Introduction

For critics of the GMC, overseas doctors of color signified the collapse of the historical boundaries of nation and empire that had long restricted the practice of British medicine domestically to a distinct social group. Rather than expanding these boundaries in order to privilege white male doctors in the broader world, the register now facilitated the globalization of the profession within the domestic sphere. In aggregate, overseas doctors accounted for 51 percent of all admits to the full register between 1955 and 1966. Among member states in the Commonwealth, India and Pakistan were the leading exporting countries. In the medical and lay press, Indian and Pakistani doctors were unfavorably compared with doctors from nonreciprocating countries in Europe who practiced medicine under the far more restrictive terms of temporary registration. Their entitlement to full registration was deemed as little more than an obsolete privilege of a bygone imperial era when British doctors controlled the portals to Western medicine in colonial India. Decolonization not only yielded the modern nation-states of India and Pakistan but, it was feared, also diluted British medicine due to the purported national differences in medical education overseas.

Rendering these doctors into a globalized workforce suitable for Britain would involve dismantling their historically constructed access to the register as equals to domestic graduates. The retraction of reciprocity and the withdrawal of recognition would restrict medical graduates of India and Pakistan to the temporary register. Just as political imperatives informed the historical basis for opening the register to them, so too did the decision to narrow it. Even though calls for reforming the system of registration were framed in terms of buttressing the standards of medicine and ensuring patient safety, the GMC and policy makers were mindful of the internal contradictions of postwar British medicine: Britain's dependence on overseas medical labor in the face of growing demands from both the medical profession and the public to control that workforce. Although the respective decisions by the government to retract reciprocity from Pakistan in 1972 and by the GMC to withdraw recognition from Indian medical schools in 1975 were procedurally different, the net effect was the same: channeling access to the temporary register while keeping overseas medical labor under strict control in Britain.