Table 1.

Structural perspective

Subtheme	Details	Illustrative quote
Moving to another country in general
Visas*	F2s reported that Australia and New Zealand made it relatively easy for them to navigate the process. UK visa rules were cited as a reason for non-UK citizens leaving the UK.	‘…if I wanted to do that [locum for six months in the UK], I couldn’t, I need an actual job that I’m doing for the whole year to be able to stay.’ (P12, a non-UK citizen)
Economic and political considerations	The Scottish independence referendum Financial uncertainty brought about by the recent Scottish independence referendum was cited as a reason to move abroad now. Some participants stated that if Scotland were to become independent, this might put them off returning to the UK.	‘If things stayed as they are just now, I would come back quite easily. But, if Scotland was to become independent that would be a trickier one. Where are they going to get the money from to fund the budget?. …So, if that was to happen then it would be a bit more difficult to come back.’ (P3)
	Britain’s exit from the EU Britain’s exit from the EU was seen as a potential future barrier to working in EU countries, but did not influence the decision to go now.	‘I was shocked, to see the news [about the UK’s decision to leave the EU]. But I guess it won’t happen for another two years, at least. And hopefully that wouldn’t affect my chance of finding a job, because I’m going now, instead of in two years. Where I think for people after me, then it might not be as easy actually, to find a job abroad, especially in Europe.’ (P14)
Moving to another country as a doctor
Structure of healthcare systems*	Certain healthcare systems, such as Malaysia, Singapore, Canada and the USA, were seen as undesirable to work in. Reasons included long working hours, poor training opportunities, rural placements and health inequality. Some F2s felt that different healthcare systems helped the public to value healthcare professionals more.	‘I suppose medics are viewed in a better way [in Australia], just more respect. The patients probably pay a bit of insurance and they do have to take accountability for their own health care and that way they do then value all the healthcare professionals more, not just the medics.’ (P6) ‘Frankly, I didn’t want to work the 100 hour weeks that they do in Singapore.’ (P10)
Availability and quality of junior doctor jobs in the world	Many of the F2s had found it relatively easy to get the job of their choice, and quantity of jobs in their destination country was not seen as an issue. Some F2s felt that the quality of available jobs in their destination country was low, but this was not a big concern, as their reasons for leaving were not necessarily to seek quality training opportunities.	‘My impression is that basically you end up with the jobs that no-one else wants from Australia or New Zealand. Quality-wise you’re probably ending up in a job that is less good than you would get in the UK but as a friend of mine put it to me you’re not going there really for the clinical exposure… most people are going there because they want a different experience.’ (P1)
Type of patients and medicine encountered**	The typical NHS patient was viewed by some as a ‘chronic disease patient’, with many climate and lifestyle-related conditions. Going abroad was, for some, a way of experiencing different types of medicine.	‘I’m really hoping that I get a snake bite, just because that’ll be the moment that I’ve made it in Australia. I know there’s quite interesting cultural issues to medical problems. So the Aboriginal population has a huge alcohol problem… And they have different problem drugs, to here as well, so like, crystal meth. Stuff like that will be really fascinating to learn about.’ (P15)

EU, European Union; F2s, foundation year two doctors; NHS, National Health Service.