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The white elephant in the room

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