Overseas-trained South Asian doctors and the development of geriatric medicine

1. Overseas-trained South Asian doctors and the development of geriatric medicine Joanna Bornat, Leroi Henry and Parvati Raghuram ESRC RES-062-23=0514

2. 'The local boys wouldn’t touch it with a barge pole. So, in effect, geriatrics owes its origins and its beginning to the pioneers who had the vision, and the junior doctors from the Indian subcontinent - as simple as that ', Dr Mohan Kataria when interviewed by the late Professor Margot Jefferys for her study of the pioneers of geriatric medicine in the UK (interview 512/50/01 British Library Catalogue).

3. Previous study • A theoretical sample of 70 interviews with pioneers of geriatric medicine • 54 guided life histories of doctors on their contribution • oldest was 92 in 1991 and 18 had been born before 1914 • Typescripts in British Library • Scanned, checked, entered into QSR N6

4. What does re-use enable? • Reconceptualisation • New questions and new interpretation • Highlights the significance of time • Foregrounds ethical debates

5. 'They had been to respectable geriatric departments and learnt the trade but when they got appointed to x, y, z, they had Indian or Pakistani names or whatever else. And it tended to get known as the sort of, you know, dark-skinned specialty. Third world specialty almost.' (Agate, British Library catalogue, C512/8/01-02).

6. New research • Archival research on the establishment of geriatrics as a discipline and on South Asian migration into the NHS since the post-war period • Interviews with 40 retired and 20 South Asian geriatricians who are currently working in the NHS

7. Aim • Provide a new analytical framework for conceptualising the migration of skilled health workers, which demonstrates historical sensitivity towards flows of migration, the development of the NHS, and the particularities of the specialty where migrants are employed

8. Archives currently identified • BGS archives (history of geriatrics, participation of South Asian geriatricians in BGS and its committees); • British Medical Association archives (minutes and meetings of the Commonwealth Medical Advisory Bureau, International Medical Advisory Bureau to identify early history of South Asian geriatricians' contributions to the NHS); • British Library (Oriental and India Office collection); • Institute of Commonwealth Studies (papers of the Medical Association of South Asian countries, Commonwealth Medical Association and Commonwealth Medical Conference to trace early history of South Asian contributions to geriatrics); • Commission for Racial Equality (CRE and its predecessors to see if and how race issues came up in medicine and in particular, in geriatrics); • King's Fund (history of the NHS and of geriatrics to explore contribution of South Asians to this history); • National Records Office (Ministry of Labour records on vouchers given to Commonwealth applicants to trace entry of doctors to the UK in the 60s and 70s and identify different routes of migration); • Royal Society for Medicine (history of geriatric section); • University of North London library (TUC holdings of papers on NHS to see labour activism and participation of South Asian geriatricians); • Wellcome library (papers from the Commonwealth medical conferences on migration of South Asian doctors; • Overseas Postgraduate Medical Journal (1947-1951) on early history of training opportunities for geriatricians).

9. Possible analytical contributions • Explore how a national institution was constituted through the labours of non-nationals, thus undermining the hegemony of the ‘nation’ in thinking about the NHS • Reconceptualise histories of migration and racism during the 1950s and 1960s through a more nuanced analysis of class and gender • Exploring processes of inclusion and exclusion experienced by migrant doctors particularly the interplay between sponsorship/patronage and postcolonial relationships / racism • Rethink categories such as ‘class advantage’ and ‘racial discrimination’ simultaneously, moving beyond ‘intersectional analysis’ • The material effects on doctors careers of varying responses to perceived racial discrimination • Exploring how care of the elderly can be a diacritic marker of ethnic difference for migrants and the implications of this for migrant geriatricians.