Migrant Doctors Research Articles

Beyond Borders: Socio-Economic Dynamics and Demographic Profiles Shaping Migration Patterns of Romanian Doctors Across EU

Healthcare professional migration has emerged as a global phenomenon, underscoring the need to comprehend migrant doctors' patterns and characteristics for effective policymaking and workforce planning. The paper analyses medical practitioners' migration across European countries. Through a quantitative survey, it unveils socio-demographic and professional attributes specific to Romanian doctors. The study explores correlations between the demographic and professional attributes of Romanian migrant doctors and the socio-economic traits of destination countries. Employing clustering analysis, the research identifies four distinct clusters, revealing variations in medical specialisations, income levels, marital statuses, and durations of stay across different European countries. These findings provide a comprehensive understanding of migration patterns among Romanian doctors. More research is needed to investigate factors influencing Romanian doctors' migration decisions and experiences and compare their profiles to those of migrant doctors from other countries. Understanding these patterns can help healthcare workforce planning, recruitment strategies, and policy development.

Bridging the gap between patients and migrant doctors

Bridging the gap between patients and migrant doctors

Perception of the use of a telephone interpreting service during primary care consultations: A qualitative study with allophone migrants.

The language barrier prevents allophone migrant patients from accessing healthcare when arriving in a country, and interpreters are often needed to help them to be understood. This study aimed to understand perceptions and experiences of allophone migrant patients who used a telephone-interpreting service during primary care consultations. A qualitative study using semi-structured interviews was undertaken between September 2019 and January 2020. Interviews were transcribed and analysed using thematic analysis framework. Allophone migrant patients from an accommodation centre for asylum-seekers who used a telephone-interpreting service during primary care consultations with a general practitioner. A purposive sample of allophone migrant patients (n = 10). From the semi-structured interviews, we identified three themes: (1) multi-level difficulties of being an allophone migrant in the primary care pathway (i.e., before, during, and after the consultation); (2) the key role of the interpreter in the doctor-patient relationship, participating in improving the patient's management by establishing a climate of trust between the two; and (3) advantages and limitations of the TIS. However, even if a telephone-interpreting service is very helpful, allowing quick access to interpreters speaking the allophone patient's native language, certain situations would require the interpreter to see the patient to better guide the doctor during the consultation. Telephone-interpreting services enable improving communication and comprehension between allophone migrant patients and doctors. Nevertheless, the interpreter may sometimes need to physically see the patient to better guide the doctor. To do so, interpreting services using videoconferencing deserve wider development.

Exploring the Interplay between Pay, Career Barriers, and Management Support: An Intersectional Study of Migrant Doctors

Exploring the Interplay between Pay, Career Barriers, and Management Support: An Intersectional Study of Migrant Doctors

Migrant doctors’ narratives about patients

Abstract Narratives of personal and vicarious experience are part and parcel of being a doctor, as doctors routinely (re)interpret and (re)tell patients’ narratives when reflecting on clinical cases. Taking an interest in migrant doctors’ self-initiated narratives about patients in doctor-researcher interviews about cultural transitions, this study examines over thirty hours of audio-recordings of forty semi-structured interviews conducted as part of a collaborative project in Chile and Hong Kong. The study explores how migrant doctors construct their professional ‘self’ through narratives about patients, and how these narratives help migrant doctors legitimise their arguments and professional stance in criticizing cultural and societal attitudes towards health and illness, and the professional practices of local doctors. Finally, the paper reflects on the ways in which migrant doctors’ identity positionings provide space for the creation of a “symbolic territory” in which the practices of migrant doctors co-exist within the boundaries of the practices of local doctors in the host culture.

What Measures Help with the Professional Integration of Migrated Doctors in Rehabilitation Clinics?

National and international literature and our own preliminary work indicate that the professional integration of migrant doctors in rehabilitation clinics poses a considerable challenge. The STIR project worked with four rehabilitation clinics in Germany to develop various measures to ensure the structured transition and professional integration of migrated doctors. The selected measures include a short film, a website, management training, intercultural training, a peer support programme and a strategy for initial discussions. In this article we describe the preparation, implementation and evaluation of the prototypes of the above measures as part of a feasibility study with regard to acceptance, practicability and integrability. It turns out that the measures can be easily implemented in everyday clinical practice and are accepted and considered useful by the participants. Options for optimisation are described. The study provides initial indications of interventions which promote the professional integration of migrated doctors. Additional analyses of sustainability and precise customisation to the local target group are recommended.

