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Chair's focus

Racial harassment and inequality must be addressed from the outset of medical training

Last week, the BMA launched our new Charter for medical schools to prevent and address racial harassment, which is the culmination of an exemplary programme of work carried out by our Association’s medical students committee.

This important charter was developed in response to the ever-growing body of evidence demonstrating the alarming extent to which BAME students experience racial harassment and discrimination during the course of their studies. Our own Caring, Supportive, Collaborative survey found that BAME medical students were four times more likely than white medical students to say that bullying or harassment was ‘often’ rather than ‘sometimes’ a problem in their place of study. Similarly, an inquiry into racial harassment in UK universities carried out by the Equality and Human Rights Commission and published just last October found that almost a quarter of BAME students reported that they had experienced racial harassment since commencing their course. 

Most recently, an investigation jointly carried out by the BMA and BMJ revealed that of the 32 medicals schools in the UK that responded to a freedom of information request, only half even collect data on students’ complaints about racism and racial harassment.

It takes years of gruelling study, dedication and achievement to earn a place in medical school. It is incredibly demoralising for many medical students – who are at the beginning of their career as future doctors and are committed to serving in a health service that espouses equal care for all – to face personal experiences of inequality and harassment.

The charter sets out clear standards that medical schools should follow in order to stamp out radical prejudice – including ensuring that robust processes for the reporting and handling of complaints are in place and supporting individuals to speak out when they experience or witness poor behaviour (whether experienced on campus or by students during work placements). The BMA is calling on every medical school in the UK to sign up to this charter and, in so doing, to commit to cultivating a climate of fairness and inclusivity. 

On the same day, the BMJ published a special edition on racism in medicine, which you all should have received last weekend. This timely issue of the BMJ features contributions from a wide range of healthcare professionals and policy experts on an array of topics, including: the recruitment gap in speciality training, differential attainment, disproportionate disciplinary referrals, racial bias in the development of artificial intelligence technologies and how racism impacts on BAME individuals and migrants’ physical and mental health outcomes.

The BMJ held a launch event for this special edition at BMA House, which was attended by a wide range of stakeholders and black and minority representative groups such as Melanin Medics, the British Association of Physicians of Indian Origin (BAPIO) and British International Doctors’ Association (BIDA). Former BMA president Dinesh Bhugra, who has done enormous work in campaigning for racial equality, and BMA council member Sam Everington, who published seminal work with Aneez Esmail in exposing racial discrimination in shortlisting for postgraduate medical posts, were also in attendance.

I had the honour to say some opening words and be part of a panel discussion alongside NHS England Chief Executive Sir Simon Stevens, Medical Adviser on Workforce Race Equality Professor Mala Rao, incoming chair of the NHS Confederation Victor Adebowale, and third-year medical student Olalade Obadare. 

This discussion covered topics including the importance of ensuring that new medical developments reflect the evidence base on health inequalities amongst communities and ethnic groups, the need for cultural change to be led from the top and the benefits that would be generated for patients and NHS staff if its senior leadership reflected the demographic makeup of its workforce. I took the opportunity to publicise the launch of our medical school charter. 

I also emphasised the specific needs of international medical graduates coming to work in the UK, especially given that last year more doctors from overseas entered the GMC register compared to those who trained in the UK. These doctors experience unique pressures in attempting to get to grips with the NHS and navigating the practicalities of settling and building a life in a new country; and this is often exacerbated further as they are forced to confront these challenges whilst living apart from their families and support networks. They do not currently receive the induction or support which they require and deserve – a status-quo which must be overturned if the NHS is to maximise its workforce capability.

These issues and ideas are at the heart of the BMA’s Equality Matters advocacy programme. We believe that equality matters because it’s morally right every that every medical student and doctor should be given equal opportunity to achieve their full potential and progress, and because healthcare organisations rooted in equality, diversity and inclusivity provide better patient care and outcomes. Our Association will continue to champion this cause on behalf of our members in the months and years to come, from the onset of medical school training throughout their entire careers as doctors.