I’d like to talk about NY syndrome.

You’re mistaken if you think here’s another ‘overpaid’ secondary care physician writing about an obscure medical syndrome. It’s very unlikely (although possible) that you’ve come across this syndrome in a medical textbook. Even the all-knowing Google doesn’t suggest any matches.

However, it’s a concept that many international doctors in the UK will be very familiar with.

It’s often discussed with gusto when old friends meet – especially when a few wee glasses of Glenfiddich are having their relaxing effect. It is simply called ‘next year’ syndrome!

Usually, the conversation goes like this.

Doc 1 – So what’s new boss? How’s life?
Doc 2 – Oh, I have decided to return to India. I don’t like the work anymore, and the kids are growing up.
Doc 1 – That’s great. When are you going back?
Doc 2 – Next year.

This part of the conversation pauses as Doc 1 starts reminiscing about life in his hometown in India. The sweaty ride on the public bus seemed better than the air-conditioned comfort he’s gotten used to. The missed wedding of the second cousin (whom he never spoke to in India) seemed a significant life event, or the annual locality picnic (rarely attended) seemed a must-visit through the rose-tinted spectacles of nostalgia.

Fast forward another year, when the two meet again in another friend’s house; the conversation restarts after a few pegs have been downed.

Doc 1 – I thought you were going back to India this year.
Doc 2 – Yes, that was the plan, but now I have a registrar post – so I will go back next year. After all, I don’t want to bring up kids without other families around and grow old in a foreign country.

This is how the conversation repeats for a few years, until Doc 1 and (still frustrated) Doc 2 discover that new topics like global warming or the effect of Brexit are more interesting – and productive!

‘Next year’ syndrome usually starts two or three years after moving to a foreign country. This is when there is uncertainty about getting the next job, and the future appears unclear. The initial glamour and excitement of a new country have worn off. The loneliness of life as a foreigner has started to bite, and life in India suddenly seems more rewarding. It is compounded by poor job prospects and the xenophobia that can greet immigrants.

However, the return rarely happens because there is always that additional year’s training needed to prepare for life in India, or that procedure you must learn to survive in the minefields of private practice there.

Friends in India are consulted about the decision, and they throw up their hands in horror. ‘Why do you want to come back? Life is cutthroat here; colleagues stab you in the back, and patients always ask for a second or third opinion.’

By the time all the procedures are learnt, roots have grown deep in the new country, and one has got used to life here. NY syndrome then starts meaning Not (in a million) Years.

To many, ‘home’ in India means family and friends you’ve known all your life. The familiar roads you grew up walking, the park where you played, or the movie theatre you took your first date to.

But slowly, with time, new friends are made in the new country. Memories are created of kids’ nativity plays, perhaps of the Highlands trip with family from India or the camping trip to Brecon. Gradually the streets of London replace Mumbai’s, Marina Beach seems like Brighton, and Durga Puja festival in Kolkata seems... well, some things are irreplaceable!

The UK becomes the home where one is most comfortable.

Does the yearning about returning ever disappear? Probably not. But after a few years, life in the new country takes on a different meaning. Every person who decides to stay in a foreign country has their reason – with kids growing up, for example, it’s easy to settle into the luxuries of a first-world country but accept that you’ll miss family and the other comforts of India.

I suspect the biggest reason for always planning and wanting to return is that people don’t want to believe they never will. Nostalgia is like that pair of old jeans in which you are most comfortable. There’s a sense of reassurance, knowing that one can always go back. People make investments, buy houses in India, and even get their children admitted to school in India, but ‘next year’ is not needed for most.

(To declare a conflict of interest: the author used to suffer from NY syndrome but has recovered now.)

Raja Biswas is a consultant physician at Royal Glamorgan Hospital, and chair of the BAME network at Cwm Taf Morgannwg University Health Board.