What drives them home? Influencing factors of return migration to western China among clinical medicine master's graduates

Background To explore the group characteristics, mobility patterns, and key influencing factors associated with the return migration of clinical medicine master's graduates with western China household registration to employment in western China, this study providesevidence for optimizing medical workforce allocation in these areas. Methods Data were derived from the 2024 National Survey on Education Satisfaction among Fresh Medical Postgraduate Graduates. Using convenience sampling, 487 eligible graduates were selected as study subjects. Chi-square tests, t tests, and logistic regression models were employed to systematically analyze employment flow patterns and related influencing factors. Results The return migration group exhibited a city distribution pattern characterized by "stability in third-tier cities and differentiation in second-tier cities," with nearly half (49.57%) choosing employment in third-tier or lower-tier cities. Multivariate logistic regression revealed that family expectations (OR=1.33, 95% CI: 1.01--1.76) served as a significant pull factor for return migration. In contrast, the mentor factor (OR=0.68, 95% CI: 0.55--0.86) and comprehensive geographic‒economic disparity (OR=0.47, 95% CI: 0.27--0.87) constituted major barriers. Graduates with academic degrees were 0.52 times as likely to return as those with professional degrees were (OR=0.52, 95% CI: 0.31--0.88). Graduates with at least one parent in middle- to high-level occupations were 0.51 times as likely to return as those with both parents in grassroots occupations were (OR=0.51, 95% CI: 0.27--0.95). With respect to intercity mobility patterns, consistency between place of origin and employment location emerged as a key factor: when consistent, the odds of graduates choosing downward mobility were 4.46 times greater than those choosing upward mobility (OR=4.46, 95% CI: 2.62--7.58). Conclusions The return employment behavior of clinical medicine master's graduates results from a complex interplay of emotional ties, social capital, and regional economic disparities. Among these factors, the consistency between place of origin and employment location plays a dominant role in the choice of city-tier mobility patterns.