When I first arrived at medical school I was completely excited to have finally made it. The stars had aligned and finally I was where I needed to be to start off my journey through medicine. The barriers that had seemed to be in my way all the way through my application where finally broken down.
As aspiring doctors, we have been conditioned to perform and excel in almost everything we do, we are ambitious and strive to reach our full potential in our careers. Doctors are driven to do the best by their patients and perform to their best level as clinicians. Medicine is essentially patient centred but one of the aspects of the profession is that it provides us with a level of achievement and the need to continuously progress and reach the highest attainment we can. Medicine is one of few careers that provides a clear path of progression and whatever speciality you decide to take on there is a senior role to aspire to. Some examples being:
- Become a consultant in your chosen specialty
- Senior GP partner partnership
- For the academics amongst us senior lecturing or appointment as medical school dean
- NHS management directors
Medical school has opened my mind to the variety of opportunities we have as doctors. I have always felt that with hard work I could achieve my career goals and reach my full potential despite the barriers ahead of me. However, I have gradually learned that there are factors beyond my control that could affect my progression.
THE REALITY CHECK
We always focus on the number of black students we have on our courses. I remember my first introductory lecture at medical school I scanned the lecture theatre looking for the other black medical students. In a full lecture theatre, I counted 11 including myself, I was slightly disappointed by such a small number but I thought at least they’d improved from the year before. On that first day we were welcomed by our year director who also happened to be black, it was a pleasant surprise. Unfortunately, now in year 3 of medical school the reality really set in, since starting medical school he has been the only black lecturer and year director I have come across. In 3 years of medical school alone there has been no new additions and the elation I first felt seeing him in first year has now faded. Maybe it was just the location of my university or maybe they didn’t have as many black lecturers applying there, whatever it was something wasn’t quite right.
Come 3rd year of medical school and I started placement. A proper exposure to hospital medicine as well as general practice. As part of placement we tend to be attached to junior doctors but on occasion we follow consultants during ward rounds or if you’re especially lucky they rope you into something interesting for the day. As the weeks went by an uncomfortable realisation came to me, during this first placement block I hadn’t once encountered a black consultant or GP partner. I’d seen a couple of black junior doctors in passing, however these where rare opportunities. Again, I thought it must be the area I was in, there has to be more representation in other hospitals. From friends of mine in other placements sadly it was the same story, and only 1 of my friends could account for 1 consultant that she had met. As black medical students we know that representation across all levels of the profession matters, I feel that it gives us the opportunity to see the levels that we can reach, and we can even find mentors in them. I always feel a sense of motivation and pride seeing black doctors in such positions as it shows the goal is attainable.
THE EYE OPENER
I attended a launch event where Yvonne Coghill was in attendance and provided one of the most compelling talks I have received to date. She has been a driving force for workforce race equality standards and inclusion within the NHS. Up until this talk I had thought that the lack of black doctors in senior roles had been isolated to the area I was studying in. However, she shone a light on how widespread the issue was. From her talk the statistics where surprising, the most shocking being:
- Black doctors are least likely to secure consultant or specialist roles, with only 2.7% of those who apply being successful
- From data on receiving clinical excellence awards, there were no black and ethnic minority doctors who received the top awards: platinum and gold
- Across the UK medical schools there still are no black academics who have been appointed as deans
- There is a lack of diversity in NHS leadership with only 8% of trust directors in London alone coming from BME backgrounds
I naively had thought that once I had become a doctor the playing field was level as we would all be judged by the work we do and the level of skill we’d developed. Sadly, this talk highlighted the limitations for black doctors in achieving their full potential. Unfortunately, unconscious biases have been shown to be contributing to the lack of representation as well as black doctors feeling that they are scrutinised at a higher level than their colleagues. A clear issue is present and being aware of it as black medics is important in finding a solution to the issue.
Hearing phrases such as: “The first black consultant in said speciality”, “The first black medical director for any NHS trust” we are filled with a sense of pride. However, we should challenge these more as to why they are only now being represented. As Yvonne Coghill quite rightly stated that “the numbers don’t lie”, there is a representation issue in more senior roles. She has worked closely with NHS trusts and called them up on this very pitfall, and I feel that we should work to build this awareness.
SO, CAN WE BREAK THROUGH THE CEILING?
We can, and we have done. We continue to push boundaries and surpass our own expectations and those set for us. Even with statistics, black doctors continue to provide excellence in care and although the numbers are bleak it doesn’t stop us from striving for our goals. We should to be more active in highlighting the issues for change but also create our own networks to include various medics at all levels. Melanin medics has been able to create both the Doctors Network and the mentorship scheme, having black professionals in various positions allows us to know these roles are attainable and having mentorship across all levels means that we continue to be uplifted as the journey of a black doctor through their profession differs. It’s important for us to be involved in bringing awareness to this for the issue to be addressed. As we know all to well: Representation Matters!
Written By Michelle Chirimuuti