Abstract
Background
The problem statement identified for this study concerns the perceptions influencing chiropractic
graduates’ intention to emigrate from the Republic of South Africa (RSA) after graduation. Reasons
influencing chiropractic graduates intention to emigrate, where they would like to emigrate to, trends
relating to their emigration patterns and factors influencing the graduates to remain in South Africa remain
largely unexplored.
Aim
The aim of this study was to identify the perceptions influencing chiropractic graduates’ intention to
emigrate from the RSA. The proposed research questions that were focused on in this study include:
1. What are the factors influencing Chiropractic graduates to emigrate?
2. Where, globally, do the graduates’ intend to emigrate to?
3. What are the trends relating to the graduates’ choice in location?
4. What are the factors that would influence Chiropractic graduates’ to stay in the Republic of South
Africa?
Research Methodology
A survey was conducted amongst the fourth-, fifth- and sixth-year students from the University of
Johannesburg and the Durban University of Technology to identify the perceptions influencing
chiropractic students' motivations and considerations for possible emigration after graduation from
university in South Africa (RSA). A cross-sectional, quantitative, descriptive, and exploratory study with
an adapted questionnaire was used. An anonymous online questionnaire, created on Google Forms
(Google, Mountain View, CA, USA) was used to perform the study. Open and closed-ended questions
were used. The questionnaire consisted of 31 questions that took approximately 10 minutes to complete.
Results
The total number of students intending to emigrate was 75.5% (n = 74) of the sample group. If given the
opportunity to work abroad, this number increased to 98% (n = 96). There was a multitude of factors that
influenced the students decision to potentially emigrate. These factors were to travel and see the world
74.5% (n = 73), for better remuneration 73.5% (n = 72) and to gain experience abroad 73.5% (n = 72).
Only 62.3% (n = 61) of respondents stated that they would consider emigration for better living conditions. A major push factors for students was 82.7% (n = 81) of respondents indicated that the decline of the
general economic situation in South Africa (SA) was a push factor. This was followed by 66.3% (n = 65)
of respondents indicating that they don’t feel their children would be safe in SA, and 60.2% (n = 59)
respondents stated that the general decline in public services was a push factor. A further 55.1% (n = 54)
of respondents indicated insufficient opportunities for promotion in South Africa, and 37.8% (n = 37) felt
there is no future in SA. Dissatisfaction with public schools in South Africa had 32.7% (n = 32) responses,
and 2% (n = 2) of respondents thought that the workload in South Africa was too heavy and that the work
tempo is too fast-paced. Pull factors to emigrate indicated by respondents show that economic stability
had the highest response rate with 85.7% (n = 84) respondents. This was followed by being a part of a
well-managed health care system at 71.4% (n = 70). Public services that work and ensure a safe haven
for my children had 62.2% (n = 61) and 61.2% (n = 60), respectively. There were 46.9% (n = 46)
respondents who wished to do other postgraduate courses in chiropractic, and 34.7% (n = 34) wanted to
live in a value system that suits their beliefs. Only 18.4% (n = 18) respondents wished to join family/
friends abroad
The only identifiable trends relating to the students’ choice in location and why they would choose to go
there is primarily to satisfy the needs identified in the push and pull factors. The choices in location also
centred around areas that had a prominent, established number of chiropractors within in the region. The
countries identified were primarily first world, highly urbanised economic countries such as the Australia,
Canada, United Kingdom (UK), New Zealand, the Netherlands and the United States of America (USA).
Factors that would influence chiropractic graduates to stay in SA; of the entire sample group (n = 98), if
given a choice to remain in South Africa, 77.3% (n = 75) of students would consider remaining due to
family ties, and 49.5% (n = 48) reported that the weather was simply better in SA. Lack of family support
abroad was also identified as a main reason to remain as well as a sense of loyalty to SA. Some students
thought that they lacked the financial resources to emigrate and some considered the high cost of living
abroad as a reason enough to remain in South Africa.
Governmental and regulatory bodies could influence students to remain in SA through improving safety
and security primarily at 82.7% (n = 81). Health facilities and infrastructure should be improved at 79.6%
(n = 78), as well as the elimination of corruption within government and not introduce legislation and
regulations that cannot be implemented monitored and maintained was 67.3% (n = 66). Students also
felt that government should accept responsibility for their shortfalls and not use excuses such as apartheid, 60.2% (n = 59) students marked. The introduction of the NHI has students worried but was by
no means a driving factor to emigrate.
The economic impact of COVID-19 and the economic downfall that ensued in its wake played an integral
role in students’ perceptions of emigration. Irrespective of the year of study, the majority of chiropractic
students either agreed or strongly agreed that COVID-19 would have a negative effect on the South
African economy and the chiropractic profession as a whole. Some stated that if not for the COVID-19
pandemic, they would never have considered emigration.
Conclusion
In conclusion the vast majority of chiropractic students from year four to six from two different South
African universities are considering to emigrate within a 5 year period. Their choice in location largely
revolves around the ease of transition of their degree, the scope of chiropractic in the region and the
ability to travel and see the world. The countries identified were primarily first world, highly urbanised
economic countries such as the Australia, Canada, United Kingdom (UK), New Zealand, the Netherlands
and the United States of America (USA).
Push factors included that the decline of the general economic situation in SA, lack of safety and security,
the general decline in public services and public schooling and insufficient opportunities for promotion in
SA. Pull factors included economic stability, being a part of a well-managed health care system and public
services that work and ensure a safe haven for my children. Other push factors were to be a part of a
belief system that better suited their beliefs and to join family/friends abroad. Some students wished to
do other postgraduate studies for chiropractic abroad but further investigations show that this is possible
from SA and does not necessarily require you to emigrate to do so, which the students may not be aware
of.
Governmental and regulatory bodies could influence students to remain in SA through improving safety
and security primarily, ensuring health facilities and infrastructure are improved at as well as the
elimination of corruption within government. The students felt that governments should and not introduce
legislation and regulations that cannot be implemented monitored and maintained should accept
responsibility for their shortfalls and not use excuses such as apartheid. The introduction of the NHI has
students worried but was by no means a driving factor to emigrate. The economic impact of COVID-19
and the economic downfall that ensued in its wake played an integral role in students’ perceptions of
emigration. Students believed that COVID-19 would have a negative effect on the South African economy
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and the chiropractic profession as a whole. Some stated that if not for the COVID-19 pandemic, they
would never have considered emigration.