Determinants of intention to work abroad of college and specialist nursing graduates in Serbia M. Santric-Milicevic a,b, ⁎, B. Matejic a,b , Z. Terzic-Supic a,b , V. Vasic c , U. Babic d , V. Vukovic e a Institute of Social Medicine, Medical Faculty, University of Belgrade, Dr Subotica 15, 11000 Belgrade, Serbia b Centre — School of Public Health, Medical Faculty, University of Belgrade, Pasterova 2, 11000 Belgrade, Serbia c Department of Statistics and Mathematics, Faculty of Economics, University of Belgrade, Kamenicka 6, 11000 Belgrade, Serbia d Clinical Center of Serbia, University of Belgrade, Pasterova 2, 11000 Belgrade, Serbia e High School for Health Vocational Studies in Belgrade, Cara Dusana 254, 11000 Belgrade, Serbia summary article info Article history: Accepted 24 December 2014 Keywords: Development Planning Education Nursing health personnel intention International migration Nursing Serbia specialties Unemployment Background: In a country with a poor economy and limited job opportunities, the outmigration of students is not commonly perceived as a problem but rather is perceived as a solution to the high unemployment facing young health professionals. Objectives: Study objectives were to identify the prevalence of intention to work abroad of nursing graduates to point to the predictors of intention to work abroad and predictors of having a firm plan to work in a foreign country. Design: Descriptive study, a survey. Settings: College and specialist nursing schools, Serbia. Participants: 719 nursing graduates from the 2012/2013 school year. Methods: Voluntarily completed a questionnaire that was designed with regard to similar surveys administered in EU-candidate countries during the pre-accession period. Data were analysed with descriptive and multivariate regression analyses. Results: Almost 70% (501) of respondents indicated an intention to work abroad. Of the nurses, 13% already had established a firm plan to work abroad. Single graduates and those with a friend or relative living abroad were more likely to consider working abroad than were their counterparts (odds ratios were 2.3 and 1.7, respectively). The likelihood of considering working abroad decreased by 29% when the individuals' financial situation was improved. Factors associated with having a firm plan were previous professional experience in a foreign coun- try, having someone abroad and financial improvement (5.4 times, 4.8 times and 2 times greater likelihood, respectively). Conclusions: The high prevalence of intention to work abroad suggests the need to place the issue of the out- migration of nursing graduates on the policy agenda. College and specialty nursing graduates and health techni- cians are prepared to work abroad in search of a better quality of life, better working conditions and higher salaries. © 2015 Elsevier Ltd. All rights reserved. Introduction Every healthcare system requires a sufficient number of competent nursing, midwifery and other health professionals to deliver quality healthcare; thus, international health workforce mobility has been increasing for various reasons over the past decade (Freeman et al., 2012). Nurse migration may be an expression of personal or cultural motives, of freedom of choice and human rights, or it may be the result of financial and professional needs and challenges facing nurses in a particular country (El-Jardali et al., 2008). The lack of social recognition, poor wages, job insecurity, socio-political instability and economic crises may influence changes in patterns of nurse migration (Buchan et al., 2013). The recruitment of foreign-trained health professionals is a regular strategic mechanism that many countries adopt to address their domestic shortfalls in the field of nursing (Wheeler et al., 2013). To identify nursing workforce requirements and practice developments and to direct policy for the control of migration effects on health care provision, more research is needed to understand the needs and chal- lenges facing the nursing workforce (Freeman et al., 2012; El-Jardali et al., 2008). Due to the lack of registration and research or to the rela- tively small number of migrants, information from source countries (usually less developed) regarding nursing graduates' intention to work abroad is limited (Tjadens et al., 2012). Nurse migration has received considerable social attention in 2012 in Serbia because it became an EU-candidate country. Such status is Nurse Education Today 35 (2015) 590–596 ⁎ Corresponding author at: Institute of Social Medicine, Medical Faculty, University of Belgrade, Dr Subotica 15, 11000 Belgrade, Serbia. Tel.:+381 11 2643 830; fax: +381 11 2659 533. E-mail addresses: msantric@med.bg.ac.rs, msantric@yahoo.com (M. Santric-Milicevic). http://dx.doi.org/10.1016/j.nedt.2014.12.022 0260-6917/© 2015 Elsevier Ltd. All rights reserved. Contents lists available at ScienceDirect Nurse Education Today journal homepage: www.elsevier.com/nedt