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

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2

4

6

8

10

12

14

16

18

20

bangladesh burma india pakistan Sri lanka

Interviewees by Deanery

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1

2

3

4

5

6

7

8

9

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eastmidlands

eastern kentsurreyand

sussex

london mersey northwest

oxford Southyorks and

southhumber

wales westmidlands

yorkshire northern

Interviewees by age

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2

4

6

8

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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