Purpose This study examines systematically the trends, patterns and determinants of medical emigration from Peru, providing insights into the factors influencing physician mobility in a middle-income context. Design/methodology/approach We conducted a longitudinal descriptive analysis of 68,073 Peruvian physicians spanning the years 1994–2021. The dataset incorporated sociodemographic attributes and migration-related variables, with factors associated with emigration evaluated using a Cox proportional hazards regression model. Findings Medical emigration increased steadily across the study period. The hazard of emigration among physicians was associated with demographic factors, with higher hazards observed among those originally from Lima, Peru (HR = 2.43, 95% CI 2.29–2.58, p 0.001), those graduating from a private university (HR = 1.77, 95% CI 1.66–1.88, p 0.001), and those obtaining a degree from a foreign institution (HR = 1.59, 95% CI 1.44–1.75, p 0.001). Increasing age was associated with a lower hazard of emigration, with each additional year reducing the hazard by 10% (HR = 0.90, 95% CI 0.89–0.90, p 0.001). Research limitations/implications The study shows that health professional migration in Peru is driven by both internal and external factors. A limitation is the limited evidence on return migration and its psychosocial impact on returnees. Future research should explore how working conditions, burnout and mental health influence migration decisions. Incorporating the mental health component into the analysis will allow for the design of more comprehensive and sustainable repatriation policies that respond to the real needs of migrant professionals and their families. Practical implications Closing the health workforce gap requires strategic planning, specialized training and improved working conditions. Repatriation strategies should include not only material incentives but also mental health support to mitigate the effects of burnout, adaptation and post-migration stress. Comprehensive programs combining repatriation, emotional well-being and job security will promote the effective retention and reintegration of physicians. Strengthening psychosocial support will be key to consolidating a more resilient health system with motivated professionals committed to their return to Peru. Social implications Medical migration impacts equity in access, deepening regional inequalities. The repatriation of professionals should not be limited to labor aspects but must integrate psychosocial and mental health support, ensuring dignified and sustainable reintegration. Emotional support for migrants and their families contributes to social cohesion, strengthens human capital and builds trust in the health system. Promoting safe working conditions, adequate housing and psychosocial assistance favors both the retention of professionals and equity in healthcare for the most vulnerable populations. Originality/value This work documents a notable growth in medical emigration from Peru over the past five years, placing the trend in the wider context of health workforce issues. It emphasizes the roles of geographic origin and educational background as key factors, while stressing the influence of age.
Galán-Rodas et al. (Sun,) studied this question.