British BAME and foreign doctors 'suffer
discrimination throughout careers'
================================================

British doctors of BAME origin and overseas-
trained medics working in the UK experience
"persistent and pernicious" inequality
throughout their careers, the medical regulator
has warned.

The General Medical Council (GMC) said too many
doctors are still being reported by their
employers for alleged misconduct compared with
white British-trained medics.

Doctors also experience "discrimination and
disadvantage" in their efforts to progress
medical careers because of a hostile "culture"
in too many parts of the NHS, it said.

The report, by the GMC's chief executive,
Charlie Massey, is intended to stamp out
discrimination.

In his foreword, Massey points out that the
makeup of the medical workforce across the UK is
changing. More than half of all the doctors who
joined the GMC's register last year were trained
overseas - international medical graduates
(IMGs) - and "the demography of UK graduates is
also increasingly diverse".

But, he said: "Yet, for too many doctors,
medicine is a story of discrimination and
disadvantage. From the early days of education
and training, to the leadership positions of
latter years, issues of inequality are
persistent and pernicious.

"This unfairness is deep-rooted and
longstanding. It undermines doctors' morale and
ability to perform at their best. And it shames
our health services.

"Fair treatment is not the preserve of a select
few - it is the right of all doctors, regardless
of who they are."

The report provides a detailed update on the
targets the GMC set in 2021 to tackle
"persistent areas of inequality". It set them in
response to persistent criticism of the
disproportionate number of UK-trained BAME
doctors and overseas-trained medics who were
being referred to it for alleged breaches of
their code of conduct.

Progress against those targets has been made,
the report finds. For instance, the number of
bodies such as NHS trusts or health boards
across the UK found to have referred a
disproportionate number of doctors to the GMC
for investigation, based on their ethnicity or
place they qualified, has fallen from 5.6% to
3.2% from 2016 to 2023.

Similarly, the difference in rates of employers'
referral of medics to the GMC between ethnic
minority and white doctors fell from 0.28% to
0.13% between 2016 and last year.

As well as the "sustained signs of improvement"
in such referrals, the "attainment gap" in how
IMGs fare in their careers when they start
training in their chosen medical speciality is
also "narrowing".

Massey told the Guardian that too many "cultures
within which doctors work are not inclusive
enough", especially given the NHS's increasingly
diverse medical workforce. The enduring gaps
between white doctors and their British BAME
counterparts and IMGs are "shaming" and
"unacceptable", he added.

However, he lauded the efforts of some NHS
employers, such as the Hywel Dda health board in
Wales, to help IMGs in particular settle in the
UK through support with finding homes and
schools, and at work through tailored induction
programmes.

Massey urged more NHS bodies to learn from such
examples and avoid the situation where a doctor
newly arrived in the UK is "thrown on to" a
medical rota with little preparation.

The British Medical Association urged the NHS to
move quicker to end discrimination and make UK
medicine a more welcoming and inclusive
environment for doctors who are not white.

Prof Philip Banfield, the BMA's chair of
council, said: "The GMC recognises, in its own
words, the 'persistent and pernicious'
inequality that ethnic minority doctors and our
colleagues from overseas are still forced to
endure over the course of their entire careers.

"While there may be signs of progress in some
areas, we will not be satisfied until doctors of
all backgrounds are afforded the same
opportunities, free from discrimination, and
treated with equal respect and fairness."

He added: "This must extend throughout their
training and career development, be reflected in
everyday interactions in their workplace with
colleagues and patients, and in the very way the
GMC conducts itself and treats doctors
undergoing fitness-to-practise proceedings."

The "disparities" disclosed in the GMC's report
are unacceptable, the Department of Health and
Social Care said.

"We are proud the NHS is one of the most diverse
organisations in this country but these
disparities in career paths are clearly
unacceptable. This report shows that while
progress is being made it is vital we go further
and faster to address these inequalities," a
spokesperson said.

"As we fix the broken NHS and deliver our
10-year plan for health we will seek to close
these gaps. We are committed to supporting NHS
England's Equality, Diversity and Inclusion
Improvement Plan, which sets out targeted
actions to address the prejudice and
discrimination - direct or indirect - faced by
healthcare professionals."



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