For resident doctor Salih Suliman life is finally starting to look up.

Born to Eritrean parents who had to flee their home country owing to war, Dr Suliman was born in Saudi Arabia. From an early age he had dreamed of becoming a doctor, inspired in part by watching his grandfather provide traditional medicine to friends and neighbours.

Now a specialty trainee 2, with dreams of one day becoming a GP, Dr Suliman is enjoying his work and his new life in Manchester where, when he is not caring for patients, he enjoys spending time with friends, engaging in charity work and playing football.

To reach a point where he could live the kind of normal life many other people take for granted, Dr Suliman was forced to flee his home and endure many years of uncertainty, isolation and danger as an asylum seeker.

Figures published by the Commons library show that, in 2024, there were 84,200 applications for asylum in the UK relating to 108,100 individuals, then the largest number ever recorded, with data up to June this year showing 88,700 applications relating to 111,100 people.

While there are no definitive statistics on the numbers of healthcare professionals seeking asylum or holding refugee status, the BMA believes there could be up to 2,000 refugee doctors now living in the UK.

Securing refugee status in the UK is often just the start of the challenges faced by many doctors seeking asylum, with those who do obtain asylum then faced with an uphill struggle to re-enter medicine and resume their careers.

After completing his initial education in Saudi Arabia, and undertaking medical training in Ukraine, Dr Suliman worked for a time in Egypt and saw the revolution of 2011 and the start of the 'Arab Spring' first hand.

After briefly returning to Eritrea, Dr Suliman began to fear for his safety after being threatened with conscription into the Eritrean armed forces.

Fleeing to Europe in 2014, Dr Suliman began what was to be a more than 12-month struggle to find safety, an ordeal which saw him criss-cross Europe attempting to find refuge.

‘I arrived in Greece and was told [by the authorities] that, “Greece is broke, we aren’t going to help you”,’ recalls Dr Suliman who, following his arrival, was held in detention for one week, surviving on just one meal a day.

‘I lost quite a lot of weight in just those seven days. I was then told to leave Greece in one week or face prosecution, so I had to flee to Macedonia.’

Things only got worse for Dr Suliman after arriving in Hungary; a country that, under the leadership of Viktor Orbán, has become infamous for its harsh treatment of migrants and asylum seekers.

‘In Hungary, the police were really brutal,’ Dr Suliman says. ‘I think at that time [2014] Ebola was going on and they were particularly afraid of dark-skinned people. 

‘They put us in isolation, they stripped me. I had 200 euros on me and they took it all. I saw people getting beaten, so I was compliant with whatever they asked. We [asylum seekers] were detained for 36 hours with no meals and no access to toilets.’

Despite having even his shoes taken from him, Dr Suliman was able to escape from where he was being detained and left Hungary for Austria where he again attempted to claim asylum. 

After waiting three months for a decision, he was advised that his claim had been unsuccessful and that he would need to return to Hungary.

Efforts to claim asylum in Germany proved equally fruitless, leading Dr Suliman to go to France where he saw a group of fellow asylum seekers living under a bridge in lieu of any support from the state.

After being chased out of a number of police stations he had voluntarily attended in an attempt to apply for asylum, Dr Suliman knew he could no longer remain in France.

After stowing away in the back of a lorry, Dr Suliman arrived in the UK in 2015 and once again sought to claim asylum; a process that, at that time, required him to report to the police and Home Office every two weeks.

From first arriving in the UK, it took a total of six years before Dr Suliman was able to secure refugee status. 

During that time his application was initially rejected, a decision which saw him come close to being removed once again to Hungary, before a judicial review of his case overturned the decision and, in 2021, finally ended his ordeal. 

‘I’d been called “illegal immigrant” until I thought that was my name,’ reflects Dr Suliman.

‘In 2015, I already spoke three languages before I came to the UK, and one trick I used to learn new words was linking words that sounded alike. 

‘It’s funny now to realise I once connected “immigrant” with “imagination” as if moving countries and building new worlds in my head were somehow the same thing. But the word “illegal”? There was nothing I could link that to.

‘Despite all odds, I am glad that I am not only serving but thriving. I have started my GP training; I have started giving back to the community. I hope others will be given a chance to be as lucky as I am.’

Despite the positive outcome, the effects of those years, particularly on his career, were enormous.

‘While I was an asylum seeker I wasn’t allowed to work or do anything,’ explains Dr Suliman.

‘In total, I did not work or practise medicine for nine years.’

‘After a full decade in the UK in which I spent six years of my life on pause, not because I lacked skills, but because a system told me to wait. 

‘You are an asylum seeker you do not have rights yet [and] I wonder what I could have accomplished.’

