Rural physician supply and retention: factors in the Canadian context. Canadien J Rural Med. 2018;23(1).
40.
Young L, Peel R, O’Sullivan B et al. Building general practice training capacity in rural and remote Australia with underserved primary care services: a qualitative investigation. BMC Health Serv Res. 2019;338.
41.
Teney C, Becker R, Bürkin KB, Spengler M. Migrations- und Integrationserfahrungen europäischer Ärztinnen Und Ärzte in Deutschland. Bremen; 2017.
Metadata
Title
Turnover intention of foreign trained physicians in German rehabilitation facilities—a quantitative study
Authors
Eva Jansen
Johanna Schmidt
Manuela Marquardt
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-024-10902-7

Other articles of this Issue 1/2024

BMC Health Services Research 1/2024 Go to the issue

Research

Nurturing transformative local structures of multisectoral collaboration for primary health care: qualitative insights from select states in India

Research

Factors influencing inequality in government health expenditures within African regional economic communities

Systematic Review

Turnover intention and its associated factors among nurses in Ethiopia: a systematic review and meta-analysis

Research

Knowledge, attitudes and self-confidence with skills required for providing dementia care in physicians at primary healthcare settings in Vietnam

Research

Exploring cross-boundary collaboration for youth mental health in Sweden – a qualitative study using the integrative framework for collaborative governance

Research

Physicians’ irrational attitudes on the antibiotic prescribing for the treatment of COVID-19 in Turkey: A multicenter survey