A new book on racism in medicine has described the discrimination and harassment that black and ethnic minority doctors face throughout their career.
From entry to medical school to applying for senior house officer posts and to seeking discretionary points (extra payments that doctors can earn at the top of their career), non-white doctors are at a substantial disadvantage, the book shows.
Naaz Coker, editor of Racism in Medicine: An Agenda for Change , highlighted a "canteen culture" of "racist acts, jokes and statements." Ms Coker, director of race and diversity at the King's Fund, an independent healthcare charity, which published the book, called on medical institutions to take decisive action to stamp out racism.
She wrote: "Medical institutions have a responsibility to create easily accessible channels for members to report racist incidents. These must be channels in which they can have the confidence that their concerns will be addressed without the members being ostracised or marginalized. Leaders in medicine have explicitly to challenge racist behaviours and actions, regardless of whether they are dealing with colleagues or patients."
Ms Coker said that the Race Relations (Amendment) Act 2000, which extends current race relations legislation, and the incorporation of human rights legislation into UK law have meant that the time is right to tackle the issue of racism.
Shahid Dadabhoy, a northeast London GP and a contributor to the book, told of a concrete wall that prevented non-white doctors from progressing up the career ladder.
He wrote: "Much of this 'concrete wall effect' has followed me throughout my medical career and is one of the major reasons why I became a general practitioner. In my later medical life, I noted the compelling power to force conformity with the majority white attitudes. If you worked in hospital-based medicine to be ‘in' you had to socialise with white colleagues on their terms. If you didn't you never got trained, were denied access to certain posts, rotations, and crucially, never got an advancement."
Dr Dadabhoy told the BMJ that ethnic minority doctors who chose to remain in hospital medicine hit a glass ceiling.
"The classic euphemism in hospital medicine is that of associate specialist—this is a euphemism for an ethnic minority doctor of relative seniority who cannot get a consultant post.
"The fundamental problem with racism in the NHS is that it robs the NHS of talented people by denying them career pathways," he said.
He attacked the royal colleges for being slow to admit that ethnic minority doctors were under-represented in their institutions after the inquiry into the murder in south London of Stephen Lawrence, a school boy from an ethnic minority group. He added that the Royal College of General Practitioners, in its response to the inquiry, overlooked the experience of second generation doctors.
"There needs to be an admission that not all ethnic minority doctors are first generation, and we cannot ask the Overseas Doctors Association what they think all the time—they are only a proportion of the ethnic minority doctors in the United Kingdom."
The book is available from the King's Fund, 113 Cavendish Square, London W1M 0AN, price £15.99.
