11289 FACTA UNIVERSITATIS Series: Economics and Organization Vol. 20, No 1, 2023, pp. 15 - 28 https://doi.org/10.22190/FUEO221116003L © 2023 by University of Niš, Serbia | Creative Commons Licence: CC BY-NC-ND Original Scientific Paper FACTORS THAT AFFECT EMPLOYMENT DECISION OF FUTURE HEALTHCARE PROFESSIONALS IN SERBIA1 UDC 331.5:616-051(497.11) Snežana Lazarević1, Jelena Lukić Nikolić2 1College of Sports and Health, Belgrade, Republic of Serbia 2Modern Business School, Belgrade, Republic of Serbia ORCID iD: Snežana Lazarević https://orcid.org/0000-0003-2048-1684 Jelena Lukić Nikolić https://orcid.org/0000-0003-0632-8974 Abstract. Rising trend of international mobility of healthcare workers, ageing population, new diseases and infections bring many challenges to the national healthcare system. Consequently, it is necessary to pay special attention to the development of the healthcare system, as well as the attraction and retention of healthcare professionals. The aim of this paper is to examine and analyze the key factors that influence the decision- making process of future healthcare professionals regarding employment. 444 participants who are studying or have finished one of the accredited study programs in the Republic of Serbia in the field of medicine participated in the empirical research in the period from 2020 to 2022. The research results showed that three key factors that future healthcare professionals value when deciding on employment are: opportunities for career advancement, opportunities for personal growth and development, and a pleasant work environment. The fourth place was taken by an interesting, significant, and challenging job, while salary is in the fifth place. The optimal functioning of the healthcare system depends on the healthcare professionals, so the obtained results are valuable for leaders, managers, and decision makers in healthcare institutions. They are well-informed to adequately prepare employee value proposition not only for the attraction of healthcare workers, but also for their retention in the long run. Key words: healthcare professionals, employment, recruitment, working conditions, career opportunities JEL Classification: J24, M50 Received November 16, 2022 / Revised March 08, 2023 / Accepted March 15, 2023 Corresponding author: Jelena Lukić Nikolić Modern Business School, Terazije 27, 11000 Belgrade, Republic of Serbia | E-mail: jelena.jl.lukic@gmail.com https://orcid.org/0000-0003-2048-1684 https://orcid.org/0000-0003-0632-8974 mailto:jelena.jl.lukic@gmail.com 16 S. LAZAREVIĆ, J. LUKIĆ NIKOLIĆ 1. INTRODUCTION Healthcare represents one of the most responsible activities of human society, with a dominant social function. The basic right of every human being is to receive adequate health services without distinction based on race, religion, economic and social status, as well as political orientation (World Health Organization, 2020). The imperative for growth and development of each individual and the entire society is health, which is viewed through the concept of physical, mental, and social well-being (Strategija javnog zdravlja u R. Srbiji 2018-2026, 2018). That is why one of the priority goals of every Government is to preserve, improve and protect the health of the population, and to provide quality and affordable health services on the primary, secondary, and tertiary level. Therefore, it is a great responsibility of the Government to create a strategy for the development of the health system, to implement adequate health and social policies, as well as to introduce various measures that will ensure the improvement of health of individuals, families, and the entire society. The need for professional healthcare will be increasing in the future due to many factors, including: population ageing, new diseases, infections, and many other health and well-being challenges (Cristea et al., 2020). Bearers of the key values of each national healthcare system are healthcare employees and associates (Fernandes et al., 2022). With professional approach and competent work, they direct activities towards treatment, care, prevention of diseases and risky forms of behavior. Knowledge, skills, abilities, attitudes, values, and motivation of healthcare professionals represent the important potential in healthcare and play a significant role in achieving high quality services and general well-being of the population. The key drivers of quality healthcare are: education, employment, good working conditions, training, and retention of competent healthcare employees (Lagarde et al., 2019; Kitsios & Kamariotou, 2021). The aim of this paper is to examine and analyze the key factors that influence decision- making process regarding employment of future healthcare professionals in Serbia. The paper is organized as follows: The first chapter is focused on the key reasons for the migration of healthcare professionals, while the second chapter is devoted to the key motivational factors. The third chapter describes the research design, while the fourth one deals with the results of research findings and discussion. 