Employment, psychosocial work environment and well-being among migrant and native physicians in Finnish health care.

BACKGROUND Although international migration of physicians is increasing, research information on their adjustment to working in a new country is scarce. This study examined the differences in employment, perceptions of psychosocial work environment and well-being between migrant and native physicians in Finland. METHODS A cross-sectional survey was sent to a random sample of physicians in Finland (N = 7000) and additionally to all foreign-born physicians licensed to practice in Finland (N = 1292). The final response rates were 56% (n = 3646) among native Finns and 43% (n = 553) among foreign-born physicians. RESULTS Migrant physicians worked more often in primary care and on-call services and less often in leadership positions than native Finns. They more often experienced lack of professional support and lower work-related well-being compared with native Finns. Those migrant physicians who had lived for a shorter time in Finland perceived less stress related to electronic patient records systems and higher organizational justice compared with native physicians or those foreign physicians who had migrated earlier. CONCLUSIONS Foreign-born physicians are more often employed in the primary care sector, where there are most difficulties in recruiting from the native workforce in Finland. Attention should be paid to enhancing equitable career opportunities and well-being among foreign-born physicians working in Finnish health care. Although migrant physicians are relatively well adjusted to Finnish health care in terms of perceptions of psychosocial work environment, their lower well-being calls for attention.

[1]  T. Heponiemi,et al.  Psychosocial factors in GP work: the effects of taking a GP position or leaving GP work. , 2013, European journal of public health.

[2]  H. Magnúsdóttir Overcoming strangeness and communication barriers: a phenomenological study of becoming a foreign nurse. , 2005, International nursing review.

[3]  Alan A. Monavvari,et al.  International medical graduates: past, present, and future. , 2015, Canadian family physician Medecin de famille canadien.

[4]  A. Zolberg,et al.  Birds of Passage: Migrant Labor and Industrial Societies. , 1981 .

[5]  Tarja Heponiemi,et al.  Differences in well-being between GPs, medical specialists, and private physicians: the role of psychosocial factors. , 2012, Health services research.

[6]  T. Heponiemi,et al.  Organizational commitment among general practitioners: A cross-sectional study of the role of psychosocial factors , 2010, Scandinavian journal of primary health care.

[7]  Tarja Heponiemi,et al.  Health, psychosocial factors and retirement intentions among Finnish physicians. , 2008, Occupational medicine.

[8]  J. Bernstein The Professional Self-Evaluation of Immigrant Physicians from the Former Soviet Union in Israel , 2000, Journal of Immigrant Health.

[9]  Zeynep Aycan,et al.  Impact of Culture on Human Resource Management Practices: A 10-Country Comparison Влияние культуры на практику HR-менеджмента: сравнение 10 стран , 2000 .

[10]  Matthew J. Thompson,et al.  Do international medical graduates (IMGs) "fill the gap" in rural primary care in the United States? A national study. , 2009, The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association.

[11]  M. Kivimäki,et al.  A short version of the Team Climate inventory : Development and psychometric properties , 1999 .

[12]  T. Getzen,et al.  Economic and demographic trends signal an impending physician shortage. , 2002, Health affairs.

[13]  Tarja Heponiemi,et al.  Effects of active on-call hours on physicians' turnover intentions and well-being. , 2008, Scandinavian journal of work, environment & health.

[14]  Regina Aistleithner,et al.  WHO Global Code of Practice on the International Recruitment of Health Personnel , 2016 .

[15]  M. Yi,et al.  Korean nurses' adjustment to hospitals in the United States of America. , 2000, Journal of advanced nursing.

[16]  S. Lee,et al.  Variations in geographical distribution of foreign and domestically trained physicians in the United States: 'safety nets' or 'surplus exacerbation'? , 2000, Social science & medicine.

[17]  Amelie F. Constant,et al.  Labor Market Segmentation and the Earnings of German Guestworkers , 2003, SSRN Electronic Journal.

[18]  J. Kawi,et al.  Facilitators and barriers to adjustment of international nurses: an integrative review. , 2009, International nursing review.

[19]  B. Lowell,et al.  Immigrants and the Healthcare Workforce , 2004 .

[20]  J. Colquitt On the dimensionality of organizational justice: a construct validation of a measure. , 2001, The Journal of applied psychology.

[21]  Nano Trias,et al.  Fill the gap , 2010 .

[22]  Marko Elovainio,et al.  Psychosocial stressors at work, psychological stress and musculoskeletal symptoms in the care for the elderly , 1997 .

[23]  W. Palm,et al.  Health Professional Mobility and Health Systems - Evidence from 17 European Countries. , 2011 .

[24]  T. Hintsa,et al.  Developing a Short Measure of Organizational Justice: A Multisample Health Professionals Study , 2010, Journal of occupational and environmental medicine.

[25]  C. Normand,et al.  The national and international implications of a decade of doctor migration in the Irish context. , 2013, Health policy.

[26]  P. Harris,et al.  The nurse stress index , 1989 .

[27]  J. Connell The international migration of health workers , 2008 .