A qualitative study of the factors influencing the global migration of anatomical pathologists in KwaZulu-Natal, South Africa

Abstract

Background: The aim of the present study was to identify the factors that influence the global migration of South African anatomical pathologists working in the province of KwaZulu-Natal.

Objective: The present study answered the question ‘what factors influence Kwazulu-Natal-based histopathologists to emigrate out of South Africa?’, thus providing insight into an under-researched medical specialisation.

Methods: A qualitative approach and purposive sampling were used. Data included 11 in-depth interviews with histopathologists working in KwaZulu-Natal (KZN), and one interview with a former KZN-based histopathologist now working in the United States. The interviews were recorded and transcribed. The data were coded for patterns, and these patterns generated themes. The processes of coding and thematic generation were iterative.

Results: Six themes were discovered from the data. Of these, five themes suggested reasons for the potential emigration of histopathologists. These included: lack of recognition by clinical doctors, lack of career-pathing opportunities, the deterrent of compulsory service in the public sector upon qualifying, socio-economic and political instability in South Africa, and endemic levels of crime. A sixth theme revealed that remuneration was not a deciding factor as to whether histopathologists choose to emigrate.

Conclusions: Remuneration was not revealed to be a reason for emigration, as these specialists’ salaries are commensurate with global salaries. The findings, whilst not generalisable, suggest that more work needs to be done on the human relations aspects of retention for these medical specialists. This has implications for human resources for health policy.

Agtergrond: Die doel van hierdie artikel is om die faktore te identifiseer wat die globale migrasie van Suid-Afrikaanse anatomiese patoloë wat in die provinsie van KwaZulu-Natal werk, beïnvloed.

Doelwit: Hierdie artikel beantwoord die vraag: ‘Watter faktore beïnvloed histopatoloë wat in KwaZulu-Natal gebaseer is om uit Suid-Afrika te migreer?’, en verskaf sodoende insig in ’n ondernagevorste mediese spesialisasie.

Metodes: ’n Kwalitatiewe benadering en doelgerigte steekproefneming is gebruik. Die data het 11 diepgaande onderhoude met histopatoloë wat in KwaZulu-Natal (KZN) werk en een onderhoud met ’n voormalige KZN-gebaseerde histopatoloog wat nou in die Verenigde State werk, ingesluit. Die onderhoude is opgeneem en getranskribeer. Die data is vir patrone gekodeer en hierdie patrone het temas gegenereer. Die koderingsproses en tematiese generering was herhalend.

Resultate: Ses temas is in hierdie data ontdek. Hiervan het vyf temas redes vir die moontlike migrasie van histopatoloë voorgestel. Dit sluit in gebrek aan erkenning deur kliniese dokters, gebrek aan loopbaangeleenthede, die afskrikmiddel van verpligte diens in die openbare sektor na kwalifisering, sosio-ekonomiese en politieke onstabiliteit in Suid-Afrika, en endemiese misdaadvlakke. ’n Sesde tema het aan die lig gebring dat vergoeding nie ’n beslissende faktor is in histopatoloë se keuse om te migreer nie.

Gevolgtrekkings: Vergoeding blyk nie ’n rede vir migrasie te wees nie, aangesien die salarisse van hierdie spesialiste in ooreenstemming met globale salarisse is. Hoewel dit nie veralgemeenbaar is nie, stel die bevindings voor dat meer werk aan die menseverhouding-aspekte gedoen moet word om hierdie mediese spesialiste te behou. Dit het implikasies vir menslike hulpbronne in gesondheidsbeleid.