2. THE KEY REASONS FOR MIGRATION OF HEALTHCARE PROFESSIONALS In today's unstable conditions which are characterized by constant challenges - globalization, economic crisis, decline in economic growth, global pandemics (COVID- 19, SARS, bird flu, anthrax...) and migrant crises, healthcare systems (especially in developing countries) are faced with numerous challenges. Among the key challenges are how to strengthen already fragile healthcare systems, which policy and practice of motivating and retaining human resources to apply, and how to slow down the rate of migration. Concerning fact according to the World Health Organization (2006) is that 57 countries are faced with critical health workplace shortage. Furthermore, low birth rate, ageing population, and high migration rate affect labor availability (Arandarenko, 2021). The trend of migration of medical professionals (especially nurses and technicians) from developing to developed countries has started since 2000 (Brush, 2008). The most frequent factors that impact the migration of healthcare workers are: poorly equipped Factors that Affect Employement Decision of Future Healthcare Professionals in Serbia 17 working environment, lack of resources and tools for effective working, low salary, poor working conditions, limited educational and career opportunities (Wiskow et al., 2010). Economic, social, professional, personal, as well as political factors of migration dominate among healthcare workers (Dywili et al., 2013; Willis-Shattuck et al., 2008). Here is primarily referred to individual needs and desires for ensuring a better quality of life (higher salaries), personal safety, healthy environment, as well as better opportunities for training and professional career development (Kingma, 2007). Migrations are present among all healthcare workers. For example, while medical doctors are more likely to migrate because they expect benefits to their growth and development, medical students also migrate abroad due to the opportunity to accumulate diverse and valuable skills (World Bank, 2020). In countries with limited employment opportunities, the departure of young people is often not seen as a problem, but as a solution to high unemployment rates (Santric-Milicevic et al., 2015). The European Training Education report states that „the Serbia’s biggest export ‘product’ is labour“ (Arandarenko, 2021, p. 5). The main reasons for leaving Serbia are better opportunities and conditions for employment, working, and living (Djurić & Tiodorović, 2018). The study of World Bank (2020) showed that the main reasons for migration of doctors and medical technicians from Serbia to other countries are the inability to find work and low salaries. This trend of migration is especially present among young people who have just finished formal education. Research conducted among 719 nursing graduates from 2012/2013 academic year in Serbia showed that almost 70% indicated the intention to work abroad hoping for higher salaries, better working conditions, and higher quality of life (Santric-Milicevic et al., 2015). International mobility and uncontrolled migration flow of healthcare workers can threaten the national healthcare system and have consequences for the management of human resources and the processes of planning, recruitment, development, and retention. The lack of healthcare professionals additionally increases the level of workload and stress of those employees who remain, which can directly affect the decline in performance and the reduction of quality of provided healthcare service. Research conducted in 2007 in Clinical Center Nis in Serbia in which 770 healthcare workers participated showed that more than two thirds of them are overloaded with work (Nikić et al., 2008). The growing healthcare needs of the population, at the national and global level, require healthcare systems with a stable and strong infrastructure, and sustainable human resources (Kingma, 2008). That is why it is necessary to pay special attention to the definition of the national strategy for development of the healthcare system and retention of healthcare professionals. Retention of healthcare professionals is the key to successful functioning of healthcare institutions, and it leads to savings in costs needed for recruitment, hiring, socialization and orientation of new workers. 3. THE KEY MOTIVATIONAL FACTORS FOR HEALTHCARE WORKERS The number of authors examined what motivates people to become healthcare professionals in low and middle-income countries (Uganda, Sierra Leone, Cambodia, Zimbabwe). The results showed that the most impactful are intrinsic motivational factors such as: „personal calling” (helping people in community, serving people, saving the lives of people), desire for status of professionals (feeling of pride when wearing uniforms) and high respect of community (Witter et al., 2018). Similar results 18 S. LAZAREVIĆ, J. LUKIĆ NIKOLIĆ are obtained in a study in rural areas in Vietnam where the key motivational factors for being healthcare workers were: respect from community, good interpersonal relations, and collaboration (Thi Hoai Thu et al., 2015). Furthermore, results from research conducted in Northwest Ethiopia showed that among main motivational factors for healthcare professionals are: leadership, support, participation in decision making, opportunities for