'A British Problem Affecting British People': Sickle Cell Anaemia, Medical Activism and Race in the National Health Service, 1975-1993.

Recent historiography has explored a contradiction at the heart of the British welfare state—it was founded on and supported by migrant and non-white labour, whose own healthcare and broader welfare state entitlements were neglected. This article explores how this contradiction was exposed and challenged by some of the health service’s own workforce, who witnessed and contested racism in the National Health Service (NHS). This is discussed through the lens of the treatment of sickle cell anaemia (SCA), a genetic trait and disease more common in people of African, South Asian, Middle Eastern and Mediterranean descent, which has been highly racialized as affecting black people in particular. By pushing for improved responses to pain in sickle cell disease, and demonstrating the need for SCA screening in urban areas, healthcare professionals within the NHS—many of whom were black or migrant nurses, health visitors or doctors—articulated the status and entitlements of Black British citizenship.

Experiences of frontline Pakistani emigrant physicians combating COVID-19 in the United Kingdom: a qualitative phenomenological analysis

BackgroundThis study aims to explore the experiences, beliefs, feelings, and challenges faced by Pakistani migrant doctors working in the United Kingdom in times of the COVID-19 pandemic. The qualitative study aims to explore the lived experiences, beliefs, feelings, and challenges faced by Pakistani migrant physicians working in the United Kingdom during the COVID-19 pandemic.MethodsAn exploratory phenomenological approach was used to collate data on experiences expressed during the COVID-19 pandemic. Purposive and snowball sampling was used to target participants, which were doctors of Pakistani origin involved in the direct care and management of COVID-19 patients in different NHS hospitals of the United Kingdom. Semi-structured, in-depth telephonic interviews were conducted with study participants in May 2020. Data analysis was done parallel with data collection by using an inductive qualitative approach.ResultsWe recruited ten frontline physicians. Four theme categories emerged from the data analysis: 1) Working across borders and cultures, 2) Role of beliefs for coping with stress and fear, 3) Passion and profession, and 4) Scaffolding the Pakistani health system. Overall, the results show that the participants received limited professional support, in terms of counseling and psychological rehabilitation. Instead, they had to use self-management strategies to cope with the situation.ConclusionThe intensive work exhausted participants physically and emotionally. They were holding a lot of grief and hurt inside, but still, healthcare professionals showed the spirit of professional dedication to overcome difficulties. Although currently coping with their emotional problems, comprehensive professional support should be made available to cater to the wellbeing of frontline physicians.

Towards more effective health workforce governance: The case of overseas-trained doctors.

The over-reliance on overseas-trained doctors remains a pressing problem in a handful of countries. This study aimed to explore the experience of rural and remote overseas-trained doctors as regards to their migration, recruitment and ongoing support in Australia as the basis for more effective health workforce governance. Qualitative interviews were undertaken with overseas-trained doctors in rural and remote Australia. Interview questions focused on the experiences of overseas-trained doctors. Migrant doctors working in general practice in rural and remote Australia. Overseas-trained doctors who met inclusion criteria participated in interviews (n=14), which were digitally recorded and transcribed. Thematic coding and analysis were conducted with input from the study's Expert Policy Stakeholder Group. Overseas-trained doctors enjoyed the relative autonomy of working in rural or remote general practice and were grateful to be in Australia. Specialised rural and remote skills such as cultural competence in matters of Indigenous health and specialised emergency rural skills was a key finding as was the deskilling or lack of career development opportunities. Our analysis pointed to the mismatch in expectations and experiences between overseas-trained doctors, policy-makers and employers, as some doctors experienced obstacles with registration, or the location was not ideal, or there was a lack of awareness of Indigenous-related health and cultural challenges. In the context of Australia's continuing reliance on overseas-trained doctors, this study revealed the need for improved communication and coordination between overseas-trained doctors, policy-makers (education, health, employment and immigration) and employers, as a basis for more effective health workforce governance.

