Headlines such as “doctor shortage” and “NHS crisis” are all too familiar and all too often based on fact. A frequently employed solution to these problems has been to attract doctors who are trained overseas to work in the UK – a seemingly obvious approach, though one that gives little thought to the country losing its homegrown medical staff. So what of the doctors and nurses who flee their homelands in the face of danger and hardship, arriving on these shores as refugees, educated, experienced and ready to work? These people would appear to present the answer to the shortage of medical staff in Britain, but even in the enlightened 21st century there are stumbling blocks – both in practical terms and in fitting in.

Refugee Doctors is a timely overview of the trials and tribulations faced by medically trained refugees. It aims to show how they and the medical community as a whole can ease their transition from refugees or asylum seekers to fully employed and, just as crucially, accepted doctors.

While it boldly attempts to cover every angle, the book is itself no more than a basic outline of what is a deeply complex situation. Laid out in the form of a teaching textbook, this feels very much like a framework that could be much further illustrated, whether by a teacher who uses it as a guide, or by a student who would then seek to undertake further research to get to the root of the various topics discussed. However, for the refugees themselves, this book has amassed a vital collection of contacts, addresses and websites, all of which offer suggestions for career advice, study groups, further educational assistance and general support.

What this book also manages to do effectively is to put the role that refugee doctors have played in this country into its historical context. Refugees with medical training have arrived in this country over the last 500 years, facing and overcoming adversity to rise to prominent roles in their profession. This background serves a dual purpose, both showing refugees who may be downhearted or struggling that there is light at the end of the tunnel, however distant it may seem, and drawing attention to the fact that refugee doctors have real talent and potential to offer.

Some of the earliest precursors to today’s refugee doctors were the Muslims expelled from the Iberian peninsula in 1492 and the Huguenots who were forced to flee France during the 17th century religious wars. From the first group, one Rodrigo Lopez rose to be Elizabeth I’s personal physician. He was later expelled under suspicion of poisoning by James I, before being recalled by Oliver Cromwell. Lopez’s turbulent career shows both the esteem in which refugee doctors can be held, and also how little progress this nation has made in accepting and furthering the careers of medically trained individuals from foreign lands.

The group that has repeatedly shown how hard it is to achieve acceptance is the Jews, who have been forced to flee to the UK a number of times. While obviously nowhere near the levels of the anti-semitism in Nazi Germany, emotions towards Jewish refugees during the 1930s and ‘40s nevertheless ran high, with both the Medical Practitioners Union (MPU) and the Royal Colleges of Physicians and Surgeons proving deeply hostile. After the war, the MPU attempted, unsuccessfully, to have the refugee doctors expelled, while the Royal College’s president, Lord Dawson, commented that “the number [of refugee doctors] that could be usefully absorbed or teach us anything could be counted on the fingers of one hand”.

These examples, which now seem both alien and inconceivable, help to place into perspective the equally blinkered views that are held towards refugee doctors today.
The book acts as something of an eye-opener to the difficult and often harrowing lives of refugee doctors by presenting personal experiences from two refugee doctors, Dilzar Razak Kader and Zharghoona Tanin. These firsthand recollections are crucial in adding flesh to the somewhat dry bones that make up this boxes- and bullet point-heavy book. Tanin talks of “an atmosphere of despair and frustration” due to the fact that his “applications…did not seem to make any impression on people who were supposedly aware of how their hospitals suffered from a lack of sufficient personnel”.

Tanin describes being ignored, the latent xenophobia driven by the tabloid media, and standing up to the stereotype that refugees in all walks of life are the source of unemployment and the scourge of the taxpayer. This humanises the faceless stories seen in the media – which provides the sketchy knowledge that most observers would have of this subject. For the refugee reader it brings hope as well, for Tanin explains how she approached authorities in the London Deanery, who “were in support of the integration of refugees into the health system” and who helped her to overcame the obstacles in her path.

Merely by placing the personal struggles of doctors such as Tanin alongside more practical chapters detailing advice and direction, this book is performing a valuable and important role. The historical background and the real life approach help to breathe life into the newspaper tales we read, while the more detailed and directory-like chapters of the book explain and outline how the medical system in the UK works, how refugees can seek work and support, and what specific skills refugee doctors can bring (one suggestion being in emotional counseling, particularly considering the hardships they themselves have been through). The editors have sensibly kept the chapters short and distinct, with each providing a springboard for further study and research. This is a valuable starting point, both for those merely wishing to know more about the subject and, vitally, for the refugee doctors and the people who they work with who, to quote the book’s tagline, seek support and integration, both into the NHS and the UK itself.