Professional satisfaction and dissatisfaction among Fiji specialist trainees: what are the implications for preventing migration?

The migration of doctors from developing countries threatens the health status of the populations left behind. This qualitative study was conducted to explore why an unexpected number of Fiji specialist trainees left the public sector, often to migrate, using a lens of professional satisfaction. Forty seven Fiji doctors, including 36 of 66 who undertook specialist training in Fiji, were interviewed about the factors that led to their own professional satisfaction and dissatisfaction. Three major components of professional satisfaction emerged: professional growth, service, and recognition, with considerable overlap between categories. The aspects of professional dissatisfaction were more varied but could be categorized as the absence or blocking of the elements of professional satisfaction. From the interviews, a professional satisfaction model was developed featuring the three overlapping central elements of satisfaction on a background of an enabling health system. This model might have implications for health systems seeking to retain their workers.