NHS risks losing one third of ethnic minority doctors due to racism, finds BMA report

by BMA media team

Press release from the BMA

Location: UK
Last reviewed: 15 June 2022
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“I was called ‘headscarf b**ch’ by a patient. A patient refused to be seen by me as my name did not sound British. A supervisor did not wish to discuss the experience of the patient not wishing to be seen by me and I was met with mostly silence.”

- Testimony from a junior doctor of Mixed-Other ethnic background

A landmark BMA report into racism in medicine has revealed a profession in danger of a major exodus of doctors of ethnic minority backgrounds, due to persistent and intolerable levels of racism faced at a personal and institutional level. Nearly one third of doctors surveyed have considered leaving the NHS or have already left within the past two years due to race discrimination, with 42% of Black and 41% Asian doctors in particular having considered leaving or having left.

The survey, one of the most comprehensive of its kind on the experience of racism in the medical profession and workplace, paints a picture of institutional barriers to career progression, dangerously low levels of reporting of racist incidents, and a building mental health burden on ethnic minority doctors.

The report identifies systemic failure which will need every health organisation to work together bring an end to structural racism and rectify the disproportionate outcomes in careers and job satisfaction faced by different ethnic groups.

Dr Chaand Nagpaul, BMA chair of council, said:

“The NHS was built on the principle of equality of care for patients whoever they are, but this report shows that the NHS is shamefully failing in this principle for its own doctors, with those from ethnic minorities reporting alarming levels of unfair treatment and racial inequality at work.

“It is deeply concerning that so many of those surveyed did not report racism, either out of fear of recrimination, being labelled a troublemaker or a lack of confidence it would be properly investigated. This means that doctors are suffering in silence, and the true extent of racism is neither exposed nor addressed.

“Our report depicts the scale of their suffering - being overlooked for promotion, forced to change their chosen specialty, feelings of isolation and exclusion. With 60% Asian and 57% Black respondents seeing racism as a barrier to career progression, patients are failing to benefit from the full skills and talent of an ethnically diverse workforce.

“What all this this adds up to is a tragic waste of potential as doctors of ethnic minority are held back, dragged down or simply walk away from the profession.

“Experiencing racism is extremely distressing, with nearly two thirds of doctors we surveyed saying their mental wellbeing had deteriorated as a result, with many suffering depression, low self-esteem and anxiety. There is evidence that incivility can affect the cognitive functioning of doctors, and consequently this is having an adverse impact on patient care.

“Racism is wrecking the lives of many doctors, affecting patient care and threatening services. The time for talk on this is over. Our report makes a range of clear recommendation for change which demand action across the health system, from Government to NHS organisations, leaders and other institutions.”

The five themes under which the report’s recommendations come are:

  • Being explicit about the need for change
    • This includes the need for centralised guidance on HR processes to be available across all organisations in the medical profession so that everyone is on the same page
  • Improving racial literacy
    • Equality, diversity and inclusion training should be mandatory in medical school curricula
  • Investment in root cause analysis and evaluation of interventions
    • Mandatory ethnic pay gap reporting to go with gender pay gap reporting
  • Improving reporting processes
    • Medical students and doctors must have access to independent avenues to raise concerns, such as Freedom to Speak up Guardians
  • Increased accountability
    • All organisations responsible for the progression of doctors must publish their outcomes by ethnicity

Ends

Notes to editors

Additional findings in the report include:

  • Almost half of respondents (49%) described being subject to discriminatory comments from more senior doctors. Two in five respondents (41%) described derogatory comments from patients regarding their ethnicity, country of origin, heritage, name, and accent.
  • Overseas qualified doctors experience racism more often than doctors trained in the UK. 84% of respondents who qualified overseas said they had experienced racist incidents in their workplace in the last two years, compared to 69% of respondents who trained in the UK.
  • Respondents who had qualified overseas were twice as likely to think that racism was a barrier to their career progression than those who had qualified in the UK (60% compared to 27%).
  • Of those who had reported experiences of racism, nearly 6 in 10 total respondents (58%) said that doing so had had a negative impact on them. Negative impacts described included being viewed as a troublemaker, being made to feel like the report was an overreaction, being overlooked for progression opportunities, and being made to feel like the incident was their fault.
  • Experiences of racism included discriminatory comments, being treated differently to other colleagues based on ethnicity, including being given fewer opportunities, more scrutiny of work, bullying by patients and colleagues, continued mispronunciation of names, and social exclusion.
  • Just over 90% of Black and Asian respondents, 73% Mixed and 64% of White respondents said racism in the medical profession is an issue.
  • 36% of White non-British respondents said racism was holding back their career.

Quotes from the report:

A consultant of Black, African background said: “Less confident to report such incidents again because no action was taken against the perpetrator. I feel uncomfortable and anxious of reprisals.”

A junior doctor of Asian background said: “Working in A&E was a nightmare. Continued racist behaviour from patients and their relatives. Due to this, I have decided not to pursue a career in emergency medicine.”

A junior doctor of Pakistani background said: “When interacting with senior colleagues, I would notice that they were nicer and more helpful towards other junior doctors who were born in UK and were white. I would be clearly treated and spoken to differently.”

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The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.