The making of careers, the making of a discipline: Luck and chance in migrant careers in geriatric medicine

Abstract

The geriatric specialty, unpopular among most UK born and trained medical graduates, provided an opportunity for career development and achievement for those doctors whose training had been non-standard for a variety of reasons. Migrant doctors who have played a substantive role in the UK National Health Service since its inception made an important contribution to the building of that specialty, at the same time building their own careers. This paper draws on oral history interviews with the UK trained pioneers of geriatric medicine and with South Asian overseas trained doctors who entered the geriatric specialty in the middle decades of the twentieth century. It critically reviews the literature of skilled migration, specifically in terms of ‘brain drain’ and ‘push–pull’, focusing on historical and socio-cognitive communities and emphasizes the contribution of individual narratives of career development in the lives of migrants. Focusing on the use of luck and chance in accounts it suggests that although such terms are indicative of chance upon opportunity, they also suggest a role for agency in career development in contexts which were not auspicious. The outcome, for those interviewed, was regarded positively in career terms, but also had a significant part to play in the development of the career of the specialty of geriatric medicine and in the lives of the marginalized people for whom they developed a service.