BY SUEVON LEE, MEDILL NEWS SERVICE

Kishore Sajjanraj in his East Ham,

London home with his visa that's soon to expire

These reminders of home, along with the cheap rent and proximity to local hospitals, are what perhaps draw the hundreds of junior doctors from India to this largely immigrant corridor.

The doctors, fresh graduates from India's medical schools and licensed to practice medicine back home, have been coming to Britain to receive training in specialized fields of medicine. They hope to take what they've learned back to places like New Delhi and Madras to address the health needs of the population.

"Lots of my professors have been trained in the UK. Sub-specialty training is not available in India," said Kishore Sajjanraj, a 25-year-old junior doctor training in paediatric medicine.

Yet many Indian doctors, as many as 5,000, may be forced to leave Britain without completing their training. Starting April 3, 2006, the Home Office instituted new rules which restrict employers from awarding work visas to overseas doctors unless the employers can prove no other suitable candidate from Britain or a European Zone country could be hired.

A shortage of medical posts, spurred by a significantly larger number of British medical school graduates in recent years, has Britain's government scrambling to figure out what to do with, what it claims, is an excess number of doctors in the country.

"We now have more than 117,000 doctors working in the NHS [National Health Service], 27,400 more than in 1997, as well as record levels of doctors in training in UK medical schools," Health Minister Lord Warner said in a prepared statement. "There is therefore no longer a need for a specific category in the immigration rules to enable doctors and dentists to train in the UK for many years."

Previously, overseas doctors were allowed into the country on a work permit-free visa. In fact, they had been actively recruited since the 1950s to address the dearth in Britain's health force after the founding of the National Health Service in 1948.

Britain's National Health Service experienced a 68 percent jump in its supply of doctors between 1997 and 2006 alone. Between 1998 and 2005, the number of doctors from India who took and passed a compulsory exam required to train in Britain jumped from 1,000 to 6,600, according to figures from Britain's Department of Health.

Feeling "cheated"

Aruj Qayum, a 30-year-old from Delhi interested in international children's health, said he was informed by advertisements that there would be a guaranteed supply of jobs if he came to train in Britain.

"I feel as if I've been cheated," he said. "Every country should give preference to their own first, I understand that. But they should have told us first. If they told me the situation, I wouldn't have come here."

Sajjanraj, the paediatrics trainee, estimates that he has sent 900 job applications out to various hospitals and has not yet heard back from any of them. The posts he is eligible to apply for are offered only twice a year, in February and August, and last six months to two years.

"Something that was difficult before has become impossible," he said of the job search. "Those who started their training, let them finish and get back home with dignity."

Some overseas doctors say hospitals in India would not hire them if they knew they had only partially completed their specialized training.

"Forget money, forget everything, if I'm going back I'm losing two-and-half years. No one will consider this experience," Qayum said. "If I go in the middle of my training, it means nothing. I have to start from scratch in my country."

The rule changes, some say, signal the government's latest attempt to try to curtail the number of foreigners in the country, as the immigration debate increasingly adapts to the British political agenda.

Dr. Ramesh Mehta, director of the British Association of Physicians of Indian Origin (BAPIO), estimates that only six percent of Indian doctors who train in Britain choose to stay and practice permanently in the country.

Other industry professionals claim the government is trying to backpedal after having lured too many overseas doctors into the country.

"It's absolutely outrageous," said Dr. Gordon Dutton, a paediatric ophthalmologist at Children's Hospital in Glasgow. "How could a government implement a policy that is so racist? They're putting a complete blanket ban as part of a knee-jerk reaction because they realize they've brought too many doctors in."

BAPIO has gone so far as to file a legal motion asserting that overseas doctors received "little or no warning of the changes" and that the government failed to take "correct procedure" in its implementation of the changes. The doctors' advocacy group had previously submitted a petition of 6,000 signatures of protest to Health Minister Warner, a notice that has gone unanswered, according to Mehta.

DHS officials declined to comment directly on the issue. "It would be inappropriate to make any comment at this time," a spokesman said.

Some organizations are trying to find a compromise between the two sides. The British Medical Association, a professional group for doctors, has requested a two-year grace period during which junior overseas doctors could find a training job post without being required to have a work permit.

"Many are going to have to completely uproot themselves and their families, take their children out of school, sell their homes, and make arrangements to leave the country, all at very short notice," the BMA argued in an April press release.

Racking up expenses

Sajjanraj has pointed to the huge costs he has incurred during his training process, money that would go to waste if he is forced to go back early. The medical exam every overseas doctor must take upon arriving in Britain costs 600 pounds (about $1,100). Sajjanraj has also had to extend his visa twice, a process that costs a total of 1000 pounds ($1,841).

The amount he has spent on renewing his visa alone is equivalent to 40,000 Indian rupees, enough to purchase a new motorbike or a small home in India.

Living in London, one of the costliest cities in the world, has forced Sajjanraj to share a cramped room in East Ham with two others. The room costs him roughly 50 pounds ($92) a week in rent.

"Doctors in India are considered elite, but that's not the case here," he said.

Overall, Sajjanraj estimates he has spent roughly 8000 pounds ($14,700) since arriving in Britain in December 2004. His parents, owners of an automobile parts store in Madras, have exhausted all their savings and taken out loans to support him.

Yet Sajjanraj is hopeful that the constant pressure being applied to the British government may result in something positive. He is determined to remain in London until the end of August--the next time his visa expires--even though many of his discouraged colleagues have already returned to India.

"If I went back home and found out the rules changed or a transition period was given, I would curse myself and think, 'Oh God, what did I do? I should have stayed there until my visa expired,' " he said.

June 2006

11-Jul-06 | 11:54 AM
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Filed under: Feature Stories, India, United Kingdom



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