Historically, doctors waiting more than 12 months for an outcome on an asylum application had been able to seek work, with medical professionals included on the SOL (the shortage occupation list).

The scrapping of the SOL and replacement with the ISL (immigration salary list) in April 2024, however, changed this, with medicine no longer included following recommendations made by the Migration Advisory Committee.

This decision has disproportionately affected asylum-seeker doctors, many of whom spend years unable to work while waiting for their bids for asylum or subsequent appeals against rejections to be decided.

In a letter to the Parliamentary under-secretary of state for migration and citizenship Seema Malhotra earlier this year, BMA council chair Tom Dolphin called for the permanent reinstatement of asylum-seeker doctors’ right to work.

‘Being unable to work can negatively impact mental health and can hinder a person’s ability to rebuild their life in their new communities,’ wrote Dr Dolphin.

‘It takes huge drive and motivation to become a doctor, and we understand from our own members that medicine can form a fundamental part of their unique identity. Helping asylum seeker and refugee doctors re-enter medicine in the UK goes some way to helping them to reclaim that sense of identity while benefiting our country.’

Sadly, Faisal Ibrahim (name changed) knows only too well the toll this state of limbo can have financially and psychologically.

Born in an Arabic country, Dr Ibrahim qualified as a doctor and spent the early years of his career working as a family medicine and community doctor.

The Arab Spring of 2011 and the subsequent military coup in his home country in 2013, were to change his and his families’ lives forever.

After joining in demonstrations against the military takeover, Dr Ibrahim was arrested and jailed for six months. During his imprisonment he was beaten and tortured by the authorities, before eventually being released.

Two years later, after again being arrested for demonstrating against the Government, he received what he felt was a chilling final warning from a member of the security forces.

‘I was threatened by a police officer who told me that if I ever came back to demonstrate against the Government I would be arrested again and, this time, “no one will know where you are”,’ recalls Dr Ibrahim.

‘After this, I took the decision to leave the country, to flee to anywhere for safety.’

Unable to return back home, Dr Ibrahim was later joined by his wife and children and spent nearly a decade travelling and working in different parts of Africa.

Despite the enormous challenges of his personal situation and being physically separated from his parents and siblings, he managed to advance his medical career and was in the early stages of founding a medical project.

Unfortunately, after coming into conflict with the authorities in the African state in which he was residing, Dr Ibrahim was warned the was at risk of deportation back to his homeland, a prospect which made him turn to the UK as a place of possible sanctuary.

After arriving in the UK by plane, Dr Ibrahim along with his wife and children were placed into hotel accommodation for asylum seekers. Unable to work and acutely aware of the growing hostility towards refugees, Dr Ibrahim says that, while he felt safe, he was also frustrated.

‘[Before having to leave Africa] I was in a very stable situation. I had a very good salary and I had the ambition to establish my own medical project owned and funded by me. I have managed to succeed in the [medical] royal college exams from the UK.

‘Contrast this to suddenly living in a hotel where you don’t know how long you will be there or what will be done to help you.

‘Protesters were coming to the hotel from time to time and filming people and saying, “the Government is spending money on those people who are coming to take our money”, and so on.

‘I stayed with my family for eight months in that hotel. It was bad, very bad, and we tried so many different times to get out, [but] no one was caring, no one was listening and no one was offering help.’

After finally moving into new accommodation, Dr Ibrahim began the process of returning to medicine by completing exams, his GMC registration and applying for a work permit. At that time the Home Office refused to grant him the work permit saying in their reply ‘we see that your circumstances do not differ from any other asylum seeker, and so we will not grant you the work permit’.

Like Dr Suliman, Dr Ibrahim sought and received significant support from REACHE (Refugee and Asylum Seekers Centre for Healthcare Professionals Education) Northwest.

For more than 20 years, REACHE has helped doctors join the NHS workforce through assisting with developing language skills to a level required for the occupational english test and preparing for parts one and two of the PLAB (Professional and Linguistic Assessments Board) examination.

REACHE helps doctors seeking asylum to navigate the immigration system, guides doctors through their GMC registration and helps them gain experience through accessing doctor-led clinical-skills programmes in the NHS.

To date, the group has supported almost 300 refugee and asylum seeker doctors into joining the health service.

They include Kateryna Stelmakh who came to the UK in 2022 following Russia’s invasion of her home country Ukraine.

Having been living and working in Northern Ukraine right in the path of the then advancing Russian forces, Dr Stelmakh took the decision to seek safety initially in neighbouring Poland.

She decided to journey to the UK having only recently visited the country to spend time with a friend there, and still in possession of a valid visa.

By the time she landed in the UK on 26 February 2022, the situation back in Ukraine had already escalated significantly.

