15 Jul Representation Starts With Access to Education
Medicine should reflect the society it serves. Currently it is a very homogenous field, as the majority of workers in the medical field come from more advantaged socioeconomic backgrounds. In addition to this, when looking at access to Medical education, students from Black ethnic backgrounds, especially Caribbean origin, make up a small proportion of students. The field has come a long way, but it is still far from diverse and, even more troubling, far from a true reflection of the patient population.
The lack of diversity in Medicine is multifactorial. It stems from only a small proportion of students being from less privileged background, highlighted by a study of 22 UK medical schools during 2009-2012. Students from less privileged backgrounds are less likely to apply and also less likely to gain a place. Looking back to my experience of applying to study Medicine, it was a very difficult and confusing world to navigate. I did not have any connections with existing doctors or medical students, and I went to a state school in Croydon. I knew I was hardworking and had the grades, but I lacked a lot of confidence and self-belief. Medicine seemed like a career for middle class White students or exceptionally gifted Asian students and I didn’t fit into either group.
Even when studying Medicine, I have been told many times that I did not sound or look like a medical student. I think this comes as a manifestation of how many people are not aware of their own unconscious racial bias when it comes to what black people should do or can do. It does feel very isolating and frustrating that I sometimes feel like I cannot be my unapologetic self out of fear of being judged or stereotyped. This seems to be a regular occurrence for black employees regardless of industry – in fact a survey recently found that of 2,000 UK workers, 49% of BAME individuals interviewed felt they had to mask part of their identity to fit in at the office, and felt pressure to aspire to a certain expression of professionalism that favoured their white counterparts.
There are clear benefits of improving the diversity of the medical workforce. It would allow doctors to be more representative of the populations they serve, enabling patients to feel they can better connect with their doctor and believe their doctor has a holistic understanding of them as a person. Another reason why diversity in the medical profession is so important, is to combat health inequality caused by racial bias. Black women are up to five times more likely to die from pregnancy related causes than White women. This statistic is similar in the US however, in the UK Black African people make up just under 2% of the population of England and Wales. This leads me to believe the reason for the disproportionate number of deaths is beyond factors such as immigration or culture.
Racism is a very uncomfortable topic to discuss, especially without the voice or input of an individual who has experienced it. The very fact that this is an uncomfortable topic, is part of the reason why it must be approached. People think racism has to be overt and obvious to exist, (such as in the form of racial slurs) but overt racism is not why the death rate for Black mothers is so high. Systemically racist barriers to a diverse workforce and consequential medical research, programmes, and treatments is. Another result of this that I also noticed very early on in my medical career, is that clinical presentations on darker skin people was completely omitted from the education and was a massive failing both to the doctors themselves and to patients of ethnic origin.
By way of breaking down the cycle of systemic and systematic racism, research has proven that being at a diverse medical school has also been shown to positively effect medical students’ attitudes to diversity-related issues. I am witnessing this through the change I am making with Black Medical Society Aberdeen (Instagram: @bmsaberdeen) as a result of an open letter written demanding more effort to make the curriculum more inclusive and change the attitude towards casual racism within the school. I have also founded the African and Caribbean Medical Education Foundation, which aims to change the face of medicine to reflect society and tackle health inequality by encouraging and helping young black students from lower socioeconomic backgrounds to get into Medicine.
Author: Jessica Eze