If you visit a restaurant or want your car washed in East Ham, one of London's poorest suburbs, chances are that you will be served by a waiter or a garage attendant who is actually a qualified medical doctor from India.
Drop in at the Mahalaxmi temple in East Ham or at the Swaminarayan temple at Neasden or elsewhere in Britain, and you would most likely partake of the 'prasad' (free meal) in the company of unemployed Indian doctors, who would avoid meeting your eye.
For thousands of such Indian doctors, Friday's high court ruling, disallowing a judicial review of the changes to immigration rules in April 2006 that made it virtually impossible to gain employment in Britain's National Health Service (NHS) is the latest in the saga of shattered dreams, ennui and frustration.
The employment situation for the doctors was difficult long before the high court ruling was delivered. For several years, doctors from India have struggled to find suitable training posts even after passing the mandatory tests for employment in the NHS.
Thousands have sought refuge in the slums of East Ham, where nearly ten live in accommodation meant for two persons. In most cases, the houses they live in are infested with rats, cockroaches and bedbugs.
"With what face do we go back to India and say that we could not get a job in Britain? We took loans from family and friends to come here. That money has run out long ago. Our family members have no idea of our plight," Deepak Srivastava (name changed), a doctor from Delhi, said. Deepak and his colleagues say that widespread coverage of the Friday judgement in the Indian media is likely to cause unease among their friends and family members back home.
"How can we now inform our family members that all this while we have actually been working as waiters, washing cars or doing other jobs that we would never accept in India", Deepak said.
Long before the April 2006 changes to immigration rules, Britain's General Medical Council had begun cautioning non-European Union doctors about the job situation here. A survey conducted by the organisation before the changes were announced revealed that even after doctors passed the qualifying tests, finding employment had become increasingly difficult.Key findings of the survey were: Of those International Medical Graduates (IMGs) who passed the qualifying tests between January and September 2004, only 48 per cent found their first post within six months.
For those passing between October 2004 and February 2005 this dropped to only 35 percent. Of those who did find posts, 74 percent of the posts were for less than six months. Of those IMGS who passed between January and September 2004, 19 percent had not found a post after a year. For those passing between October 2004 and February 2005 this jumped to 34 percent. The GMC said: "We anticipate International Medical Graduates' (IMGs) employment prospects will significantly worsen following the Department of Health announcement that from 3 April 2006, IMGs who wish to work or train in the NHS will need a work permit".
Every day, nearly a 100,000 job applications are posted. A doctor of Indian origin, who holds a senior post in the NHS, told IANS: "Hundreds of applications are received for even minor jobs, mostly from these unemployed Indian doctors. Nobody has time to go through them.
"You need to show some work experience to brighten your job prospects but it is extremely difficult to get that work experience. Some hospitals now charge the unemployed doctors to work for a few days or weeks so that they can then claim some work experience. But that too is no guarantee of a job". There are several reasons for too many doctors chasing too few jobs here.
The NHS has been facing budget cuts for some years, forcing it to reduce manpower. Local medical colleges are also producing more medical graduates, many of whom find themselves in the same situation as their Indian counterparts - they are also unable to find jobs.Added to this is the large number of medical professionals from an expanded European Union who have the right to work in Britain.
A major reason for the large number of unemployed Indian doctors in Britain is the increased frequency of holding the mandatory qualifying test called the Professional and Linguistic Assessment Board (PLAB) test. Every overseas doctor needs to pass this test before being registered for possible employment. Earlier this test used to be held twice or thrice a year.
Now it is held twice or thrice a week. The success rate is also higher with the result that there are now more doctors who have cleared the test. According to official figures, nearly 1,000 passed the test in 1998, but the number sprung to 6,666 in 2005. Parts of the PLAB test are held in centres in India while one part is held in London. Coaching centres are flourishing in places such as East Ham, while many doctors fall easy prey to similar services offered on the internet.