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A faulty production line

The white elephant in the room

Dr Shaba Nabi

dr shaba nabi duo 1440x960px

dr shaba nabi duo 1440x960px

One of my earliest memories is from the age of six, when my infant school put on a production of Snow White. Despite being the best reader, I already knew at that tender age I was not in the running for the lead role because I was not white. Instead, in keeping with Hollywood tradition where the black guy is the villain, I was cast as the wicked stepmother.

Such truisms continued into secondary school, where I knew I would always be the last to be picked for team games. It wasn’t until I became the captain of every sports team in the school that I was finally accepted.

It was a miracle I landed a place in medical school, when it was exposed that St George’s had a points system that downgraded women and anyone with an ethnic-sounding name.1 Considering this medical school was one of the most multicultural in London, I shudder to think of processes elsewhere. In fact, my older brother was kicked out of Barts for failing his first-year exams a month after the death of our father. Unlike several other students who were allowed to stay after failing their exams twice, my brother was not a white, ex-public-school boy who played rugger.

A memorable moment for me as a medical student was the time I was sent to Cambridgeshire to achieve my quota of deliveries. I thought my luck was in when a woman was admitted to the labour ward already 9cm dilated. But the kind midwife quickly ushered me away saying: ‘This one’s not for you, pet.’ Then I spotted, written in red ink all over the woman’s notes, ‘No Pakis anywhere near me’. The irony was that she ended up having an instrumental delivery in theatre attended by an African obstetrician, an Asian anaesthetist, a Chinese paediatrician – and me holding her hand.

I would love to look back on those bad old days and say things are different in 2018

But racism within general practice is far more covert. GP partnerships see themselves as a family or a marriage – one that must not result in an acrimonious divorce. Normal HR rules do not apply as it is vital to find the ‘right fit’ for the practice. This means finding someone who looks like you, dresses like you and speaks like you. A love of Kiss FM over a fondness for Radio 4 was definitely not the right fit for the leafy suburbs.

So, despite holding membership of two royal colleges (with distinction) and having leadership experience outside the NHS, I faced rejection after rejection. But I was fortunate enough to take the old MRCGP exam and not endure the CSA challenges faced by our current BME trainees. Obviously, good communication skills are essential in our profession, but performing role play with an actor may not be the best tool to calibrate this in a certain cohort of doctors.

I would love to look back on those bad old days and say things are different in 2018. But as my daughter is getting ready to perform in Beauty and the Beast at the Bristol Hippodrome this summer, I have already warned her that despite being a talented actress, she is unlikely to be cast in the role of Belle because she is too young.

But sadly, I know her age is not the only reason.


1 Commission for Racial Equality, 1988. Medical school admissions. Report of a formal investigation into St George’s Hospital Medical School

Dr Shaba Nabi is a GP trainer in Bristol




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Readers' comments (40)

  • Vinci Ho

    Guilty pleasure ?
    Or not feeling guilty when having a extramarital affair??
    Walk of shame???

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  • Hi Merlin
    I probably would agree with your opinion if the evidence supported it. Could you provide that evidence? I think it's important that our strongly held opinions on such important issues are robustly evidenced.

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  • Vinci Ho

    Suddenly , we have 'evidence' of discriminatory issues everywhere in the media.
    Fake news really???
    Hasty judgement + arrogance + disrespect?
    Conscious or unconscious?

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  • Macaque

    Tribalism is in our DNA. But we should all be selfless and look at the bigger picture, because we have the biggest brains in the animal kingdom.

    Fairness and equal opportunity! Is it not a very British thing, and quite cool? Perhaps I am wrong about that.

    Disgruntled white male doctors with apparent lack of empathy here will be happier if they give a helping hand to their BME colleagues. We are in the caring profession. We don't do 'dog eat dog'. Or do we?

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  • Unfortunately, appearances is what people notice.
    In some parts of the country, practices are looking for people who speak languages the majority of while male applicants cannot, but the patients do, and outnumber those who can speak English, so they are discriminated against.
    It is lawful to advertise for a welsh-speaker in Wales, but there are few.
    My mother worked with the JobCentre in a part of the country where the number of BME residents was below the national average for the population: hence BME applicants for jobs had an unfair advantage of 'majority' applicants, because employers had to fulfill quotas of BME emlpoyees; and of women against men too, though this was not doctor employment, it did cuase resentment amongst the local comunity, indeed, may have spawned racism as a response, I do not know.
    The message is, we have to respect all, and not discriminate, but at the same time, yes, it is very important for new GPs to fit in with existing practice members : but is the onus on whom to ensure a good fit??

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  • Fair point "kids2old". My evidence is anecdotal. Friends children with straight As and still not able to get into medical school. Certain medical schools stating that they positively discriminate.

    GP colleagues. Those in 50s and 60s are often white and male.

    Younger colleagues rarely white and male.

    Not saying that this is a bad thing. I just think the article is disingenuous and inaccurate which helps nobody. I fully accept that white males have a massive advantage in most sectors of like in the UK. General Practice and Medical School entry seems one of the few areas where that is not the case.

    CSA and GMC hearings--a different kettle of fish.

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  • I have seen racism first hand in medicine, and it is pointless to deny its existence. In terms of recruiting in my practice in South/Mid Wales, however, I can say for definite that we couldn't afford the luxury of any discrimination, in that for our last 7 partners came from 8 applicants, and the one we rejected was white Female and English. Our current 'ethnic mix' is 5 Welsh, 4 English, 1 Scot, 1 Irish, 1 Kenyan Sihk, 1 English salaried, 1Jersey Salaried, and of these 6 women 7 men, and if you think it shows a white bias, it doesn't, it reflects a bias merely to offering the job almost to anyone that applies. I'd love the luxury of having 10 applicants for a partnership vacancy.

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  • AlanAlmond

    I’m afraid racial predudice works both ways. As a white Dr working as a Locum in Birmingham I have come to realise it’s almost impossible to get accepted for Locum work in certain practices serving a predominantly Asian population. They just don’t seem to want to employ a white guy with a English surname. In a big city like Birmingham, sometimes being white is a bit of a problem. Theres racism here too, just not the kind so often written about in articles like this.

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  • AlanAlmond

    Dr T. | Doctor in Training05 May 2018 3:01pm
    I’ve just read your comment and am struck by the inflexibility and self certainty of your approach. These aren’t atributes usually associated with balance or real understanding. Open your mind a little and you might see beyond the end of your nose. BME Drs are significantly over represented in the medical workforce compaired with the population they serve. What’s your take on that? Exlotation by the white majority perhaps, forcing the BME minority into a high status well paid profession? Perhaps this inbalance is the real ‘white elephant in the room’.

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  • Macaque

    @Alberto, there can be many other reasons why you are not getting locums in certain practices in Birmingham ;-) I think it is time 'you look beyond your nose'. LOL

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