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The NHS owes doctors who trained abroad an apology for racism

BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k2360 (Published 31 May 2018) Cite this as: BMJ 2018;361:k2360
  1. Rajgopalan Menon, retired GP and former chair Leeds Local Medical Committee
  1. menonsnr{at}btinternet.com

Racial abuse was ubiquitous but the NHS offered a total lack of support, writes Rajgopalan Menon, reflecting on a 40-odd year career as a GP

As a doctor who trained in the southern Indian city of Visakhapatnam and started working for the NHS in 1974, my experiences are similar to those of many doctors from the Indian subcontinent who arrived in the UK in the late ’60s and ’70s.

All non-white staff faced overt racial abuse, but we just had to cope. Being referred to as a “wog” was a regular occurrence. More alarming was the constant use of “black bastard” by patients at night in the emergency department of a district general hospital of a northern English mill town.

I remember being on call for paediatrics for a month—only the consultants alternated—covering all admissions, the special care baby unit, the delivery suite, plus the ward. Even in such an intense working environment racism was ever present.

Often parents told me that they did not want a black doctor to touch their child. I would remark, “I am brown actually,” to diffuse the situation. Sometimes it worked. If it didn’t I would call the consultant. Fortunately, one always came--but they never confronted the racism or backed me.

All of my registrars during my training years were foreign trained doctors from the Indian subcontinent. They were excellent clinicians, with skills they were willing to teach. But many failed to obtain higher qualifications, and I wonder if institutionalised racism was the reason.

Many doctors who had trained abroad had only temporary medical registration in the UK, even though the majority were senior house officers or registrars and had to sit qualifying examinations here to obtain full registration.

“Are you a local candidate?”

The examinations these doctors faced were not standard. Candidates working in the north of England were asked, “What is the commonest antibiotic used in London hospitals?” Or, “You speak very good English, are you a local candidate?”

After training, seeking a practice was similarly difficult. No suburban practice would consider an Asian doctor. Many of my generation set themselves up in areas predominant in immigrants.

My course organiser for the vocation training scheme arranged for white colleagues to have interviews with prospective practices in affluent areas but asked me to apply to single handed practices in deprived areas.

Even in deprived white working class areas, we were never welcomed. Shouts of “nigger” and “Paki” were common, mostly at night during home visits.

The front door of my surgery was smeared with faeces, but this was quickly cleaned up by staff and patients. After 10 years’ practice I’d won most of them over, and after 32 years they did not want me to leave. But that still does not erase the pain of racism I endured.

“Go home”

Immigrant doctors have not all had the same experience. My wife trained in Wirral, having come here in 1978 after qualifying in Manipal, Karnataka, but denies experiencing as much racism. One patient told her that she did not want to be seen by a black doctor. The ward sister responded: “Then leave the ward: we have no other doctor.” A white surgical registrar told her that she should go home to where she came from.

This year we are celebrating 70 years of the NHS, but only a token exhibition at the Royal College of General Practitioners seems to acknowledge the many foreign trained doctors who have arrived here since the late ’60s and who enabled the health service to be expanded faster than would otherwise have been possible.

The NHS, royal colleges, General Medical Council, and BMA owe doctors who trained abroad a collective apology for their inaction on racism and for turning a blind eye toward it at all levels: in training, higher qualifications, and conditions of employment.

The global #MeToo campaign to denounce sexism and sexual misconduct, and the campaign for justice for the Windrush generation, should inspire us: now is the time for non-white healthcare professionals to speak up about the abuse we have suffered working in the NHS.

Footnotes

  • Feature, doi: 10.1136/bmj.k2336
  • Competing interests: I have read and understood the BMJ Group policy on declaration of interests and have no relevant interests to declare.

  • Provenance and peer review: Not commissioned; not externally peer reviewed.

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