Respected physician in Syria, unemployed refugee in the Netherlands: An analysis of the integration of Syrian refugees with a medical degree in the Dutch medical field

Abstract

Refugees in the Netherlands are expected to integrate in society and find employment. Despite years of education, Syrian refugees who graduated in medicine (SRGMs') struggle to enter the Dutch medical field. To ensure patient safety, physicians with a medical degree obtained outside Europe are obliged to finish an ‘assessment procedure’ (AP) and might be forced to redo clinical internships, before being allowed to practice medicine. In this research, SRGMs' experiences were analysed using Bourdieu's capital theory. Semi-structured interviews were conducted with 17 SRGMs. In Syria, they acquired much capital as physicians, in the shape of financial means (economic capital), connections (social capital), medical degrees and skills (cultural capital), and status (symbolic capital). Their medical skills often provide the only capital that remains when arriving in the Netherlands, but it loses value as they have to prove their competence first in the AP. This is a long and arduous process. The mean duration, for those who had yet finished the AP, from arrival to employment was 4.5 years (n = 5, range 2.7–5.8 years). SRGMs experience difficulties in these AP years because they are forced to study from home and feel excluded from medical practice. They are unable to regain their economic, social and symbolic capital, whilst struggling to get their cultural capital acknowledged. Mentally this is challenging and when they do finish, this capital gap leaves them at a disadvantage when applying for competitive job applications. Once employed, SRGMs need time to adjust but are finally rebuilding their capital and integrating in Dutch society. Both SRGMs and Dutch society benefit when SRGMs' integration in the Dutch medical field improves. Although certain challenges for SRGMs seem inevitable, by offering a clinical internship before the assessment of SRGMs' skills, their capital acquisition might improve which would facilitate their integration.