Background: Physician emigration is increasing exponentially in developing countries. In Nigeria, with the last decade's unprecedented brain drain, it has gained the popular moniker 'japa syndrome'.

Aim: This study aimed to determine push and pull factors affecting physician migration in Nigeria, to provide evidence-backed recommendations for physician retention policies.

Materials/methods: A cross-sectional study was conducted among attendees at the 2022 Abuja Cardiovascular Symposium hosted by Limi Multispecialty Hospital and the Nigerian Cardiac Society. Convenience and snowball sampling were used, and 295/400 responded to comprehensive self-administered questionnaires (73.7% response rate). Data was analysed using SPSS v.26.

Results: Most participants (79.4%) were aged 20-39 years (Mean 35 years SD ±10.17); female (58.6%); married (58.4%) and had family size below six (73.6%). About 85.8% were employed, and 55.9% worked in private establishments. Solely basic medical degrees were possessed by 64.4%, and 63.7% earned N300,000-N399,999 (USD 396.82-USD 527.78) monthly. Top destinations were UK (50.5%), Canada (43.3%), and USA (37.9%), with low remuneration (71.2%), insecurity (62.7%), and difficult working environments (55.9%) most frequent push factors. Postgraduate-training frustrations (38.6%), and limited educational opportunities for oneself (37.6%), children (26.4%), or spouse (19.7%) were the least. High earning potential (76.6%), career growth opportunities (70.8%), and high-level equipment/technology (54.9%) were frequent pull factors.

Conclusion: Physician emigration threatens Nigeria's health system and should be addressed multi-sectorally to boost physician remuneration and improve work environments and societal security. Additionally, innovative education and digital technology would encourage health workforce retention.

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