At the time of globalization, internationalization has become a relatively new phenomenon in higher education. Mobility, also known as “internationalization abroad”, is the most referred to activity in internationalization and takes in itself a great variety of forms [9]. As an important dimension of internationalization of higher education (IHE), faculty mobility among deserves comprehensive study. Yet the scope and nature of international mobility of faculty is a rather understudied phenomenon [9]. In a general way, facing local shortage of global knowledge, institutions of higher education around the world compete for international faculty. In most studies, international faculty concerns the flow of academic staff from Low-and middle-income countries (LMICs) to High-income countries (HICs), which has caused the brain drain in LMICs. Although they engage in international recruitment for headhunting the hot talents, the result can never meet their needs for development. In China, there has been a reverse brain drain in the last decade, 84.48% of the Chinese students and scholars who went abroad for further studies or settlement was reported to have returned for development between 1978-2018 [34]. However, excellence initiative to develop “double first-class universities” [30] has called for a further open-up of education. A reform has been carried out in the field of talent related work by creating an innovative mechanism called “Yin Pei Bing Ju”, which means to provide international training opportunities for local talents while introducing the overseas. Cultivation of local talents equipped with global competence to participate in international affairs has become another driving force for internationalization and mobility.
To study IHE, “it has to identify and analyze the global, regional, national and institutional commonalities and differences in the development of internationalization” [8]. At institutional level, according to the “Comprehensive Internationalization” mode [1], “all constituents at a college or university – student, faculty, and staff - are learners and central to the institution’s equitable, intercultural transformation”. For sure, faculty members play the critical role in the enhancement of institutional core strength, and determine the level of discipline development, quality of talent cultivation and promotion of academic reputation. On the other side, administrative staff, as the main body for management from decision level to executive level, undoubtedly influence the condition of internationalization and guarantee the quality of internationalization. Basing on 17 national reports, De wit et al. also raised our awareness of the important role of academic and administrative staff in the further development of IHE [8]. Therefore, whilst evaluating IHE, university staff can never be ignored.
Motivated by IHE, internationalization activities have been carried out in medical education. Given that transnational mobility has brought challenges for medical practitioners across the world, particularly in the light of the COVID-19 pandemic, internationalization of medical education (IoME) has become an emerging trend, which can impose a great impact on the improvement of worldwide healthcare. Yet it has received sparse attention in the global literature thus far [46]. With a scoping review, student mobility was identified to constitute the major format in IoME [46], and medical educators should be included as another key element [45]. Moreover, among the published articles on IoME in the past 20 years, most of them originated from HICs and the full spectrum of internationalization activities is needed [46,48]. In China, medical universities have implemented a myriad form of activities to keep in consistence with the policies of internationalization in the last decade [28-29, 31], keeping student exchange, faculty’s mobility and research collaboration as the main forms. However, existing researches focusing on faculty’s mobility were mostly exploratory, quantitative method was rarely used [50]. As research on longitudinal outcomes of the actions on IoME is called for in the global scale [48]. These are the reasons why we conceived this study. Despite a high speed of development, China’s higher education was identified to be at the initial stage of internationalization and the imported internationalization has been the strategy all along [3], outward mobility for advanced knowledge in academic skills and managerial skills was still the main approach before the global COVID-19 pandemic. To this end, an in-depth investigation on the outward mobility of medical university staff and faculty members over time is crucial to understand their current status of internationalization and complement the literature with Chinese practices and patterns.
Internationalization of medical education
The COVID-19 pandemic has not only had an enormous impact on the global scale, but heightened the need for IoME. To date, the definition of the term “internationalization of medical education” (IoME) is not universally agreed upon and its understanding is obscure. Taking it as a unique area derived from and consistent with IHE, Wu [45] is the first who raised IoME as “the process of purposefully integrating international, intercultural, or global dimensions into medical education in order to enhance its quality and prepare graduates for professional practice in a globalized world”, and stressed that this process “does not solely focus on cultural difference”. Before that, IoME was often misused with Public Health (PH) and Global Health (GH), which are parts of medical curricula, as there is overlap between them. Wu [45-46] differentiated IoME as a means to achieving the goals set by GH/PH, like the improvement of health for people worldwide. In the process of IoME, multiple players are included, university staff and faculty members are among the key players, involving administration, research, teaching, and service [2].
Faculty mobility
Compared with university staff, the current literature in the context of higher education focused mainly on faculty mobility. Faculty mobility, in a broad way, refers to the international mobility of faculty, which is usually defined as cross-border movement of faculty members for the purpose of work or professional development.
Extant studies performed on faculty mobility presented a wide range, they examined many issues, such as academic profession [10,19], scientific productivity [18], policies and coping mechanism [42], and internationalization level [11]. However, there is much to explore about the phenomenon of international faculty mobility in emerging societies, and across various institutional types and disciplines [39]. In China, the current literature tended to emphasize high-level research universities [6, 25, 49], known as “double first-class universities” [32], a very limited corpus of literature discussed faculty mobility of regional universities that constitute the main part of higher education system in China, and follow the government policy of internationalization, and place similar emphasis on the practices of internationalization strategy. Futhermore, IoME is now vital [45]. As argued that it is impossible to make generalizations without extensive and in-depth analysis over time [39], this study aims to perform a thorough examination with a focus on the outward mobility of university staff and faculty members in a regional medical university, a type of institution matriculating 80% of the medical students in China [37], to conclude by identifying the main types of mobility, its major trends and the implied key issues in the IoME, and to provide reference information for the policies.
In this study, we try to investigate both staff and faculty’s outward mobility, and recognize it as the staff and faculty members employed by the sample university disperse world-wide for a limited period of time. They conducted teaching, research and other foreign affairs related activities, or attended overseas programs for the enhancement of skills in administration, teaching and research, which include degree studies. Mobility for private reasons was beyond our study.