They are coming and – I found myself thinking – for goodness’ sake, let’s hope they hit the ground running when they get here. The Foreign Doctors Are Coming (Channel 4) isn’t explicitly a film about NHS staffing or Brexit – there are only a couple of euphemistic references to increased demand for doctors and leaving the EU isn’t mentioned – but in its meandering, neutral way it tells us a lot about how tricky it is to replace a carefully nurtured asset with a new version shipped in from afar. When that asset is people, it is really hard – mainly for them.
Before doctors from outside the EU can join the NHS, they must pass the Plab 2. Set by the General Medical Council at its assessment centre in Manchester, it is a daunting interactive exam in which medics dash in and out of a series of rooms, each containing an actor or a mannequin standing in for a patient, to display their practical skills against the clock. Imagine The Crystal Maze adding a “hospital in meltdown” zone.
The 40% upswing in applicants in the past three years has been a boon for Dr Kuraya Ramaswamy – “Dr Swamy” – who runs a private training academy in a Levenshulme office block. His 12-day course imbues doctors with a quality the Plab 2 looks for, because the NHS prizes it more highly than overseas health systems do: bedside manner. This boils down to conversational and cultural niceties, which are fertile ground for a documentary seeking sweetly funny eccentricity.
Andrew Dedman’s light-touch film focuses on Dr Swamy, who is introduced via a textbook “chat to the windscreen”: driving on the morning commute with the camera riding shotgun, he offers an overview of his professional domain that suggests his office is more a comedy stage than a workplace. “The Manchester people have a special accent,” observes Dr Swamy, weaving gaily through drizzle. “What they say is: ‘Nice one, mate. Are you all right, cock?’ It is very, very, very funny here!”
With Sue Johnston’s narration shifting from serious to deadpan, and a soundtrack of those nimble, vaguely sarcastic classical flourishes pioneered by The Great British Bake Off, absurdity reigns. A session on explaining the need to insert a catheter into the urethra provides an easy comic win, as a student solemnly converses with what Dr Swamy christens “Mr Smith”: a grey plaster model of a penis, testicles and a pelvis.
The scenes with the most thespian fun are ones in which Dr Swamy casts himself as the difficult patient or relative, opposite a student playing a doctor on their rounds. In one of these improvs, Youven, a clammy bag of nerves despite being a qualified medic back in India, tells Dr Swamy that his imaginary wife is “in the hands of God”. Dr Swamy leaps on the error. “I want a proper doctor! Is this how you talk to me?” As soon as his bravura rendering of an insufficiently mollified spouse is over, he looks straight down the lens and grins, a breaking of the fourth wall that even Nev from The Call Centre may have felt was a bit cheeky.
Later interviews show, however, that beneath that flip exterior is a solid-silver hero. Dr Swamy keeps in touch with successful former students and is acutely aware of how important his work is, for the NHS and the applicants. As the film goes on, he melts away and we track the doctors: Anna, a sensible type from Brazil blinking levelly through big specs, and Youven, who crumbles painfully.
Youven arrived two years ago to start a family and pursue a dream of flourishing in Britain. Most of that time has been spent bringing his English up to speed, while toiling in low-paid jobs. Now it is the big one and his wife and one-year-old daughter are relying on him. Their savings have only just covered the Plab 2’s rather unwelcoming £840 admin fee.
People taking important professional exams often make for surprisingly moving observational documentaries – Channel 4 had one last year about cabbies doing The Knowledge that was as gripping as an Olympic final – but this ends up more bleak than exciting. While Anna edges through, Youven is burdened by the sacrifices he and his loved ones have made and he slides irreversibly into a panicked funk.
We are told that Youven intends to retake his Plab 2. His ilk deserve all the help they can get, because the stakes, for them and us, look awfully high.