Migrant clustering: the role of patronage networks in South Asian medical migrants' labour market participation in the UK

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Migrant clustering the role of patronage
networks in South Asian medical migrants' labour
market participation in the UK

• Parvati Raghuram,
• Joanna Bornat and Leroi Henry
• The Open University

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

• Two year ESRC funded project to undertake oral
  history interviews with working and retired
  geriatricians trained in South Asia in order to
  explore their experiences and contribution to the
  development of the care of older people in the
  UK.
• http//www.open.ac.uk/hsc/research/research-projec
  ts/geriatric-medicine/home.php

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Literature and gaps

• Social networks in migration
• Migrant networks as exclusive
• Skilled labour migration and networks
• Networks as facilitative
• Clustering
• Clustering as disadvantage

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Methods

• 60 oral history interviews with retired and
  serving geriatricians
• 16 Completed
• 8 Transcribed

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Selection of informants

• Primarily recruited through British Geriatrics
  Society
• Invitation letters
• Newsletter
• Personal contacts
• Searches of hospital and other websites
• Snowballing

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Current sample

• Gender all male
• Post
• Nine retired or semi retired consultants
• Six serving consultants
• One serving junior doctor
• Country of qualification Nine Indian, one
  Bangladeshi, three Sri Lankans, one Burmese, two
  Pakistani
• Geographically dispersed but clustered in North
  Wales, South Wales, Manchester and West Midlands

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Geriatrics
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Geriatrics
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Findings

• Socio-cognitive networks
• Family and friends leveraging the structural
  temporariness of labour markets
• The embodiment of patronage in networks
• Networking across disciplines

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Socio-cognitive networks (a)

• power of narratives related to training in the
  UK.
• doctors mobility embedded in a network of
  professional development
• breakdown in connectivity due to barriers based
  on assumed superiority or prejudice might present
  substantial impediments to mobility inside the UK

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Socio-cognitive networks (b)

• The first two weeks I was getting acclimatised,
  wondering what to do then my brother found this.
  And I sent job applications with my reference
  from consultant and so on and didnt work at all,
  you know, when I first came. I sent lots of
  applications with copies of my glowing reference
  from my consultant in Sri Lanka, didnt help at
  allYeah. So I think once you get a good
  reference then its good. But patronage
  definitely helps because Ive certainly seen
  British people doing it too. They know somebody
  who knows somebody and they are its more
  difficult now, its more fair actually now.
  Patronage doesnt help that. P0021

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The structural temporariness of labour markets

• Role of source country social networks in
  facilitating and lowering the costs of migration
• Critical role of short term contracts in
  obtaining first jobs and thus accessing UK
  doctors patronage systems
• Limits of source country networks

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Source country networks and the structural
temporariness of labour markets (b)

• it was quite common for me for example to ring my
  friendand say Hey look theres a Sri Lankan
  doctor whos very very good, hes done very
  nicely, hes coming overAre there any jobs
  coming up there? Then he will say Well there
  are no jobs here but there is a locum that Im
  looking for. In fact Im stuck actually I need a
  locum in situ very badly. Would your chap I
  said Yeah, he would be very good So he offered
  the locum to him. And then he got his first job
  you see and got a reference. And thats the first
  thing, you need a reference. Because if you get a
  reference from Sri Lanka it doesnt mean the same
  thing as one from here. Oh then he would say A
  permanent job is coming up, you can apply but of
  course I cant guarantee the job you will have to
  come for interview and see and obviously you
  cant plant but you can get opportunities like
  that. And locums were the greatest opportunity
  because you cant give a person a permanent job,
  you know, but you can always give a person a
  locumSo we used to certainly phone each other
  and say if we know and that used to start from
  Sri Lanka.

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The embodiment of patronage in networks (a)

• Engaging with pre-existing UK patronage systems
  through demonstrating worthiness
• Networks embodied in the consultants
• Space for prejudice, idiosyncrasy and
  discrimination
• Access to consultants horizontal networks
• Limits and boundaries

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The embodiment of patronage in networks (b)

• In that post I spent most of the time in the ward
  looking after the patients. Being totally
  committed to the patients and teaching. And
  making myself known by presenting cases to the
  various groups of meetings. Whatever I could do
  locally to people to know me I made every effort.
  When most of the people might go home by five o
  clock I never went home until I see my last
  patientAnd so one day one of the consultants
  turned up at about six thirty, seven in the
  evening and he saw me still doing the round and
  said What are you doing there? Im finishing
  my patients. Still there are two more left He
  said You are too dedicated he said, and the
  next year recommended me for a senior
  registrarship post to the professor.

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Networking across disciplines (a)

• Barriers to chosen specialty / geriatrics as
  accelerated promotion
• Support from gurus
• Clustering as recognition of opportunities in the
  context of discrimination

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Networking across disciplines (b)

• L0025 I knew that I will never get a job in
  general medicine, it is highly competitive and
  the preference is given to the local population.
  I didnt feel bitter about it because Ive
  experienced that before in another country.
  (laughs) So I didnt feel bitter about it. I
  said Whatever the job I get Ill take geriatric
  medicine and then see how it is
• L0023 Because my consultant, who was exactly
  like me, I know him now, he was a trained
  cardiologist and then there were openings in
  geriatrics so he quickly moved into that area and
  he said Look if you want to go through the fast
  track up then this is a less crowded road. You
  could do geriatrics and you could do cardiology
  and you could, it would be a good way up rather
  than waiting in the queue

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Conclusions

• Diversity of networks familial, professional,
  source country and patronage that migrants
  navigate
• Migrant and non-migrant networks are not wholly
  distinct. Migrants too become incorporated into
  non-migrant networks over time.
• Type of networks and what they can do for
  migrants varied over time and career trajectory
• Migrants agency in managing networks
• Partial incorporation into networks can lead to
  ethnic clustering even amongst skilled workers