Study as work: the role of 'training' in the lives of medical migrants to the UK Leroi 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 projects/geriatric-medicine/home.php

Interviewees by country of origin

Interviewees by Deanery

Interviewees by age

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