State-of-the-art or the art of medicine? Transnational mobility and perceptions of multiple biomedicines among Nigerian physicians in the U.S.^*

* This article is planned to be part of the special issue ‘Mobility and (dis)connectivity in the global health enterprise’, guest edited by Dominik Mattes and Hansjörg Dilger.

ABSTRACT

Over the last 40 years, several thousand Nigerian-trained doctors have migrated to the U.S. to practice in what they regard as the state-of-the-art of global biomedicine. Based on interviews with Nigerian physicians, this article shows how their professional mobility, and their transition to the new professional environment of U.S. biomedicine, makes them aware of local differences in practicing medicine. Adapting to local ways of practicing in the U.S. creates a new sense of belonging and professional identity. Yet they also juxtapose highly technologised U.S. biomedicine with what they were trained to excel in within the medical profession in Nigeria – namely the ‘art of medicine’ – that is, possessing profound clinical skills to diagnose with few investigative technologies. By stressing their competence in the art of medicine, which they see as lacking among their U.S.-trained colleagues, they negotiate their position in a global biomedical landscape and reconnect to a distinctly Nigerian way of practicing medicine. Their narratives thus shed light on perceptions of multiple biomedicines from the point of view of physicians moving from the global South to the global North, and how within a global biomedical landscape both ruptures and connectivities of competence are imagined.

KEYWORDS:

• Biomedical pluralism
• Nigeria
• physician migration
• medicine as art
• global health

Acknowledgements

For valuable comments on earlier versions of this article the author wants to thank Hansjörg Dilger, Dominik Mattes and the AK Medical Anthropology at the Freie Universität Berlin. The author is particularly grateful to the editor and to the anonymous reviewers of Global Public Health for their critical input that helped her improve the article. Finally, the author would like to thank all Nigerian-trained physicians who spared some of their time to answer her questions.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

* This article is planned to be part of the special issue ‘Mobility and (dis)connectivity in the global health enterprise’, guest edited by Dominik Mattes and Hansjörg Dilger.

1 Cf. American Medical Association. Retrieved May 23, 2017, from https://www.ama-assn.org/about-us/about-international-medical-graduates-section-imgs.

2 All names in this article are pseudonyms.

3 Emphasis added.

4 Emphasis added.

5 Retrieved May 23, 2017, from http://stanfordmedicine25.stanford.edu/.

Additional information

Funding

This work was supported by the German Research Foundation (DFG) [grant number DI 893/9].