Discrimination in medicine

Prejudice is rife in medicine. The new discrimination matching scheme from BMJ Careers could help says Rhona MacDonald

As the current political situation in France shows, discrimination is rife. So why should it be any different in medicine? The 50 rapid responses we had to a recent editorial on racism in medicine are proof that discrimination in medicine is alive and well.¹ This is hardly surprising, in a culture where a consultant surgeon thinks there is nothing wrong in saying to his junior, “You are not operating on bloody Nigerians here; you are operating on normal human beings.”²

But discrimination has many forms, not just racial. At a time where over 60% students applying to British medical schools are female,³ only 6% of consultant surgeons are.⁴ In addition, over 90% of women want to work part time, but despite recent efforts to make flexible training more accessible,^{5 6} there is still nowhere near the number of places necessary. Two women who successfully completed their preregistration house officer jobs by working flexibly said, “The NHS will benefit from having two more doctors, whereas it might have had neither of us.”⁷ 8 Only a half of clinical students think that homosexual activity could form part of an acceptable lifestyle.⁹

Then, of course, there is disability or physical or mental illness. Although doctors and students are aware, they should know better: they still discriminate against their ill colleagues,¹⁰ against those with mental illness in particular.¹¹ The BMA has recently launched a campaign for allowing disabled students access to medical school.¹² Medical students themselves are subject to discrimination, you only have to look at the case involving Heidi Cox, the centrepiece of the BMA campaign. Anecdotally, it is exactly a year since we launched the matching scheme for doctors who have a chronic illness¹³ ; I was moved by letters and emails from doctors from all over who have had their lives made even harder by prejudiced and bigoted colleagues.

One of the added miseries of being discriminated against is the feeling of isolation it brings. Many doctors feel they are alone to battle against the world, fearing that speaking out could harm their careers. This is where the BMJ Careers’s discrimination matching scheme, at bmjcareers.com/discrimination, launched this month, could help. (Also see the special Career Focus in BMJ Careers of 11 May 2002.)

The scheme works in exactly the same way as the chronic illness matching scheme (see box), aiming to match doctors—who feel they are being discriminated against, in some way—by their specific requirements. When a suitable match is found, they are both sent each other’s email addresses so they can contact each other for informal advice and support.

We have left out some forms of discrimination—for example, religion and age—and the scheme will not stamp out all the evils of discrimination in medicine so prevalent today. Hopefully, though, it will help healthcare workers who are discriminated against know that they do not have to suffer in silence. If you are in such a position then please sign up.

Medical students are a new and, potentially, more open minded generation of doctors to be. With your healthcare colleagues, you are in a unique position to help eliminate discrimination from the workplace. While we can try to help those already affected, with ideas like the discrimination matching scheme, your younger generation is in a position to make the future a better and less prejudiced environment to work in.

1. Bhopal R. Racism in medicine. BMJ 2001;322:1503-4. bmj.com/cgi/content/full/322/7301/1503
2. Dyer C. Plastic surgeon settles discrimination case. BMJ 2001;322:844.
3. Rise in female applicants. Employing doctors and dentists. 2002 London: Chamberlain Dunn, 2002:3.
4. Morris C. Women in surgical training. BMJ 2001;323(7324):S3. bmj.com/cgi/content/full/323/7324/S3-7324
5. RCP Working Party on Women in Medicine. Post MRCP questionnare. In: Women in medicine: career choices and opportunities: a report from the Federation of Royal Colleges of Physicians. London: Royal College of Physicians, 2001.
6. Davies J. Government scheme gives doctors a break. Employing Doctors and Dentists. London: Chamberlain Dunn: 14-5.
7. Draeger E, Hazell D, Peters TJ. Job sharing as a preregistration house officer. BMJ 2002;324:S44. bmj.com/cgi/content/full/324/7333/S44
8. MacDonald R. Homophobia in medicine. studentBMJ 2002;9:358-9.
9. McColl P. Homosexuality and mental health services. BMJ 1994;308:586-7.
10. Thompson WT, Cupples ME, Sibbett C, Skan DI, Bradley T. Challenge of culture, conscience and contract to general practitioners for care of their own health: qualitative study. BMJ 2001;323:728-31.
11. Why am I crying? BMJ 2001;323:1010.
12. BMA campaign pushes GMC for disabled students’ rights. BMA News. 9 March 2002:1.
13. MacDonald R. Career advice for doctors with a chronic illness. BMJ 2001;322:1136-7. www.bmj.com.cgi/content/full/322/7295/1136