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Gold, incentives and meh

I am a BME doctor and I worry about my future in the NHS

Dr Punam Krishan

punam krishan 3 x 2

As a doctor working in the NHS, I have always believed that I was protected. I live in a nation that advocates fairness and equality. Ahead of the world, we represent diversity. We are lawful and welcoming to all walks of life… or are we?Recent developments within our medical community have sent shivers down our spines. Our states of mind shaken, our stomachs lurching with anxiety inducing a painful insomnia as we ruminate over our fate.

Born and brought up in Scotland, this is my home. The colour of my skin is brown which when paired with a distinctive Glaswegian accent tends to generate some curiosity in the minds of my patients. A question I’ve sometimes been asked is: ‘Where are you from, doctor?’ My reply of ‘Glasgow’ is seldom sufficient and is usually followed by, ‘but where are you actually from?’ This question does not offend me because curiosity is intuitive and should be welcomed. If I can know personal things about my patients, it’s only fair they can know a bit about me.

It is, however, when curiosity becomes an interrogation, either in consultation or in the form of a complaint that I begin to feel a helpless panic come over me. The ‘coloured doctor’, as I have sometimes been referred to, is demeaning.

Experiencing racism from patients does not compare to the fear institutional racism generates within us

Amongst all the pressures faced by doctors in the UK today, racism – both covert and overt – is an additional stressor that black and minority ethnic (BME) doctors face on a daily basis.

But I must admit, as unnerving as it is to experience racism from patients, it does not compare to the level of fear institutional racism generates within us.

Around 30% of our NHS workforce has a BME background. This is not an insignificant number. We encourage the uptake of foreign doctors to help fill gaps in our grossly understaffed NHS, yet many happily turn a blind eye when these doctors face racial abuse, bullying, scapegoating and indeed criminalisation of their work.

In light of the case of Dr Bawa-Garba and reviewing the published data, I learnt that BME doctors are far more likely to get public warnings and restrictions to practice compared with their Caucasian counterparts. Thankfully I have never had to face a GMC investigation and, until now, I never doubted that the GMC could ever be anything other than fair.

However, as an Asian doctor, I now quiver at the realisation that our professional governing body apparently deems BME doctors to be less able and more culpable compared with Caucasian doctors when judging clinical errors and complaints.

It is widely recognised that outcomes of medical recruitment, exams and applications to specialties are more favourable for white than BME applicants. Forget the data, one simply needs to look at those in positions of influence in both undergraduate and postgraduate boards in medicine and we can see how embarrassingly misrepresented it is.

If as a British-born Indian doctor I feel like this, it makes me sick to think how those who have left their native countries to come and work tirelessly for our NHS must feel. For most such doctors, English is not their first language, and many have an accent. Western culture may be wildly different to what they know. They get judged for this, when it is their knowledge and expertise that should be judged and not how they dress, talk or act in a social setting.

In a time where travelling is the modern-day hobby, we travel the world to learn about cultural diversity, yet when doctors from such cultures come and work with us, institutional racism is shamefully letting them down.

For BME doctors, rejection by patients, colleagues and governing bodies due to racism and bigotry is contributing cumulatively to moral distress and clinical burnout.

I believe this is reversible if we start addressing it now. Let us all work together for the sake of our profession. Let us all work together without any judgement and let us all lead by example to create a tribe of incredible doctors and nurses who support and respect one another.

We are in a profession where we can influence society. Let us not give the media and public more ammunition because our work will always remain grounds for criticism and litigation.

Those at the top, the ‘snowy white peaks of the NHS’ and the GMC, need to recognise that the global climate is changing. It is time for drastic measures to be put in place to address institutional racism as a contributing factor to punishing doctors unfairly. Otherwise an avalanche will come down and bury the NHS and them with it.

Dr Punam Krishan is a GP in Glasgow


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Readers' comments (17)

  • “The Snowy White Peaks of the NHS.” Here is the link for anyone who hasn’t come across this report, it makes for some interesting reading and highlights the extensive patterns of discrimination faced by BME doctors.

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  • AlanAlmond

    So the ONLY reason BME Drs are over represented in GMC hearings is racism? This is the current dogma?
    The fact that disproportionate numbers of these folk were trained over seas and have English a second language has NOTHING to do with it? I’m certainly not suggesting racism isn’t an important issue but I find the selectivity of the arguments in these debates highly depressing. For sure it plays well to a particular audience making up a large subgroup of Drs but I’m not convinced it’s currently a balanced, entirely honest, nor open debate.

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  • A quote from Hollywood film executive Franklin Leonard - "when you are accustomed to privilege, equality feels like oppression" - reported in article (#MeToo and the evolution of man) by Simon Kuper in the FT magazine... Interesting reading...

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  • Is this causation or correlation? Certainly the doctors I have worked with who have had the poorest grasp of English have tended to be BME. The number has been extremely low whereas I have personally not worked with a non-BME doctor who had poor english, so the relative rates are very high if expressed as a ratio.

    Frankly I do not have enough information to make any sweeping statements. Clearly others feel less constrained.

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  • "This is a British Passport--you are obviously not British!"

    "I am"

    "We will see about that--where were you born?"


    "OK--where were your parents born?"

    "Oh --Sheffield"

    "But where were their parents originally from?"


    "Pakistan! We're getting somewhere!"

    Come Fly With Me 2011

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  • A simple solution would be to stop paying into the GMC's coffers.Isn't it a bit odd that we're paying for an organisation that is set out to flog us at the earliest opportunity.How masochistic is that?If the public wants us crucified then let them pay for the public executions.Unfortunately our profession is too spineless to even do that.Everyone is feathering their own nest.

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  • In my opinion problems of this kind stem from cultural back ground and people's believes.
    Unfortunately with all the political influence of the mass media,even religion,which supposed to guide us to the right path, has been manipulated, misinterpreted and in most societies has been pushed aside.
    The government or GMC can not monitor people for their racist or any form of mean/discriminating comments or tendencies. It is up to our parents to teach us the basic human values,to my experience following a good religion could be a very safe and efficient way of doing it. My grandpatents were both proper Muslims and they thought me from when I was 4,all people are equal in front of god, the only superiority comes from your spiritual purity, that's something they don't teach you in university. Such
    Racist behaviours stem from a wrong upbringing and the death of moral values in the society. Please do not judge each other by the skin colour, age,sex,religion,etc ..Start by judging ourselves, asking what have we done to help each other?

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