A new study has found that high workload is a push factor propelling clinical oncologists to leave cancer care practice, and relocate to other countries.
Clinical oncologists are doctors specialised in cancer management and treatment including chemotherapy, radiotherapy, and targeted therapy, among others.
The study, which was published in the American Society of Clinical Oncology Journal, found that the more outpatients a clinical oncologist sees, the higher the intention to leave.
The study titled ‘Brain Drain in Cancer Care: The Shrinking Clinical Oncology Workforce in Nigeria’ also found that the United States (31%), the United Kingdom (30%), and Canada (10%) were the top countries of destinations for Nigerian clinical oncologists.
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The research suggests that Nigeria’s new National Cancer Control Plan and the Federal Ministry of Health need to explore innovative approaches to attract and retain the clinical oncology workforce, which would lead to improvement in cancer survival and outcomes.
“Increasing the number of clinical oncology programmes and positions available, improving work conditions, and introducing work benefits may mitigate the shrinking clinical oncology workforce in Nigeria,” it said.
The massive brain drain in Nigeria’s health sector is a major public health concern, with only about 24, 000 actively licensed physicians currently caring for the country’s over 200 million population as a result of brain drain, according to the Nigeria Medical Association (NMA).
The country also suffers from an inadequate number of clinical oncologists caring for its population. According to the researchers, there are only 80 clinical oncologists providing care for more than 120,000 patients in Nigeria, yet the country is losing its oncologists to high-income countries.
They said the staggering deficit is likely to worsen as about 90% of Nigerian physicians are eager to leave the country for perceived greener pastures in the United States, the United Kingdom, Canada, etc.
The researchers, comprising Runcie Chidebe, Tochukwu Orjiakor, and Nwamaka Lasebikan, sought to find factors that are responsible for the brain drain in cancer care.
They used a correlational design; 64 clinical oncologists completed turnover intention (TI), workload, and satisfaction measures. Multiple linear regression was used for the data analysis.
The lead researcher, Runcie Chidebe, said the study examined the push and pull factors to stay or leave the clinical oncology workforce and Nigeria.
Chidebe who is also a cancer advocate and executive director of Project Pink, said previous studies have examined general physician migration abroad.
He said, “Although there are studies that have explored brain drain among medical practitioners in Nigeria, studies focusing on clinical oncologists are scarce.
“To our knowledge, this is the first study investigating the push and pull factors in the clinical oncologist workforce in Nigeria and possibly the first study using a correlative design and statistics to explain clinical oncologist brain drain in Sub-Saharan Africa.
“Some significant findings emerged from this study. We found that clinical oncologist workload and time spent on outpatients significantly predicted turnover intention. The number of outpatients seen was also positively linked to turnover intention. Hence, the more outpatients a clinical oncologist sees, the higher the turnover intention.”
He said higher clinical workload impacts patients’ treatment outcomes; hence, the country may not improve cancer survival rates without improving the workforce.
He further explained that the implication of this study’s finding is that if brain drain in cancer care remains unchecked, access to timely treatment would be worse, and patient outcomes would significantly become poorer.
“Nigerian government should improve working conditions, invest in postgraduate colleges, and increase remuneration. A government-to-government agreement needs to be explored to get destination countries to invest in medical school training in Nigeria,” the research team said.
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