4 - The International Crisis of World War II and the Differential Treatment of Overseas-Trained Doctors, 1933–48

Summary

Introduction

As the interwar landscape of international politics rapidly shifted from the threat to the reality of a second global war, the influence of British medicine was once again challenged, from the plight of Jewish medical refugees in the United Kingdom before the war to the wartime need to supplement the domestic supply of doctors. The register proved to be a rather flexible instrument in accommodating overseas-trained and refugee doctors, in large part due to the multiple points of entry to the medical market, yet the conditions under which refugee doctors were admitted to the register and legally entitled to practice medicine were not identical. Institutional interests and national needs shaped whether or not the register differentiated overseas doctors from domestic doctors in ways that assimilated or marginalized them in the community of British medicine. As I will show in this chapter, the experience the council gained in internationalizing the register during wartime established a precedent for a new postwar registration category for overseas doctors. Temporary registration, which became available with the passage of the 1948 Medical Act, combined access to medical labor with restrictions on where and how long overseas doctors could practice medicine in the United Kingdom.

More so than any other group, Jewish medical refugees from the early 1930s on were vulnerable to differential treatment. Fleeing brutal persecution in Germany, Austria, and later Italy, Britain only permitted a fraction to enter as aliens. Stateless and subject to Home Office employment restrictions, these doctors and medical students who sought to practice medicine in the United Kingdom had few choices beyond requalification. As Kenneth Collins and other scholars have documented, nonuniversity licensing bodies in England and Ireland were resistant to calls from the government to accommodate more Jewish aliens. At a moment when the economy was struggling to recover from depression, any increase in the number of doctors beyond replacement levels raised competition anxieties. When the refugee crisis appeared to grow rather than decline, accommodation was seen as a precedent that was liable to change the ethnic composition of British medicine.