UCL, London, UK
The Wilson Centre, Toronto, Ontario, Canada.
BMJ Glob Health. 2024 Jun 27;9(6):e014840. doi: 10.1136/bmjgh-2023-014840.
Following India and Pakistan gaining independence from British colonial rule, many doctors from these countries migrated to the UK and supported its fledgling National Health Service (NHS). Although this contribution is now widely celebrated, these doctors often faced hardship and hostility at the time and continue to face discrimination and racism in UK medical education. This study sought to examine discursive framings about Indian and Pakistani International Medical Graduates (IPIMGs) in the early period of their migration to the UK, between 1960 and 1980.
We assembled a textual archive of publications relating to IPIMGs in the UK during this time period in . We employed critical discourse analysis to examine knowledge and power relations in these texts, drawing on postcolonialism through the contrapuntal approach developed by Edward Said.
The dominant discourse in this archive was one of opportunity. This included the opportunity for training, which was not available to IPIMGs in an equitable way, the missed opportunity to frame IPIMGs as saviours of the NHS rather than 'cheap labour', and the opportunity these doctors were framed to be held by being in the 'superior' British system, for which they should be grateful. Notably, there was also an opportunity to oppose, as IPIMGs challenged notions of incompetence directed at them.
As IPIMGs in the UK continue to face discrimination, we shed light on how their cultural positioning has been historically founded and engrained in the imagination of the British medical profession by examining discursive trends to uncover historical tensions and contradictions.
在印度和巴基斯坦从英国殖民统治下获得独立后,许多来自这两个国家的医生移民到英国,为英国刚刚起步的国民保健制度(NHS)提供支持。尽管这种贡献现在得到了广泛的赞誉,但这些医生当时经常面临困难和敌意,在英国医学教育中仍然面临歧视和种族主义。本研究旨在考察在 1960 年至 1980 年期间,这些医生移民到英国的早期,关于印度和巴基斯坦国际医学生(IPIMGs)的话语框架。
我们在这一时期组装了一个关于英国 IPIMGs 的出版物文本档案。我们运用批评话语分析来考察这些文本中的知识和权力关系,通过爱德华·萨义德(Edward Said)提出的contrapuntal 方法,从后殖民主义的角度进行分析。
这个档案中的主要话语是机会。这包括培训机会,对于 IPIMGs 来说,这种机会并不公平;将 IPIMGs 塑造为 NHS 的救星而不是“廉价劳动力”的机会错失了;这些医生被认为是在“优越”的英国体系中,他们应该为此感到感激。值得注意的是,也有反对的机会,因为 IPIMGs 对针对他们的无能观念提出了挑战。
由于英国的 IPIMGs 继续面临歧视,我们通过考察话语趋势来揭示历史紧张局势和矛盾,揭示他们的文化定位是如何在历史上建立起来的,并在英国医学界的想象中根深蒂固,从而为他们的处境提供了历史背景。