Emigration intentions and their association with workplace violence among Egyptian medical students and early career physicians

Abstract

Egypt faces a critical physician shortage, exacerbated by emigration. It also reports one of the highest workplace violence rates among healthcare workers in Africa. However, the link between emigration intentions and workplace violence remains underexplored. This study aimed to determine the prevalence of emigration intentions and their association with workplace violence exposure among medical students and early-career physicians in Egypt. A multicentric, cross-sectional study was conducted across 35 Egyptian universities from June 2024 to January 2025. Data were collected using an online questionnaire covering sociodemographics, workplace violence exposure, and emigration intentions. Participants were recruited through convenience sampling. Independent predictors of emigration intentions were assessed using binary logistic regression. The study included 1,134 participants, comprising 581 medical students and 553 early-career physicians. Emigration intentions were reported by two-thirds of students and early-career physicians (69.5% and 67.8%, respectively). Workplace violence was experienced by 35.6% of students and 72.3% of early-career physicians. Exposure to workplace violence was associated with increased emigration intentions in unadjusted analyses; however, after adjustment, it remained significant only among early-career physicians in relation to exposure from colleagues or senior healthcare workers (AOR = 1.58, 95% CI 1.01–2.46). The most commonly suggested strategies to mitigate emigration included optimizing working conditions and remuneration (82.7%) and implementing anti-violence and safety policies (65.3%). Emigration intentions and workplace violence are prevalent among medical students and early-career physicians in Egypt. The significant association between violence exposure and emigration intentions necessitates preventive measures to decrease emigration rates and the strain on Egypt’s healthcare system.