Joana Sousa Ribeiro Ph.D Student in Sociology CES, University of Coimbra, Portugal ESRC Seminars Migration Policy and Narratives of Societal Steering “Integration, Inclusion and Narratives of Societal Steering” University of Sheffield, 14th of March 2008 The Professional Integration of Migrants – a “Reverse Knowledge Transfer”?

To analyse, in a longitudinal way, the process of professional integration of healthcare professionals (nurses and physicians), coming from countries of Eastern Europe to work in Portugal. To understand how structural pressures (from academic institutions, professional bodies, labour market demands) and opportunities (e.g. subsidised programmes) lead to particular professional integration mobilities. Aims

Main Questions How specific non-State and nonprofit arrangements give rise to particular “opportunity structures”? How are specific non-State and nonprofit arrangements influencing knowledge transfer (or, rather, a “reverse knowledge transfer”)? How do the Third Sector organisations facilitate, or inhibit, the professional integration of skilled immigrants? Is it replacing the State on that process?

Used Methodology Biographical interviews made to nurses and physicians that came from some Eastern European countries (Ukraine, Romania, Russian Federation and Moldova) to Portugal, targeting a longitudinal approach. Semi-structured interviews to Institutional Actors, such as, Physicians’ Association, Nurses’ Association, Health Ministry, a Nurse Trade Union, a Physician Trade Union, a Nursing school, a Medicine Faculty and a Foundation. Interviews and Participant Observation to a Non- Governmental Organisation – Jesuit Refugee Service – that is responsible for the selection of applicants (doctors and nurses), from countries with which Portugal doesn’t have any agreement, in order to participate in a Professional Integration Program, financially supported by a Foundation.

Research Context – Portugal Admission policiesAdmission policies In spite of the announcement of some measures (e.g. the fast-track diplomas recognition, special work visas), there isn’t any special programme targeting the recruitment of skilled professionals. Integration policiesIntegration policies –Portugal does not have an introduction programme (exception “Portugal Welcomes”- Limitations: small-scale, declined participation, limited budget). –ACIDI (High Commission for Immigration and Intercultural Dialogue) has a significant role in the definition and implementation of the integration policies (although the Service for Foreigners and Border Control (SEF) produces some initiatives as well). –Since 1998, a Consultative Committee for Immigration Affairs (COCAI) ensures that immigrant associations, the social partners and institutions of social solidarity participate in defining the integration policies. –Since 1999, the Commission for Equality and Against Racial Discrimination (CICDR) aims to eliminate the discrimination based on race, nationality or ethnic descent. –In May 2007, the government presented a comprehensive Plan for the Integration of Immigrants, for the period 2007 to 2009.

Research Context – Overqualification Per-cent of highly-qualified employed who are working in low and medium skilled jobs ( average, 15-64) Source: OCDE (forthcoming) Native Born Foreign Born Belgium Denmark Germany France Italy Netherlands Portugal Spain UK

Research Context – Eastern Europeans in Portugal The East European immigrants were recently studied by some Portuguese academics (Baganha et al., 2004) that proved the skilled scope of the flows and the underemployment that they suffer. The interviewed East European professionals suffered a downward process of occupational mobility. Most of the males are incorporated in the building sector, as brick-layers, hodman or machine operators. For the women, the work experiences were more diversified. They include working as employees in restaurants, bakeries, poultry farms or cafés; cleaning, fruit wrappers on warehouses, maids, escort services in bars, providing care to disabled and aged persons.

From Brain Waste to Skills Recognition… Institutional arrangements, like the legal framework and the self-regulatory mechanisms of the professions, shape the occupational integration of professional migrants. As medicine and nursing are self-regulated professions, to resume their previous profession the non-EU physicians and nurses had to participate in a process of recognition of their diplomas, performed by the medical and nursing Schools. This recognition generally involves a training period and, only for the physicians, a set of exams – communication, theoretical and patient clinical diagnosis exams. The process is time-consuming, bureaucratic and, as it is not compatible with a work journey, expensive.

From Brain Waste to Skills Recognition… The regulatory frameworks that shape the processes of professionalisation have diversified, not only in scope but also with respect to the interests of different groups involved in these processes. To be able to register as a nurse or as a physician involves a process of re-accreditation, which means the overcoming of systemic barriers and the fulfilment of several institutional requirements, mainly the ones come from medicine faculties, nursing Schools, embassies or consulates, the Borders and Foreign Bureau (SEF), the Health Ministry and employers.

From Brain Waste to Skills Recognition… The health care sector creates a number of specific barriers to professional mobility and integration. There were difficulties related with: a)the unfamiliarity with the regulatory bodies, employers and academic institutions; b) the lack of coordination and miscommunication between academic institutions and professional bodies; c)the process of getting official transcripts sent by institutions outside Portugal; d) the unknowing of the occupation-specific language; e) the lack of recognition of the professional experience gained outside Portugal; f) the adjustment to the Portuguese workplace culture and the misunderstanding of the care giving culture.

Migrants Professional Integration – the Role of non-Sate Nonprofit Actors The Third Sector (e.g. NGO’s and Foundations) has a role in the process of re-acquisition of professional identity: a) as a service provider (of language courses, of training programmes, of financial support); b) as a bridge-builder of social capital; c) as a promotor of internal bonds; d) as a mentor for newcomers; e) as a certifier.

Portuguese Case Study – The Jesuit Refugee Service (JRS) From Voluntarism to Institutionalisation … An “Intimate Civil Society”? (Santos, 1990) 1992A Catholic international organisation, based in Portugal since 1992; Late 90’sLate 90’s: in the context of the East European immigrants’ flows, changed its scope of action - from Refugees towards immigrants; : a Physicians Professional Integration Program were launched with the financial support of the Gulbenkian Foundation; Since 2003Since 2003: growing mediatisation of the JRS activities – created an independent agenda from the State policies; : a Nurses Professional Integration Program were launched with the financial support of the Gulbenkian Foundation and the Equal Programme, co- financed by ESF;

Portuguese Case Study – The Jesuit Refugee Service (JRS) September 2006September 2006: belonging to a Platform of Represenative Structures of Immigrant Communities (PERCIP) in Portugal; : formalisation of the support given regarding the credentials recognition through the creation of the GAEQ (Office for the Credentials Recognition); Since 2007Since 2007: participation as a consultant and as a future manager of physicians overseas recruitment scheme, to be promoted by the Health Ministry; March 2007March 2007: change of its juridical status - from a NGO to a Private Institution of Social Solidarity (IPSS); February 2008February 2008: its leader was co-opted for the ACIDI (knowledge transference regarding the aplication to the NSRF and the credentials recognition).

Final Remarks The social construction of immigrants’ skills, resulted from the selectivity of the migration policies, from the integration policies, or from the absence of both, allows us to understand the importance of the relations among meso- level actors (e.g. the Professional Associations, the non- state initiatives, the academic institutions) as a key factor for the recognition of the “ascribed qualified migrant” to a achieved skilled professional”. Mostly perceived as important actors regarding the implementation of social integration policies, the Third Sector organisations (e.g. NGO’s and Foundations) have also an active role in the “creation of structures of opportunities”, in what regards the re-acquisition of professional identity.

Final Remarks The Third Sector affects not only the migrants’ occupational mobility but also, to some extent, the role of the State involvement in the professional integration process. As a secondary actor, or as a co-operate partner? Reverse Knowledge TransferA “Reverse Knowledge Transfer ”? = The absorption and application of practice-evidence in integration policy making.