professional development, appropriate work schedule, necessary equipment, and good communication channels (Weldegebriel et al., 2016). Healthcare professionals are mostly motivated with factors such as autonomy, supportive supervision, respect, good interpersonal relationships, and clear growth opportunities (Veenstra et al., 2022). Similar results are obtained in semi-structured interviews with doctors in Spain – they are driven by intrinsic motivational factors such as helping others, providing quality service, dedication, and help (Berdud et al., 2016). The study of Kjellström et al. (2017) in five primary healthcare centers in Sweden showed that work motivation for healthcare professionals is achieved due to clear goals, lateral collaboration, and systematic improvement of work quality. In Czech Republic are introduced special measures for recruitment and retention of healthcare workers: higher salary grades, benefits in public-health facilities, continuous programmes for professional development and growth, flexible working hours, and part-time contracts for people with children (Wiskow et al., 2010). The results of research conducted in 22 public hospital clinics in Warsaw, Poland, showed that the main factors of job satisfaction among medical doctors are quality of work, status, respect, and autonomy (Chmielewska et al., 2020). Furthermore, research regarding healthcare workers in countries of the European Union with the highest salaries showed that in most cases intrinsic motivators influenced the decision to go to work abroad. For example, in Germany, nurses are leaving the country due to dissatisfaction with working conditions, low salaries, and inadequate professional recognition. On the other hand, doctors emigrate because of the high level of workload and stress, inadequate working conditions, and structured training after completing postgraduate studies (Ognyanova et al., 2014). In Serbia there is a declining trend in the number of healthcare professionals under 35 years who will replace retired healthcare workers. Those young professionals are more mobile and willing to frequently change employers searching for better working conditions (Milićević et al., 2018). Research showed that for healthcare workers in Serbia salary was not the most impactful factor for leaving the job (Council on Linkages between Academia and Public Health Practice, 2016). Based on data from the report of the Institute of Public Health of Serbia from 2019, the satisfaction of employees in 324 health institutions has increased compared to previous years. In 2019, the percentage of satisfied employees was 46.8%, while the percentage of dissatisfied decreased to 19.7% (Horozović & Jaćović Knežević, 2020). For years, healthcare professionals give the highest satisfaction ratings to professional factors such as: quality cooperation with colleagues, support from superiors, the ability to express one's own opinion and ideas, the relationship between patients and employees, available time for organization, and implementation of work. However, the factors that cause the greatest dissatisfaction among healthcare workers are: salaries, insufficient human resources and inadequate distribution of work among existing workers, lack of or exploited medical equipment, inadequate policy and practice of the reward system, disorganized work, and overload with administrative tasks. Other researchers stated that the intention of healthcare workers to leave their current job is increased when they feel tension, stress, and pressure (Tripković et al., 2021). Results from research conducted in Vojvodina among 719 Factors that Affect Employement Decision of Future Healthcare Professionals in Serbia 19 healthcare professionals showed that they are mostly satisfied with secure jobs, support from supervisors, independence at work, good work relationships, personal qualities of supervisors, and positive working atmosphere (Grujičić et al., 2018). Babić et al. (2014) showed that in the private and public sector, motivation among healthcare workers was positively related to relationship and support of colleagues. What is worrying is that almost one third of doctors and nurses employed in the public health sector plan to find a job in the private health sector or to move abroad for better career opportunities, professional development, recognition, better working conditions, modern equipment, work-life balance, and greater transparency (World Bank, 2020). The situation is even more dramatic among younger health professionals. In 2014, about 80% of first-year and fifth-year medical students in Serbia planned and intended to work abroad (World Bank, 2020). 