Lisbon , Portugal

No more Doctors as Stone Masons! Recognition of the Qualifications of Immigrant Doctors and Nurses

Jesuit Refugee Service & Calouste Gulbenkian Foundation

February 16, 2011

Solving the doctor shortage by helping immigrant health professionals re-enter their fields

When Alexandru Godina arrived in Portugal from Moldavia, the only work he could find was a stone mason despite his experience as an internist and head of a small-town clinic.

Yet, as with the rest of Portugal, the city of Lisbon has a shortage of qualified medical professionals.

And like most global cities, they also had hundreds of highly educated and underemployed immigrants like Godina, already living within the city, waiting for the chance to use their training and skills.

Many of these were doctors who had come from countries that did not qualify for automatic recognition of their degrees. Since the recognition process involves financial, administrative and support barriers, many of these medical professionals were as a result, grossly underemployed and forced to work jobs that were not reflective of their training, ambitions or potential contribution to their new country.

Working Solutions

To bridge the gap between the lack of practicing doctors and immigrants whose skills are unrecognized, the Calouste Gulbenkian Foundation together with the Jesuit Refugee Services created the Professional Integration of Immigrant Doctors project. It was part of the foundation’s effort to involve more practical experimentation in the area of social and professional integration of immigrants.

The program ran from 2002 until December 2005 and had the goal of helping 120 immigrant doctors, not currently working in the medical profession, to transition back to their professional careers.

Since each of the doctors in the pool had a different background and unique challenges, the project subsequently provided each one with a tailor-made solution. However, all of the candidates still went through the following stages: candidate selection, gathering of all required documents, delivery of the documents to medical school; training period, final exam, and registration in the medial council and professional integration.

In addition to social support through the Calouste Gulbenkian Foundation, the program also provided practical financial support to alleviate cost barriers for application and translation fees, textbooks as well as Portuguese language courses focused on technical medical terms that would help transition immigrant doctors into the Portuguese hospital environment.

The project also used strategic partnerships as a way to create the administrative and governance framework that would best support the project. For instance, through partnerships with migration services, the project was able to expedite the renewal of visas; with frequent contact with the medial council, they facilitated the bureaucratic process; and they used their contacts in the Ministry of Health to lobby to support the placement of these doctors in the labor market.

Building on Success

By the end of the project, almost 90% of the doctors (including Alexandru Godina) were practicing medicine again and as a result, contributing and integrating more fully into Portuguese society.

The Calouste Gulbenkian Foundation and the Jesuit Refugee Service used the pilot as a jumping off point to refine their ideas. In 2005, they started a new two-year program focused on the qualification of nurses with the help of the Amadora-Sintra Hospital and the Francisco Gentil Nursing College, incorporating lessons learned from the initial project. For instance, they added support for the individual nurse or doctor’s family to create a more successful and holistic integration. Another improvement features a more efficient and organized Portuguese language course since it was identified as a key factor for success.

However, the Calouste Gulbenkian Foundation and Jesuit Refugee Service realized that the only way to facilitate the long-term entrance of recognized doctors into the labour market and overcome administrative time gaps was through legislative and systematic changes that included agreements with both health institutions and the Ministry of Health.

By late 2008, the success of the previous projects led the national Ministry of Health to partner with the Calouste Gulbenkian Foundation and Jesuit Refugee Service, and fund a new program, the Professional Integration of Immigrant Doctors (PIPMI) that will matriculate  -and integrate- another 150 immigrant doctors per session. In December 2010, the Foundation renewed its commitment to this groundbreaking programme for a third year (2011).

As Andre Jorge, Director of the Jesuit Refugee Service, says, “This program is an example that can improve the lives of immigrants who come to us and simultaneously meet the needs of the country’s development.”

Making it Work for You:

  • When implementing practical solutions to integration problems, look for the systemic or overarching cause as the way to make the larger and more permanent change.
  • The combination of social support, strategic partnerships and practical financial support all contributed to the success of this project.
  • Ensure the language training is appropriate for the profession.
  • Include support for the families involved.

Themes: Work