Doctors Beyond Borders: The Transnational Migration of Physicians in the Twentieth Century ed. by Laurence Monnais and David Wright (review)

The breadth and depth of Doctors Beyond Borders is reflected in its index, which literally spans A (AB Astra) to Z (Zanzibar), yet its editors make clear in their apposite introduction that the book is "selective in its coverage… [and] focuses on physician migration… within the English-speaking world" (15), noting that similar research could and ought to be undertaken for physicians across la francophonie, along with Spanish-speaking doctors in Latin America. Nonetheless, included in this sweep are studies based in the Caribbean, Australia, New Zealand, Sweden, Ireland, United States, United Kingdom, East Africa, and Canada. Also impressive is the consistent high quality of all ten essays by the sixteen contributors, along with the many attempts by authors to refer to each other's works in the collection thereby conferring a coherence that is not always found in such projects.

Central to most essays are issues of race, ethnicity, culture, gender, and to some extent class, and how such factors were often either stimuli for migration and/or obstacles to assimilation in a new institutional setting and homeland. While many instances of frustrated hopes and dreams are documented based on a wide array of archival sources, the printed record, and oral histories, others reveal surprisingly constructive outcomes and positive changes to local societies and healthcare practice worldwide. Juanita De Barros in her study of West Indian physicians from 1900 to 1938 argues that discriminatory imperial and colonial policies at this time negatively affected these doctors, but moves to counter and dismantle them began when these same doctors returned from international medical studies imbued with new social and political ideas and network contacts useful in their fight against racism. Sex discrimination is explored in John Armstrong's essay, which examines the plight of women doctors in New Zealand from 1945 to 1975. As New Zealand's medical institutions were, for all intents and purposes, an extension of those in Britain an "old boys' club" atmosphere prevailed. Established (male) doctors mentored younger doctors (also overwhelming male) to follow the path they previously took by pursuing postgraduate medical training in the UK. This pipeline consisting of "international connections… and network of informal professional relationships … [was] heavily gendered" (119) as it excluded young women who might wish to pursue specialty medical education abroad resulting in a disproportionate number of female specialists, or a clustering of those who became specialized in gendered fields such as obstetrics and children's health.

War, too, occasioned medical migrations with mixed consequences. John Weaver's contribution on the flight of Jewish doctors to Australia and New Zealand from 1933 to 1945 reveals that while hundreds of doctors were admitted to these countries, those who were granted registration to practice was only a fraction of that number. Curiously, Italy was a conduit for many as an antiquated law recognized Italian medical credentialing; for many other medical refugees the path to the antipodes was an arduous one with no guarantee of being granted a medical licence — many ending up as health inspectors or laboratory technicians. In comparison, only twenty-five Jewish doctors migrated from Nazi Germany to Sweden as Annika Berg shows, yet the debate within the domestic medical profession that ensued over them was heated and complex. Those opposing were not necessarily anti-Semitic, while the agenda of supporters was not always grounded in humanitarianism; rather, issues to do with the healthcare labour market and the economics of medical practice figured. The war in Vietnam resulted in about 125,000 "draft dodgers" crossing into Canada from the US between 1966 and 1976 and, as David Wright, Alex Ketchum, and Gregory Marks explore, not surprisingly there were medical migrants among them. Actual numbers may have been small (perhaps only a couple of hundred), but the situation was complicated as such migrants include qualified American...