4. RESEARCH DESIGN The healthcare institutions as employers need to be prepared for attraction and retention of future healthcare professionals. Management of any healthcare institution has a responsibility to devote their time and effort to measuring and managing employees, with the key goal to improve human capital efficiency (Veselinović et al., 2022). Having in mind previously mentioned facts regarding healthcare professionals, the key research questions (RQ) are: RQ1: Which factors affect decision-making process of future healthcare professionals regarding employment? RQ2: Are there differences regarding gender, volunteering and working experience of future healthcare professionals? In order to answer the imposed research questions in this paper desk-top and survey research were conducted. Desk-top research was based on relevant literature review on this topic, as well as on contemporary trends regarding employment and healthcare professionals. Survey research was conducted using a questionnaire which consisted of six questions. The first five questions were of demographic nature and related to age, gender, education, employment status, previous experience in volunteer activities and professional practices. The sixth question was formulated in the form of a five-point Likert scale named „Factors influencing the choice of employer”. The scale consisted of 11 factors for which respondents answered from 1 (not at all important) to 5 (extremely important) depending on the influence that these factors have on the decision of employment. Those factors were selected regarding: economic value (salary, benefits - paid parking, gym, private health insurance), professional value (career advancement opportunities, opportunities for personal development, an interesting, significant and challenging job, working with modern technologies), working conditions (pleasant working environment, easily accessible company location, working time flexibility), and reputation value (company reputation - comments on social and professional networks, corporate social responsibility). Given the fact that respondents are students belonging to the most networked generation that predominantly uses mobile phones, tablets and computers, the questionnaire was conducted online. In the period from June 2020 to May 2022, a total of 444 respondents, who are studying or have finished one of the accredited study programs in the Republic of Serbia in the field of medicine, filled the questionnaire. 20 S. LAZAREVIĆ, J. LUKIĆ NIKOLIĆ The collected responses were analyzed using Statistical Package for Social Sciences - SPSS 21.0. (Armonk, NY: IBM Corporation). Normality of data distribution was tested by Kolmogorov-Smirnov test and by reviewing histograms, asymmetry (skewness), flatness (kurtosis), normal probability curve (Normal Q-Q plot) and rectangular diagrams (boxplot). As the assumptions about the normality of data distribution for statistical analyses within the measurement scale were met, parametric statistical techniques were applied. A t-test of different groups was used to examine the differences between the two groups within the measurement scales, while Anova (analysis of variance) was used to examine the differences between the three groups. In all tests comparing differences between groups, Leven's test for assessing the homogeneity of variance was applied. In all cases, the homogeneity of variance was satisfied (p> 0.05). 5. RESEARCH RESULTS AND DISCUSSION Students of vocational and academic medical studies in Serbia born between 1995 and 2005 participated in the research. The largest number of respondents was born in 2000 (27.3%), followed by those born in 1999 (23%). Regarding gender structure, female respondents were dominant (68.9%), while 31.1% of respondents were male. The largest number of respondents (91%) attended vocational or academic bachelor studies. A small number completed master studies (2.9%), while 5.9% of respondents were attending master's studies. Out of the total number of respondents, the largest number was unemployed (67.6%), but there was a certain number of respondents who worked for less than a year (11.9%), then from 1 to 3 years (11.7%) and over 3 years (8.8%). Regarding volunteer activities, it is interesting to highlight the fact that 63.3% of respondents volunteered, while 36.7% did not participate in those activities. The Cronbach's Alpha coefficient for the statements given in the Likert scale „Factors influencing the choice of employer” was 0.84 which indicates a high degree of reliability of the scale and justifies its application. Table 1 shows descriptive statistics based on the values of arithmetic mean (M) and standard deviation (SD) for each of the offered factors that influence participants when choosing an employer. Table 1 Descriptive statistical analysis for the scale „Factors influencing the choice of employer” Factors M SD Economic value Salary amount 4.29 0.815 Benefits (paid parking, gym, private health insurance) 3.80 1.074 Professional value Career advancement opportunities 4.68 0.689 Opportunities for personal development (continuous improvement and acquisition of new knowledge and skills) 4.58 0.721 An interesting, significant, and challenging job 4.44 0.778 Working with modern technology 3.71 1.071 Working conditions Pleasant working environment 4.54 0.725 Easily accessible company location 3.71 1.044 Working time flexibility 4.10 1.004 Reputation value Company reputation (comments on social and professional networks) 3.45 1.133 Corporate social responsibility 4.03 1.011 Source: Authors’ Calculation Factors that Affect Employement Decision of Future Healthcare Professionals in Serbia 21 The key factors that have the highest values of the arithmetic mean and the lowest values of the standard deviation