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Table 4 Examples of sources of wellbeing emerging from coding

From: Oppression, liberation, wellbeing, and ecology: organizing metaphors for understanding health workforce migration and other social determinants of health

EPV matrix cell number

Number of comments

Illustrative codes (description)

Illustrative quotes

25

37

Expanded opportunity in the health labor market (Relative abundance and fairness in distribution of employment opportunities)

“Back home, there is a ceiling. Once you achieve certain specialty you can't move further in your career development. But, in the US, the sky is the limit, I would say. So, you have a lot of opportunities to go ahead in your career.” (Ethiopian-trained, male, 35, internal medicine, Washington, DC, USA)

27

50

Financial comfort (Competitive income; timely remuneration; financial security; personal savings, etc.)

“I am getting paid well for doing something that I like. And, I am paid in such a way that I can afford to help people around me also get a better education. All my brothers and sisters who are younger than me have been able to leave Cameroon because I have been practicing medicine in the US.” (Cameroonian-trained, male, 43, pediatrics, Virginia, USA)

“I consider myself among those that are a bit on the better side when it comes to standard of living. I earn quite a lot of money according to my standards, because it is enough to take care of a lot of my problems and that of my family.” (Nigerian-trained, male, 45, community medicine, Kano, Nigeria)

29

32

Attractive work environment (World-class facilities and equipment; state-of-the-art technology, etc.)

“When I went to George Washington University Hospital while I was there in the US, the place was clean and sweet. I mean, it was nice to work in there, you see? But then back home, the environment is not checked well, the place is not maintained.” (Ghanaian-trained, female, 33, public health, Accra, Ghana)

“Here [in the US] you see state-of-the-art technology, investigations, lab tests. You don't hear about those problems you hear of in Ethiopia regarding paying for prescription, paying for lab tests, paying for imaging studies. And sometimes, even the people you treat don't see their bill. It's the insurance companies who pay.” (Ethiopian-trained, male, 38, internal medicine, Washington, DC, USA)

33

3

First-class citizen status (Right to dignity and equality; freedom from discrimination; loyalty to home country, etc.)

“Well, I am staying in my country, because I love Ghana, and I love being a first-class citizen in Ghana. And, I believe that no matter what you do, where you go, and who you become, forever, you'll never be a first-class citizen in anybody else's country but your own.” (Ghanaian-trained, female, 33, public health, Accra, Ghana)

35

14

Institutional support (Immigrant-friendly and culturally sensitive residency programs)

“I like everything about my residency training program. I like the job satisfaction. I like the fact that you see results. I haven’t had any experience with racism because of course I am at Howard University. So, I like it. It is an extension of Ghana to me.” (Ghanaian-born and trained, female, 35, critical care, Washington, DC, USA)

36

19

Securely attached to home (Attachment to homeland; sense of community; feeling of belonging; place identity, etc.)

“I have never regretted practicing in Nigeria, and it has never crossed my mind to go and practice outside Nigeria. …I would like my children to have a sense of belonging. Yes, I feel they have their pride when they grow up in their own country and believe that they're at home.” (Nigerian-born and trained, male, 45, community medicine, Maiduguri, Nigeria)

“We believe that Ghana is our home, and we stay in Ghana, and we work in Ghana. And, then if you need to go for a holiday or travel, you save up some money and then you go. But, by all means you come back to our home, and we will be here.” (Ghanaian-trained, female, 33, public health, Accra, Ghana)