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Many women refugees face a difficult and dangerous journey to the UK. They leave behind their extended families, friends and communities. Once in the UK they face a bewildering set of problems.
As well as social and language barriers, they need to find somewhere to live, schools for their children and face the long bureaucratic legal task of having to verify their refugee status in order to gain any form of employment.
Like many other foreign doctors seeking to practise in the UK, they also need to pass a series of English language assessments and undertake clinical placements before they can get GMC registration.
Frances Lefford, the Medical Women’s Federation representative on the BMA’s Refugee Doctors and Dentists Liaison Group runs a book club at the RWA (Refugee Women’s Association) to help women refugee doctors improve their conversational English. She talks about how this group came about and what women gain from being part of it.
How did you come to establish a book club for refugee women doctors?
I helped refugee doctors at the RWA, with CV preparation and job applications. While chatting with a young refugee doctor, I discovered that she had recently failed IELTS (International English Language Testing System, one of the language exams for international doctors seeking GMC registration) despite speaking English fluently.
She gave me the impression that there were cultural issues underlying this. This prompted me to suggest setting up a book club at the RWA to help the doctors improve their conversational English skills.
I have taught and mentored undergraduate medical students for many years at University College London. I was also doing weekly clinical sessions as a GP so I was familiar with the NHS structure and training programmes for junior doctors.
I felt that a book club would support women doctors dealing with a work situation which had parallels with the challenge of unemployment CV gaps which I and my peers had faced previously – because of demanding domestic commitments, child care, and lack of flexible working hours.
How does the group work?
Book club meetings run monthly from September to July each year. The RWA book club recruits book club members, houses the book club library and provides the all-important tea and biscuits. Jasmina Dimitrijevic, the RWA project manager, co-facilitates the meetings.
About 26 women refugees have come to the book club over eight years. These have mainly been qualified doctors, occasionally other healthcare professionals, usually nurses. The majority have come from Afghanistan, Iraq, Iran and Sudan.
They range from women in their late twenties, who have recently graduated in their home country, to experienced women doctors in their 40s most of whom have school-age children.
The women refugees can’t always attend and therefore short stories have been more manageable for monthly discussions. Popular books have included The Moth: a collection of personal short stories and A Thousand Splendid Suns by Khaled Hosseini, which we read over four meetings.
One of the doctors in the group passed her IELTS exam soon after we had completed this, which was a joyous event and a powerful incentive for the rest of the group.
What kind of issues do you discuss in the group?
Members feel comfortable to discuss challenging cultural and social topics – often provoked by the book we’re reading. This has led to lively discussions on female genital mutilation, euthanasia, organ donation and abortion.
What kind of personal challenges have the women refugees experienced?
Although every individual is unique, consistent themes have emerged: a sense of dislocation and a painful loss of professional identity as well as social status. Many women fear becoming deskilled and becoming socially isolated.
As mothers they are pleased and proud that their children can speak English and progress within the educational system. However they have concerns about their children’s loss of cultural inheritance and values.
Why do you think it’s been successful?
Refugee women doctors often have a high status in their home communities with good salaries. They find their current refugee situation demoralising and sometimes humiliating. It’s important that a doctor leads the group because it reinforces their professional identity as members of a peer group. However it is particularly hard for women who are experienced consultants as they have to re-train.
The social environment is key. It’s a small group and discussion is relaxed and non-judgemental. The setting is safe but it takes time for some members to feel accepted and able to speak about confidential issues.
A doctor told us that she felt embarrassed when chatting with the mothers of her children’s school friends. When she was asked where her family were living previously, she answered, ‘I was in Holloway, [part of Islington in north London] and repeated that several times. Everyone assumed she was had been in Holloway prison and began questioning her credibility. This was soon clarified but was an uncomfortable experience.
The overall mood lightens during meetings and group members become more confident, expressive and fluent when speaking English. Women also learn about British culture. When someone passes IELTS and can move on to take the professional clinical exams there is a group celebration. We laugh a lot and we also share sadness and sorrows faced by refugee women doctors.
I thoroughly enjoy exploring the idiosyncrasies of the English language with the group, comparing cultural customs and values, sharing experiences we have in common and challenging cultural boundaries.
Frances Lefford is the Medical Women’s Federation representative on the BMA’s Refugee Doctors and Dentists Liaison Group. She has been a GP and senior lecturer and clinical researcher at University College London.
Some useful links:
BMA‘s Refugee Doctor Initiative
The BMA provides a range of free support for refugee doctors including 24-hour counselling service, individual advice on employment issues and access to the BMA’s library. BMA charities may help with costs, including relocation costs, for refugee doctors who are registered with Reache or Building Bridges.
Refugee Women's Association
RWA provides advice and training on a range of issues affecting women refugees, including their rights, entitlements and employment, including English language skills. For more information about the book club and language skills for refugee women doctors contact Jasmina Dimitrijevic (Project Manager) - [email protected]
Building Bridges Programme
The Building Bridges programme is an NHS-funded partnership between the Refugee Council, London Metropolitan University’s Refugee Assessment and Guidance Unit (RAGU), and Glowing Results, which provides support to refugee health professionals in London.
The programme supports refugee doctors to re-qualify to GMC standards and secure employment appropriate to their professional qualifications. It gives support with passing all the registration requirements – including the PLAB exams and pre-employment clinical attachments.
Reache North West
REACHE North West supports refugee doctors living in the North West of England with their GMC registration. It provides: English classes, PLAB examination preparation, placements and clinical attachments and other support.