are: career advancement opportunities (M=4.68; SD=0.69); opportunities for personal development (continuous improvement and acquisition of new knowledge and skills) (M=4.58; SD=0.72); and pleasant working environment (M=4.54; SD=0.73). Furthermore, the arithmetic means greater than four were given to the factors related to: an interesting, significant, and challenging job (M=4.44; SD=0.78); salary amount (M=4.29; SD=0.82); working time flexibility (M=4.10; SD=1.00); and corporate social responsibility (M=4.03; SD=1.01). Those results are not surprising having in mind the study of Bratton et al. (2010) which stated that financial incentives are important but not enough for motivating the healthcare professionals. Other research results also showed that opportunities for career development and personal growth are the most important motivational factors among healthcare workers (Weldegebriel et al., 2016; Chmielewska et al., 2020; Veenstra et al., 2022). A comprehensive national study conducted in Serbia in 2008 also found that non- financial aspects of job satisfaction (professional autonomy, opportunity to develop skills, collegiality, and support) are more important to medical professionals (doctors and nurses) than salary (Kuburović, et al., 2016). In the following tables (from table 2 to table 5) research results are presented in numbers and percentages, for further and easier discussion and analysis. Table 2 presents results regarding factors of economic value (salary and benefits - paid parking, gym, private health insurance). Table 2 Reponses regarding the importance of economic value among future healthcare professionals Factors Option Number % Salary Amount Not at all important 5 1.1 Low importance 4 0.9 Neutral 59 13.3 Very important 164 36.9 Extremely important 209 47.1 Missing response 3 0.7 Benefits (paid parking, gym, private health insurance) Not at all important 15 3.4 Low importance 37 8.3 Neutral 108 24.3 Very important 146 32.9 Extremely important 137 30.9 Missing response 1 0.2 Source: Authors' Calculation Results showed that 84% of respondents answered that salary amount is very and extremely important factor when choosing an employer, while 63.8% answered that benefits such as paid parking, gym, private health insurance are very and extremely important. Furthermore, 24.3% of respondents are neutral regarding benefits, while 13.3% are neutral regarding salary amount. Table 3 presents results regarding development value (career advancement opportunities, opportunities for personal development, an interesting, significant, and challenging job, working with modern technology) for future healthcare professionals. 22 S. LAZAREVIĆ, J. LUKIĆ NIKOLIĆ Table 3 Reponses regarding importance of professional value among future healthcare professionals Factors Option Number % Career advancement opportunities Not at all important 4 0.9 Low importance 5 1.1 Neutral 18 4.1 Very important 73 16.4 Extremely important 343 77.3 Missing response 1 0.2 Opportunities for personal development Not at all important 3 0.7 Low importance 3 0.7 Neutral 34 7.7 Very important 95 21.4 Extremely important 308 69.4 Missing response 1 0.2 An interesting, significant and challenging job Not at all important 3 0.7 Low importance 6 1.4 Neutral 43 9.7 Very important 130 29.3 Extremely important 260 58.6 Missing response 2 0.5 Working with modern technology Not at all important 19 4.3 Low importance 31 7.0 Neutral 127 28.6 Very important 145 32.7 Extremely important 120 27.0 Missing response 2 0.5 Source: Authors’ Calculation More than 90% of respondents answered that for them it is very and extremely important to have career advancement opportunities (93.7%) and opportunities for personal development (90.8%). For 87.9% of respondents an interesting, significant, and challenging job is very and extremely important, while 59.7% highly valued working with modern technologies. Other studies have also found that elements such as engaging work, the chance of career advancement, the desire to be respected, recognized, and appreciated by coworkers and the employer are among the crucial factors that motivate healthcare workers (Gupta et al., 2021). Additionally, some other research findings also showed that career development is a key determinant of motivation and happiness of healthcare professionals (Muthuri et al., 2020). Clear career plans are among the most important motivating factors for healthcare professionals. By acquiring new knowledge and skills, they can perform work in the best way possible, which consequently leads to the increase in their self-esteem and overall satisfaction (Afolabi et al., 2018). For that reason, some institutions implemented career ladders – clear path of professional advancement when healthcare professionals demonstrate new skills, and increase their job responsibilities (Vilendrer et al., 2022). Working environment, available medical devices, tools, equipment, and resources influence the overall quality of healthcare system. If those elements are not satisfactory, that may lead to stress, burnout and high level of absenteeism and turnover among healthcare professionals (Wiskow et al., 2010). Factors that Affect Employement Decision of Future Healthcare