Factors Related to Recruitment and Retention of Doctors on Remote Islands: A Systematic Review

Abstract

The doctor shortage is a general healthcare problem on many remote islands, which differ geographically from the mainland. Revealing the factors for recruitment and retention of doctors on remote islands may help develop countermeasures. We systematically investigated the factors related to recruitment and retention of doctors specifically on remote islands. The literature available from PubMed, CENTRAL, and Embase up to May 2024 was reviewed. Eligible studies were original articles with cohort, case-control, cross-sectional, and interventional designs that focused on recruitment and retention of doctors on remote islands. For this study, the “island” was defined as an area and region surrounded by water and separated from the “mainland”. The risk of bias was evaluated using the Newcastle-Ottawa Quality Rating Scale. We identified nine eligible original articles, including six cohort studies and three cross-sectional studies on recruitment and retention of doctors reported in Hawaii, Tasmania, and Maluku. In four studies on recruitment, the identified factors were island background, medical education on islands, and quality of life on islands. In six studies on retention, the identified factors were island background, medical education on islands, quality of life on islands, opportunities for professional training, family-related factors, working conditions, and financial incentives. These findings would be useful for policymakers and healthcare planners to secure doctors on remote islands. Further studies are warranted.