Ethnic minority doctors hit glass ceiling in NHS

Anne Gulland London

A new book on racism in medicine has described the discrimination and harassment that ethnic minority doctors face throughout their career.

The book shows that from entry to medical school, to applying for senior house officer posts, to seeking discretionary points (extra payments that doctors can earn at the top of their career), non-white doctors are at a substantial disadvantage.

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 marginalised. 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."

Dr Dadabhoy said that ethnic minority doctors who chose to remain in hospital medicine hit a glass ceiling. (See p 262.)

The book is available from the King's Fund, 113 Cavendish Square, London W1M 0AN, price £15.99.



studentBMJ 2001;09:261-304 August ISSN 0966-6494