Professionals in Serbia 23 Table 4 presents results regarding working conditions (pleasant working environment, possibility to work from home, easily accessible company location, working time flexibility) for future healthcare professionals. Table 4 Reponses regarding importance of working conditions for future healthcare professionals Factors Option Number % Pleasant working environment Not at all important 2 0.5 Low importance 5 1.1 Neutral 34 7.7 Very important 111 25.0 Extremely important 290 65.3 Missing response 2 0.5 Easily accessible company location Not at all important 9 2.0 Low importance 48 10.8 Neutral 127 28.6 Very important 139 31.3 Extremely important 120 27.0 Missing response 1 0.2 Working time flexibility Not at all important 7 1.6 Low importance 29 6.5 Neutral 74 16.7 Very important 136 30.6 Extremely important 196 44.1 Missing response 2 0.5 Source: Authors’ Calculation The largest number of respondents answered that for them it is very and extremely important to have pleasant working environment (90.3%), working time flexibility (74.7%), and easily accessible company location (58.3%). Those results are not surprising having in mind contemporary trends of modern workplace in which employees want to have unique experience as if they are the clients of the organization (Mićić et al., 2022). They want to feel happy, satisfied and supported at work. Many changes in lifestyles, work demands, as well as the larger number of women entering the labor market and increased need for elderly care fostered employees to appreciate the employers which give them the opportunity for flexible working time and work-life balance (Mladenović & Krstić, 2021). Having in mind the growing problem of available parking spaces, it is not surprising why easily accessible company location is also important for respondents. That is the main reason why almost one third of respondents consider location as an important factor. Table 5 presents results regarding reputation value (company reputation - comments on social and professional networks, corporate social responsibility) for future healthcare professionals. 24 S. LAZAREVIĆ, J. LUKIĆ NIKOLIĆ Table 5 Reponses regarding reputational value of employers for future healthcare professionals Factors Option Number % Company reputation - comments on social and professional networks Not at all important 30 6.8 Low importance 54 12.2 Neutral 129 29.1 Very important 145 32.7 Extremely important 85 19.1 Missing response 1 0.2 Corporate social responsibility Not at all important 11 2.5 Low importance 19 4.3 Neutral 96 21.6 Very important 136 30.6 Extremely important 182 41.0 Missing response 0 0.0 Source: Author's Calculation Regarding company reputation – comments on social and professional networks, 41.8% of respondents answered that for them this factor is very and extremely important, 29.1% had a neutral attitude, and 6.8% answered that this factor is not at all important, while 12.2% answered that it has low importance. On the other hand, corporate social responsibility is for 71.6% of respondents of very and extremely high importance, while 21.6% had a neutral attitude. Employers e.g. healthcare institutions need to be oriented toward corporate social responsibility, because young generations put a special emphasis on this perspective. Furthermore, healthcare institutions should focus their attention on the process of employer branding with the aim to attract, hire and retain healthcare professionals. Important part of employer brand is their reputation in social and professional networks (Lukić Nikolić & Lazarević, 2022). T-test and Anova were used in further analysis in order to determine whether there are statistically significant differences between different characteristics of respondents regarding their gender (male and female respondents), volunteering activities (participated in volunteering and not participated) and length of working experience (work for less than a year, from 1 to 3 years and over 3 years). The results of the t-test did not show statistically significant differences between male and female respondents t (434) =-1.279; p=0.202; p< 0.01. Furthermore, the results of the t-test did not show statistically significant differences between respondents who volunteered / performed internships and those who did not t(435) =-0.484; p=0.628; p< 0.01. Additionally, the results of Anova test did not show statistical differences regarding working experience of respondents F(df=4, n=432) = 1.726, p=0.143. The obtained results from statistical tests showed that gender, volunteering activities, and length of working experience do not affect the answers of respondents. Consequently, employers e.g. healthcare institutions can prepare universal value proposition for future healthcare professionals in order to attract and retain them in the long run. Human resource management policies and practices in healthcare institutions should be modified and adjusted according to these research findings. Factors that Affect Employement Decision of Future Healthcare Professionals in Serbia 25 6. CONCLUSION The key aim of the paper was to examine which factors are the most important for future healthcare professionals when making the decision