[Migration trends of Czech physicians]. / Migracní tendence u ceských lékaru.

BACKGROUND: Empirical study on the migration trends in the Czech Republic was a part of the larger research project run by the Research Institute for Labour and Social Affairs in Prague. The physicians were identified as a high risk professional group from the point of view of "brain drain" which was expected after accession of the Czech Republic to EU. To identify how many of the Czech physicians consider migration during their professional life, the probability of the implementation of the migration intention, the most frequent destination countries and push-pull migratory factors. METHODS AND RESULTS: Questionnaire survey was basically a pilot study in which 462 respondents participated. Sample was not representative. Very high migration potential of the Czech physicians was empirically verified; 45% of the respondents theoretically considered migration as a possible life's career. Probability that they will actually emigrate is substantially lower. Based on the used migratory behavior model it is estimated that in the forthcoming years about 6% of the Czech hospital physicians will leave their homeland to work abroad. The most popular destination countries are the Great Britain, the Ireland, and the Germany. Push-pull migratory factors are as follows to get better income, to improve language competencies, to experience more professional working conditions. CONCLUSIONS: Decline of the Czech physicians due to migration is continuously mitigated by the physicians coming from Slovakia. To consider the total number of the physicians, dramatic shortage is not expected in the nearest future. There are some indicators suggesting higher probability of real migration among high specialized middle aged Czech physicians in comparison to the young physicians.

Quality of Life, Sustainable Future and medical education.

Substantial social and environmental changes in a global world as well as a new paradigm of medicine emphasizing high technology and evidence based approach bring to the current medicine many paradoxes. Undoubtedly, new era creates many positive opportunities and challenges for medical professionals. On the other side, traditional concept of medicine as basically humanistic "helping profession" is rather threatened. In this context, there is a need for a re-defining of medical curricula and to offer to the medical students the concepts and ideas which reflect a current development. Traditional public health terms such as "Primary Prevention", "Health Promotion", "Health Protection", "Health Determinants" should be re-defined and the new ones such as "Quality of Life" and "Sustainable Future" must be introduced as an integral part of medical education. The relevant concepts are discussed in the context of specific situation of the health care transformation in Central and Eastern European Countries.