‘I arrived at Doncaster airport, and the border officers couldn’t understand what to do with me,’ recalls Dr Stelmakh.

‘I had a visa but obviously I couldn’t go back because airspace had been closed in Ukraine and I didn’t have a ticket.’

Fortunately, Dr Stelmakh was granted leave to remain in the UK and saw her visa extended under the Ukraine permission extension scheme. She received initial support from Doncaster council and members of the city’s Ukrainian centre.

Having initially planned to remain in the UK for only a few weeks, the intensifying and increasingly protracted nature of the fighting in Ukraine meant that returning home was not an option.

Although she had secured her own safety, Dr Stelmakh now had to contend with the sometimes overwhelming concern she had for her parents, who had chosen to stay in Ukraine, and for other medical colleagues who had either been drafted into the military or otherwise been unable to get out.

‘I realised at that point that I'm not going to go back, [to Ukraine] but I need to do something to survive. I started language courses to improve my English, and I started to try to socialise myself.

Eager to resume her medical career but having never previously lived or worked in the UK, Dr Stelmakh was completely unfamiliar with the NHS and medical licensing process.

‘I felt so demotivated and lost,’ she says.

‘When I started to speak with REACHE they were so helpful in terms of speaking with GMC on my behalf and helping me understand if I’m eligible to be a doctor here in the UK. That was really helpful and, honestly, they kind of lifted me up.’

Having completed her GMC registration on 5 November and successfully completing the occupational english test and both parts of her PLAB exams, Dr Stelmakh is now in the process of seeking her first job in the NHS.

‘[REACHE] helped me to gain my BMA membership and also in the GMC registrations,’ explains Dr Ibrahim.

‘They paid the fees for registration and the exams and they also have another role which is very important in talking to the Home Office.’

Sadly, Dr Ibrahim’s efforts to return to working in healthcare were thwarted by April 2024 legislation which requires that those awaiting a decision on an asylum application are not allowed to work.

‘I have more than 12 years of experience as a doctor and was in the process of finishing my GMC registration and, because I have good experience in ultrasound, I applied for work as a sonographer,’ he says.

‘I thought that healthcare workers and the healthcare sector were a priority in this country, so I was very sad when I was told they refused that application on the grounds that I was not allowed to work during my asylum claim.’

Dr Ibrahim’s situation worsened after receiving notice from the Home Office in 2024 that his application for asylum had been refused.

Despite support from REACHE in efforts to challenge the ruling, the decision is one which has left Dr Ibrahim and his family in limbo and increasingly overwhelmed by despair.

‘I went in a very bad depression,’ he says ‘I stayed at home for months. I lost the passion to anything. I was not able to go outside at all not even to walk outside the house.’

Dr Ibrahim’s experience is one that is sadly far from isolated among those attempting to seek asylum in the UK, yet the difficulties and obstacles facing such individuals could soon become all the more onerous and unforgiving.

On 17 November, home secretary Shabana Mahmood unveiled a raft of measures aimed tightening and curtailing provisions granted to would-be refugees; an approach that she described as ‘the most sweeping asylum reforms in modern times’.

These proposals, which adopt a bare minimum approach to meeting international obligations towards those seeking asylum, include cutting refugees’ leave to remain from five years to 30 months, with indefinite settled status available only to those who have been in the UK for 20 years or more.

The plans will also scrap the Government’s legal obligation to provide support to destitute asylum seekers and allow the state to appropriate the assets or income of prospective refugees in order to help fund the cost of their support.

Under the proposed system, those who see their applications for asylum rejected will see their access to legal appeals limited and the removal of failed asylum seekers sped up and increased.

Although focused on the future, Dr Suliman acknowledges that, for people like him, simply moving on from the past is an impossibility. While he is thankful to all those who have supported him, he also dreams of one day being able to return to his family’s homeland.

‘Migration isn’t the same for everyone,’ he reflects. ‘For some, it’s just moving from one place to another. For others, it becomes a never-ending journey, a life where pain keeps you awake and memories slowly fade.

‘Even through all of that, organisations like REACHE Northwest somehow managed to put my shattered body and mind back together. They gave me a push when I had nothing left and they gave me the tools to fight back and advocate loudly. They reminded me that I’m not an anomaly. I am a person with a story, value, and a future.

‘One day, my country will be safe for return, and I’ll finally be able to see my family again,’ he adds. ‘When that day comes, I want to tell them: “I’m back from my second home. I’m back to help with an arsenal of knowledge and skills — the kind that good people helped me acquire.”

‘Until then, I want to be a concierge of hope, guiding others towards belief and possibility, even when their journeys feel impossible.’