about employment. The results of conducted research in this paper showed that the main factors that future healthcare professionals value when deciding on employment are: opportunities for career advancement, personal growth and development, a pleasant work environment, an interesting and challenging job, as well as salary. The key scientific contribution of this paper is in explaining and analyzing the factors that influence the decision making of healthcare professionals regarding employment. Obtained results are valuable for scientific community in order to understand the specifics of behavior and attitudes of healthcare professionals. Furthermore, obtained results can be useful to extend and refine the theory of motivation and stress management. Increased international mobility and uncontrolled migration flow of healthcare workers may increase the level of workload and stress of those employees who stayed in Republic of Serbia. Consequently, there is need to modify and adjust human resources activities and practices in order to provide high quality of healthcare services. Scientific contribution also lies in the fact that the need for professional healthcare will be increasing in the future due to population aging, new infections and diseases. Retention of healthcare professionals is the key to successful functioning of healthcare institutions. Regarding the applied contribution of the paper, there are several important facts for the healthcare system and human resource policies and practices. Human resource management in healthcare faces numerous challenges in the processes of planning, recruiting, hiring, developing, retaining and releasing medical workers from healthcare institutions. Therefore, it is important that managers, human resource experts and leaders of health institutions carefully analyze and determine the key motivational factors of healthcare workers. Salary is not the primary motivational factor for future healthcare workers, as is often assumed and stated. Future healthcare workers are more oriented toward the development of their career, opportunities for advancement, training, acquiring new knowledge, and working in a pleasant work environment. With these research findings, healthcare systems are well-informed to adequately prepare strategy and employee value proposition not only for the attraction of healthcare workers, but also for their retention in the long run. Clear career plans, continuous education, training, and development of employees, as well as building a pleasant work environment must be at the top of the list of priorities in healthcare institutions. The conducted research is accompanied by certain limitations. One of the limitations of research is the sample which encompasses students who are just getting their education and preparing for work in healthcare. They still do not have (enough) working experience, so their answers are based on their expectations and perceptions. Furthermore, this research has not examined some specific working environment, so the questions were of a general nature and did not include leadership style, organizational culture, and the quality of interpersonal relations. Therefore, a recommendation for future research on this topic is to include and analyze a wider range of factors that may impact the employment decision of healthcare professionals. One of the propositions is to conduct longitudinal study and to examine whether preferences and attitudes of healthcare professionals are changed during their career. 26 S. LAZAREVIĆ, J. LUKIĆ NIKOLIĆ REFERENCES Afolabi, A., Fernando, S., & Bottiglieri, T. (2018). The effect of organisational factors in motivating healthcare employees: a systematic review. 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LUKIĆ NIKOLIĆ FAKTORI KOJI UTIČU NA ODLUKU O ZAPOŠLJAVANJU MEDICINSKIH STRUČNJAKA U SRBIJI Trend rastuće mobilnosti medicinskih stručnjaka, starenje populacije, pojava novih bolesti i infekcija donose brojne izazove pred nacionalne zdravstvene sisteme. Iz tog razloga je potrebno posvetiti posebnu pažnju razvoju zdravstvenog sistema i privlačenju i zadržavanju medicinskih stručnjaka. Cilj ovog rada je da ispita i analizira ključne faktore koji utiču na odluku budućih medicinskih stručnjaka o zapošljavanju. U periodu od 2020. do 2022. godine sprovedeno je empirijsko istraživanje u kojem su učestvovala 444 ispitanika koja studiraju ili su završila neki od akreditovanih medicinskih programa u Republici Srbiji. Rezultati istraživanja su pokazali da su tri ključna faktora koja utiču na njihovu odluku o zapošljavanju: mogućnosti za razvoj karijere, mogućnosti i prilike za lični razvoj i prijatno radno okruženje. Na četvrtom mestu se nalazi interesantan, značajan i izazovan posao, dok je na petom mestu visina zarade. Optimalno funkcionisanje zdravstvenog sistema zavisi od sposobnosti zdravstvenih radnika, tako da dobijeni rezultati mogu biti od koristi liderima, menadžerima i donosiocima odluka u zdravstvenim ustanovama. Oni imaju vredne i značajne informacije pomoću kojih mogu da definišu predlog vrednosti kojim će ne samo privući, već i dugoročno zadržati medicinske stručnjake. Ključne reči: medicinski stručnjaci, zaposlenost, radni uslovi, karijerne mogućnosti