Intended for healthcare professionals


Refugee doctors face enormous difficulty

BMJ 1998; 316 doi: (Published 04 April 1998) Cite this as: BMJ 1998;316:1095
  1. A Ezsias, Senior registrar
  1. John Radcliffe Hospital, Oxford OX3 9DU

    EDITOR—I have been interested by several articles about refugee doctors, 1 2 particularly because I started my life in Britain as one. It is hard for people to appreciate fully the mental anguish and physical deprivation, the sense of annihilation and loss of reference points, and the vulnerability and desperation of refugees. Highly educated refugees such as doctors may be more prone than other refugees to concentrate on their mental and spiritual deprivation; this is compounded by repeated disappointments in their attempts to earn their living by their skill and contribute to the society that accepted them.

    Although I am a European and prided myself that I had a good knowledge and understanding of European culture and history, the shock of becoming a refugee in a foreign country was overwhelming. The language difficulties, the lack of relatives and friends and knowledge of the “system,” the uncertainty and the daily struggle for survival and to keep one's sanity and integrity; all these reduced life to a miserable existence.

    I came across most of the official and unofficial refugee organisations. Some were too busy to help; others provided some help and advice, though this was haphazard and, understandably, general rather than tailored to a particular group such as refugee doctors. In the medical field I found that the most unhelpful organisation was the overseas division of the General Medical Council. I well understand that the council needs to ensure that those wishing to practise in Britain have at least the same standard of medicine as their British colleagues, but some of its requests were impossible for a refugee to fulfil (for example, to provide my original diploma). Furthermore, when I questioned its practice the division covered up its mistakes, knowing that an individual in a vulnerable position is unlikely to challenge it. However, it learnt that individuals can acquire knowledge of the system and their rights, at which point it rapidly complied with the regulations.

    Although I had considerable experience of being disadvantaged and persecuted for political, religious, and ethical convictions, I had no experience of discrimination because of the colour of my skin until I arrived in Britain. In 1987 a black woman in an official position left me in no doubt that she did not believe that a white European in Europe can be a refugee and regarded me as someone who takes opportunities away from non-Europeans.

    I must, though, pay tribute to those people in Britain who—through personal encouragement, friendship, and support from their own resources—have made it possible for me and other refugee doctors to be able to contribute to British society.

    Use of oral contraceptives by cases and controls. Figures are numbers of women

    View this table:


    1. 1.
    2. 2.
    View Abstract