Analysis of challenges in medical workforce provision in Kyrgyzstan

Introduction. Kyrgyzstan’s (KR) healthcare system faces a critical workforce shortage despite an oversupply of graduating medical students. This study aimed to identify the key pathways contributing to physician attrition in KR and provide information for future evidence-based retention policies in the region.Materials and methods. A cross-sectional study surveyed four hundred eighty last-year interns and 154 practicing physicians in three hospitals in KR. Collected data included demographic characteristics, migration intentions, professional preferences, and potential migration drivers.Results. Migration intentions were reported by 63.1% of participants, with higher rates among interns (65%) compared to physicians (57%). 31% of interns and 19% of physicians had well-developed migration plans. Additionally, 20% of interns could potentially realize the transition into part-time or dormant physicians, while nearly 20% of practicing physicians already work less than full-time in the medical field. Age emerged as a protective factor, reducing migration likelihood (OR: 0.95, 95% CI: 0.92–0.97) along with living arrangements, owning a residence reduced migration intentions by twice. Key drivers of migration intentions among interns were pull factors, but among physicians, they were push factors.Limitations arose from the nature of the observational study (cross-sectional) and method of collecting information (survey).Conclusion. KR faces significant challenges in retaining its healthcare workforce. Addressing these issues requires targeted strategies. Differentiated retention efforts tailored to interns and practicing physicians are crucial. By mitigating push factors and enhancing pull factors, KR can strengthen its healthcare system and prevent further attrition of physicians.Compliance with ethical standards. The study was approved by the Ethics Committee of Kyrgyz-Russian Slavic University on May 25, 2023. All study participants gave informed consent before the survey.Contribution of the authors. All co-authors made an equal contribution to the research and preparation of the article for publication.Conflict of interest. The authors declare no conflicts of interest.Funding. The study had no sponsorship.Received: January 13, 2025 / Accepted: February 19, 2025 / Published: June 30, 2025

physician workforce, physician migration, brain drain, physicians’ intention to migrate, push and pull factors, part-time working physicians, dormant physicians, healthcare, Kyrgyzstan