Medical Knowledge for Immigrant Iraqi Doctors and the Challenges of Reduce it impacts in the Technology Era

Medical knowledge of immigrant Iraqi doctors a great loss for the nation. Doctors’ Immigrate is affecting medical knowledge level, the standard ratios between (doctors-patients) also the quality of health services badly. The research question: How can modern technology in education and health sectors are activated to cut the effects of doctors’ migration. The research aims to identify modern technology in medical education and the implications of not using it in Iraq. significance of this research comes from focused on how can build the students of medicine college technologically, also Promote the concept of intellectual property and keep the medical scientific legacy of migrant doctors by using modern technology. This research found a strong relationship between the use of modern technology in the (education and health) sectors and reducing the impact of doctors’ migration on quality of health care in the country. The average respondent answers (3.88) agreed that bad management and internet service are strongly affecting doctors’ emigration from Iraq and decrease medical knowledge in it, also (3.53) were agree that specific IT and non-effective health information system is the main reason to decrease medical knowledge. With average (4.03) were agreed that Iraq has not the medical scientific and technological leadership at the same time, and the climate of stability and progress to achieve their ambitions. Doctors said the political impact on hiring doctors in administrative positions in hospitals / medical centers and disrupting career progress disappointed them. Therefore, the feeling of insecurity and the lack of adequate procedures convince doctors to emigrate from Iraq.

Supporting Stranded Migrant Doctors in the UK during Covid-19 Pandemic

The British Association of Physicians of Indian Origin (BAPIO) undertook a humanitarian project to come to the aid of several migrant doctors who were in the UK to take the Professional & Linguistic Assessment Board’s (PLAB) part 2 clinical examination, and had become stranded due to the lockdown during the first surge of the COVID-19 pandemic. The BAPIO PLAB stranded doctors’ project started as a serendipitous exercise in the third week of March 2020 with first a handful of migrant doctors, until it reached a peak of 267 doctors from 19 countries, and involved collaboration with multiple voluntary organisations, stakeholders, regulatory agencies and governments.
 There was no denying the complexity and intricacy of the demands on the stranded doctors, but it was even more pleasing to witness how the project team were more than ready to meet the challenges. Under the umbrella of BAPIO, the project team doctors, who previously had barely known each other, took on all the challenges - teaching, pastoral support, career advice, writing curriculum vitae, finding food, accommodation and funds for those in need; organising professional support, links with the General Medical Council, the High Commission of India and the U.K. Home Office. The project was concluded on 19 September, with all the doctors either returning home or making a decision to work in the NHS when conditions allowed them to.
 It is not possible to know how many passed their PLAB part 2 exams, but we estimated that over 50% did. The weekly virtual meetings, the camaraderie, the scale of the project, and most importantly bringing it to a closure without any major crisis, was only possible through sheer determination, understanding the needs, professionalism, leadership and excellent communication. The lessons from this project are important to illustrate the role of voluntary organisations (such as BAPIO) and the effectiveness of having established collaborative networks with official bodies and government agencies, for the future benefit migrant professionals.

Conflict in migrant doctor–local doctor communication in public healthcare institutions in Chile

When investigating intercultural communication in healthcare settings, interprofessional communication has received very little scholarly attention compared to doctor–patient interactions. Interactions among doctors, however, are an important locus for the organizational life of a hospital as the way these professionals communicate will promote (or hinder) professional effectiveness and efficiency. This paper presents the findings of a study that explores the perceptions concerning the degree and frequency of communicative conflict of 61 migrant doctors working in public healthcare institutions in the central region of El Maule in Chile. Drawing on data from a survey on communicative conflicts, the study analyses the perceptions of the migrant doctors in relation to one particular style of conflict management, namely, adaptability. Findings show that although communicative conflicts seem to occur only occasionally, moderate scores are reported for how such perceptions are believed to affect work performance. Also, the demands of communicative adaptability are perceived to be met largely by migrant doctors alone. The paper then offers considerations about the possible impact that these adaptability efforts could have on migrant doctors’ integration processes.

Social integration of migrant physicians in inpatient rehabilitation

Abstract Purpose In Germany, numerous inpatient rehabilitation facilities employ migrant physicians. Yet the remote location of many such institutions makes it difficult for migrant physicians to establish social relationships and networks near their place of employment. This lack of social resources has implications for employee retention, quality of life, and quality of care. In this light, our study examines the following questions: what social relationships do migrant doctors have access to? What challenges and opportunities do these relationships represent? Our aim is to provide concrete recommendations for stakeholders to improve the social integration of migrant physicians. Methodology Semi-structured interviews with 58 migrant physicians and their colleagues. Braun & Clarke thematic analysis. Results Migrant physicians' social relationships fall into four broad categories: friends and acquaintances in general, family, community of origin, and working team. Migrant physicians in our sample face difficulties in each of these four categories. Implications Establishing social relationships in rural and semi-urban areas is more difficult for migrants in general, and migrant physicians in particular. We propose a number of recommendations to overcome these challenges on several levels: individual, work team, institution, regional, and trans-regional. Key messages The integration of migrant physicians in inpatient rehabilitation facilities is challenging. Specific measures can help the retention of migrant physicians.

