Since the 1950s, the presence of overseas-trained doctors of color in the National Health Service in the United Kingdom has attracted persistent attention. Their numbers, countries of origin, training and credentials, right to practice medicine, and cultural competency have all been featured in the medical and lay press. This attention to overseas doctors, a designation that includes doctors from within and outside of the British Commonwealth or former empire, certainly reflects the unprecedented pace of the globalization of the medical profession since World War II, not to mention the rise of a multiracial, multiethnic postwar society. The meaning of the term overseas doctors is not limited to merely describing visible changes in the diversity of the profession. It also extends to affirming presumed certainties about the identity of British medicine. The undifferentiated description of national origins as “overseas” obscures the historical connection between British medicine and its former empire in South Asia. In highlighting heterogeneity, the term also implicitly renders the domestic profession as a homogenous social unit, bounded by the distinctive experience of the British Isles. In other words, collapsing the place of origin into a single modifier “overseas” reinforces the assumption that membership in the community of British medicine is determined by birth and training in the United Kingdom while masking the influence of the wider world in the making of British medicine.

In this book I examine the ways in which the boundaries of nation and empire have influenced the scope of British medicine in the world and as a social institution domestically. Fit to Practice is an institutional history of the General Council of Medical Education and Registration of the United Kingdom (GMC) and its management of the register between 1858 and 1978. As provided for in the landmark 1858 Medical Act, the register was more than a listing of doctors with approved medical qualifications; it also functioned as a common or national portal of entry into the profession for medical graduates from England, Scotland, and Ireland. The register defined the national and imperial boundaries of the jurisdiction of British medicine and membership within it, not only mediating where British medical graduates could practice medicine in the world, but also who was fit to represent British medicine domestically.