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Study as work: the role of 'training' in the lives of
medical migrants to the UKLeroi Henry, Parvati Raghuram, Joanna Bornat
48th Congress of the European Regional Science Association
27 – 31 August 2008, Liverpool, UK
Structure
South Asian Geriatricians project
How doctors’ mobility and narratives of career were shaped by Empire
The tensions inherent in the integration of study and work for migrants
Migrants vulnerability to changes in the regulatory environment
South Asian Geriatricians project
Two year ESRC funded project
Supported by British Geriatrics Society and British Association of Physicians of Indian Origin
60 oral history interviews with retired and serving geriatricians trained in South Asia
30 Completed
23 Transcribed
http://www.open.ac.uk/hsc/research/research-projects/geriatric-medicine/home.php
Interviewees by country of origin
0
2
4
6
8
10
12
14
16
18
20
bangladesh burma india pakistan Sri lanka
Interviewees by Deanery
0
1
2
3
4
5
6
7
8
9
10
eastmidlands
eastern kentsurreyand
sussex
london mersey northwest
oxford Southyorks and
southhumber
wales westmidlands
yorkshire northern
Interviewees by age
0
2
4
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40-49 50-59 60-69 70-79 80-89
Postcolonial ties and interests underpinning medical migration
Historical reliance of NHS on colonial and commonwealth labor
Postcolonial relations embedded in accreditation of qualifications and regulation of medical migration
Permits and the integration of work and training
Postcolonial ties, mobility and migrant doctors’ motivations
Institutional linkages in transnational socio-cognitive community
Narratives of post graduate training in the UK as markers of career success and being a good doctor
Temporary mobility for validating and updating skills
The integration of learning and work 1: the process of training in the workplace
Membership of the Royal Colleges and specialist training
Developing clinical practice and communication skills in the workplace through apprenticeship
The integration of learning and work 2: establishing oneself in the workplace
Demonstrating credentials as a competent doctor in a post colonial cognitive community
Adjusting to UK professional and organizational cultures
Deskilling to facilitate sponsorship relationships
The integration of learning and work 3: How junior doctors balance study and work
Long unsocial hours
Universal for junior doctors
Differential access to study leave
Mitigated by working time directive
The integration of learning and work 4: why medics remain
Family commitments
Commitment to socialized medicine
Resources to be a good doctor
Limited options at home
Questionable utility of migrants’ new skills in South Asia
Material factors not mentioned
The utility of migrants’ specialist skills for South Asia
Conflicting interests:
Fill gaps in UK medical labour market
Training in high status competitive specialty
Vulnerability of immigration status constrains scope for career choice
Perceived discrimination against migrant doctors
Entry into geriatrics as a response to marginalisation
Skills in geriatric medicine not marketable in South Asia
Changing regulation of learning spaces: visas
Abolition of permit free training
Self sufficiency and the nation as the primary space for arranging medical provision
The end of non-EU medical migration?
Regulating learning spaces: implications for migrant doctors
Expensive UK qualifications invalidated
Many migrants unable to complete their training
Uncertainty, unemployment, financial loss and no transferable skills
Conclusions
Migration for training within networks framed by postcolonial relationships
The blurring between work and learning can lead to a conflict of interests
In this form of migration for learning, medics are vulnerable to changes in immigration and medical training regulations
The skills developed by migrants are a consequence of their responses to UK labour market conditions
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