Making it to the Registers: Documenting Migrant Carers' Experiences of Registration and Fitness to Practise

在英国，谁可以成为并一直是一名专业的医疗工作者？鉴于人口老龄化的高收入国家普遍缺乏合格的医护人员，这一问题变得尤为突出。目前英国医疗人员的国际构成是几个因素的结果，其中之一是围绕医疗职业把关职能的斗争。更具体地说，与专业人员必须满足的技能、知识、健康和性格有关的注册和执业适宜性(Ftp)监管工具在建设现代化、专业化和多样化的医疗队伍方面发挥着关键作用。《登记在册》为全球移民照顾者深入探讨了这两种工具的真实面貌。最近的疫情突显出英国医疗保健对国际劳动力的依赖，但利用海外培训的护理人员作为灵活来源，以适应英国时断时续的医疗人力挑战，既不是什么新鲜事，也不是什么特例。因此，《注册》将侧重于这两项要求(注册和文件传输协议)的演变，并以历史文献为基础，比较法定监管者对三种“危机”情况的不同反应：二战、1960-70年代外国医学毕业生的“供过于求”，以及冠状病毒大流行。在某些情况下，监管机构更容易扩大法定登记册，以增加医护人员的可用性，而在另一些情况下，监管机构收紧要求，使其更难进入登记册。危机时期的监管选择对医疗保健劳动力的结构有长期的影响；因此，深入研究这些选择可以为更广泛的职业监管改革提供见解。BAPIO(英国印裔医生协会)是一个有25年游说和支持来自亚洲和欧洲的移民医生和护士在英国从事专业工作的组织，该组织构思了“进入注册机构”。Bapio的工作对监管政策的变化和专业人员个人的迫切需求做出了反应，这是可以理解的，这种与“进入登记册”的合作将使其能够回顾其机构历史，并评估其对移徙工人的影响，以规划其未来的工作。该项目将综合运用历史学、法律学、人类学、卫生多样性社会学和用户参与活动的学科和方法，以及我们合作伙伴和其他组织的经验和专业知识。在第一阶段，我们将使用档案研究方法来生成原始知识，了解专业监管机构和其他机构如何在历史上推广、制定、修改、使用和记录海外培训的医护人员的注册和ftp工具。在第二阶段，该项目将评估第一阶段调查结果中出现的主题，以调查移徙工人目前使用监管制度的经历。这将通过访谈和用户参与活动与BAPIO一起完成。在第三阶段，我们将在文化机构(兄弟特别收藏、利兹剧场、纱线和难民理事会)的支持下展示该项目的更广泛的适用性。我们将以各种可访问的形式制作、分享和保存原创见解，以扩大学术、政策和公众对农民工和支持他们的积极分子如何体验职业监管工具的理解。这将得到一个分享活动的支持，该活动将把移民医疗工作者、专业监管机构、政策制定者和媒体聚集在一起，一个共同策划的开放获取数字档案，以及一个以英国移民医疗劳动力为主题的政治戏剧项目

Who gets to become and remain a professionalised healthcare worker in the UK? This question has become particularly salient given the endemic shortage of qualified healthcare workers in high-income countries with ageing populations. The current international make-up of the UK healthcare workforce is the result of several factors, one of which is the struggle over the gate-keeping functions of the health professions. More specifically, the regulatory tools of registration and fitness to practise (FtP), which relate to the skills, knowledge, health, and character that professionals must satisfy, play a key function in the construction of the modern, professionalised, diverse healthcare workforce. 'Making it to the Registers' zooms in to interrogating in-depth the lived dimensions of these two tools for global, migrant carers. The recent pandemic highlighted the reliance of UK healthcare on an international workforce, but the use of overseas-trained carers as flexible sources to adjust to the UK's spasmodic health workforce challenges is neither new nor exceptional. 'Making it to the Registers' will therefore focus on the evolution of these two requirements (registration and FtP) and build on historical literature by comparing the differentiated responses of statutory regulators to three 'crisis' situations: WWII, the 'oversupply' of foreign medical graduates in the 1960-70s, and the coronavirus pandemic. In some instances, regulators made it easier to expand the statutory registers to increase the availability of healthcare personnel while in other instances, regulators tightened requirements to make it more difficult to get onto the registers. Regulatory choices during periods of crisis have long lasting effects on the structure of the healthcare workforce; studying them in depth can therefore provide insights for the reform of professional regulation more broadly.'Making it to the Registers' was conceived with BAPIO (British Association of Physicians of Indian Origin) an organisation with 25 years of experience in lobbying for and supporting migrant doctors and nurses from Asia and Europe to work professionally in the UK. BAPIO's work has been understandably reactive to regulatory policy changes and to the individual pressing needs of professionals, and this collaboration with 'Making it to the Registers' will enable reflecting back on its institutional history and assessing its impact on migrant workers to plan its future work. This project will deploy together the disciplines and methods of history, legal studies, anthropology, sociology of diversity in health, and user-engagement activities, as well as the experience and expertise of our partner and other organisations. In Phase 1, we will use archival research methods to generate original knowledge about how the tools of registration and FtP for overseas-trained healthcare workers historically came to be promoted, enacted, modified, used, and documented by professional regulators and other institutional bodies. In Phase 2, the project will take stock of the themes emerging from the Phase 1 findings to investigate current experiences of migrant workers with regulatory systems. This will be done in conjunction with BAPIO via interviews and user-engagement activities. In Phase 3, we will show the project's wider applicability with the support of cultural institutions (Brotherton Special Collections, Leeds Playhouse, YARN, and Refugee Council). We will produce, share, and preserve, in a variety of accessible formats, original insights to enlarge academic, policy and public understandings of how regulatory tools of the professions get experienced by migrant healthcare workers and the activists that support them. This will be supported with a sharing event bringing together migrant healthcare workers, professional regulators and policymakers and media, a co-curated open access digital archive, and a political theatre project on the theme of UK's migrant healthcare workforce