Migration of physicians and keys to success

There are currently nearly 1 billion migrants, of whom 259 million are international migrants, according to the World Health Organization. In the Americas, Venezuela has the highest migratory flow in the region in recent history. By September 2019, more than 4,300,000 people of all social classes had left the country. They included more than 24,000 doctors, who were fleeing the serious political, economic, and social crises affecting that nation. Others in the exodus are a large number of university faculty. The author’s personal experience as a migrant doctor is presented, and job alternatives beyond medical practice/clinical medicine are described. The exodus of highly qualified personnel is not a new phenomenon but one that negatively affects the region or country of origin, whereas the receiving place benefits from the professionals who manage to join the workforce in their field of training. This, of course, is dependent on their complying with requirements to obtain legal residency and respective licensures, in addition to finding existing alternatives according to their expertise. To achieve this objective, they require a network of relatives, colleagues, and friends who can provide guidance on the steps to be followed; being fluent in the language of the new residence; and obtaining the necessary certifications to practice the profession either by taking the legally required examinations or by obtaining another degree from a university in the country.

이주근로자와 내국인 의사 진료의 비판응용언어학적 연구: 세 기관을 중심으로

이 연구는 한 곳의 유료 국제클리닉(A병원) 두 곳의 이주근로자를 위한 무료 진료소(B센터, C병원)에서의 내국인 의사와 이주근로자 환자 사이의 문화간 의료 커뮤니케이션을 민족지학적 방법으로 비판응용언어학적 시각에서 살펴보았다. 지금까지 이주민을 대상으로 하는 선행 연구들은 주로 무료 진료소 위주로 의료 복지와 현황 파악의 입장에서 접근하며 설문지나 문헌 자료 분석을 한 것이 대부분이었고, 민족지학적으로 심층적인 접근을 한 연구는 극소수였다. 이에 이 논문은 환자의 구성과 규모 등이 상이한 세 기관에서의 진료 현장을 2년여 동안 참관하고 심층 면담 등을 수행한 민족지학적 연구를 통해 환자의 직업 전문성, 출신 국가, 진료 언어, 환자연령대, 병증 양상 등을 살펴보았다. 그 결과에 따르면 C병원은 기존 연구에 가장 가까운 양상을 보였다. 그러나 무료 기관인 B센터는 “외국유학생”을 포함한다는 점에서 기존의 연구와는 상당히 다른 분포를 보였고, 유료 기관인 A 병원은 A병원이나 B센터와 더욱 큰 차이를 보였다. 특히 B센터와 A병원에 내원하는 이주근로자 환자는 상당수가 전문직 종사자나 고학력자이고 선행 연구에 많이 포함되지 않는 국가출신이었다. 이는 무료진료 기관에 내원하는 이주민 환자들이 비숙련직, 저학력자, 몇몇 특정 국가 출신이라는 기존 연구의 결과가 지나치게 편향되어 있다는 점을 보여준다. 이에 주목하여 현 연구는 좀 더 포스트-구조주의적 연구를 포용하는 비판적 응용 언어학적 연구의 필요성을 제시한다.

The Patients’ Lexicons in Migrant Worker-Domestic Doctor Interactions at a Free-of-Charge Medical Center

The present study investigated the patients’ lexicons in unfolding migrant worker-domestic doctor interactions at a free-of-charge medical center for migrants (Center B) against those at a large general hospital (Hospital A) and those at another small free-of-charge hospital (Hospital C). In so doing, the focus was on the patients’ lexicons at Center B against those at the other institutions. Overall, the data at Center B consisted of approximately 80 consultations that the researcher himself participant-observed and audiorecorded at the three institutions over a span of two years. A qualitative investigation of the patients’ lexicons at Center B demonstrated that the patients who visited Center B initiated far more advanced scientific terminologies. Also, they adopted more nominalized forms, The lexical content and form appeared to result from the fact that the migrant patients were advanced degree seekers in agriculture, engineering, and science. Thus, the patients’ lexicons at Center B illustrated that the finding of the previous studies which argued that the patients at free-of-charge clinics were mostly unskilled laborers were oversimplistic and even stereotyping. The present study proposes a more critical applied linguistic study of migrant patient-domestic doctor consultations.

Intercultural opening: participant observation in two hospitals and two outpatient care services

Abstract Background The German healthcare system is facing intercultural diversity, since numerous migrant patients, nurses, and doctors are involved. This raises the question as to what extent everyday processes, working cultures and institutional framework conditions change because of this and how intercultural healthcare can be improved. Methods The participant observation took place on 22 days during summer 2018 in two outpatient care services and two hospitals, which show different degrees of intercultural opening (e.g. more or less migrant employees and patients). The aim was to reconstruct the daily work routine of health staff as well as the patients’ daily routine. The anonymized records include meetings, care tours, handovers and visits. The observation protocols were analyzed by documentary method and compared on two levels: degree of intercultural opening and sector affiliation. Results The results show that intercultural opening has a sector-specific impact on organization and daily work processes. The health staff of the hospital with high intercultural opening showed routine handling and relaxed reactions to communication difficulties due to the regular care of migrant patients, whereas that of the hospital with low intercultural opening showed stress-related defensive stance due to rare cases. The situation in the outpatient sector is different: The care of migrant patients was perceived to be more costly in the institution with high intercultural opening, because the migrant employees repeatedly perform additional socio-educational work that is not covered by insurance. Conclusions The migration-specific knowledge of employees has a positive effect on patient care in both inpatient and outpatient sector. However, this may be financially disadvantageous for nursing services under the conditions of outpatient care. Key messages Synergy effects arise from the involvement of migrant health workers and the care of migrant patients. Framework conditions must support these synergy effects in order to improve cultural sensitive healthcare.

Being called “skilled”: a multi-scalar approach of migrant doctors’ recognition

This article highlights the way the specific configuration of migrants’ skills relies on the relation between admission and inclusion policies, which involves several actors, time-frames and a multi-scalar integrative approach. It builds on a qualitative study which reports different scales of analysis for enhancing different actors participating in the recognition process of being called “skilled”. The study investigates how the “skilled migration” category is socio-institutionally constructed and how it corresponds to a recognition process that interplays with different scales (macro, meso and micro scales) and the corresponding actors (regulatory actors, civil society organisations and migrants). The main argument of this article is that the regulatory framework (e.g. admission policies, academic institutions’ procedures, professional bodies’ rules), organised civil society interventions and networks of power are key factors for the development of an “ascribed qualified migrant” into a de facto “achieved skilled professional”, and therefore the recognition of migrants as visible – and valued – “skilled professionals”.

“Kyrgyz Clinics” in Moscow: Medical Centers for Central Asian Migrants

ABSTRACTSocial isolation limits migrants’ access to health care, providing the context for the emergence of migrants’ own medical infrastructure. In this article, we explore the so-called Kyrgyz clinics, private medical centers in Moscow founded by doctors from Kyrgyzstan and targeted specifically for labor migrants from Central Asian countries, particularly Kyrgyzstan, Uzbekistan, and Tajikistan. These Kyrgyz clinics both provide affordable medical services and enable migrant doctors to guide migrant patients through Russia’s medical infrastructure, in the context of limited resources, lack of health insurance, low awareness of available services, and other barriers to care.

Becoming a woman doctor in Iran: the formation of classed and gendered selves

ABSTRACTThis paper analyses the pedagogical pathways of a group of first-generation Iranian migrant doctors in the UK. It explores the complex system of class production and growing up as a classed subject in Iran, a process that ties young women’s educational aspirations to female independence on the one hand and to the modern feminine, heterosexual identity that sees women as part of the patriarchal family system on the other. By using Bourdieu’s concept of cultural capital and habitus [Bourdieu 1984. Distinction: A Social Critique of the Judgment of Taste. London: Routledge & Kegan Paul] and Foucault’s theory of surveillance [Foucault 1984. “The Means of Correct Training.” In The Foucault Reader, edited by Paul Rabinow. London: Penguin Books, pp. 188-205], this paper analyses how migrant women’s trajectories of becoming highly educated are translated into their roles as mothers. Three major aspects of pedagogical trajectories are identified in the formation of classed selves: the first is the generational surveillance within families, particularly of girls by their mothers; the second is the normalisation of pathways and the importance of destined pathways that separate certain families, practices and choices in superior positions; the third is the moralising of educational choices, which distance being a doctor from classed consciousness, giving rise to an altruistic self as opposed to a selfish one.