Intended for healthcare professionals

Rapid response to:


Specialty training: ethnic minority doctors’ reduced chance of being appointed is “unacceptable”

BMJ 2020; 368 doi: (Published 12 February 2020) Cite this as: BMJ 2020;368:m479

Read all of the articles in our special issue on Racism in Medicine

Rapid Response:

Re: Specialty training: ethnic minority doctors’ reduced chance of being appointed is “unacceptable”

Dear Editor,

Is it worthwhile for young BAME doctors to dedicate themselves to the NHS?

Following recent events in Minneapolis and across the USA, I felt compelled to revisit this issue (Issue: 8223) of the BMJ and reflect upon racism’s impact on my own professional environment.

As we go through medical school alongside our white British colleagues, we are made to feel that we are on an equal footing with our peers, but sadly, this is not the case. It is difficult to articulate how it feels to be second class in a system that trumpets merit and hard work as the deciding factors in your success.

In 1912 Harold Moody, a black practitioner of Caribbean origin was denied the opportunity to practice at King’s College Hospital on the grounds of being a black man (1). Is what is laid out in this report, really so different? This is a much more subtle form of discrimination, which is even more challenging, as I do not doubt that the hiring committees involved would absolve themselves of any racism – however there is obviously something going wrong. If you also take into consideration that BAME doctors are dying at disproportionally high rates due to COVID-19 (2), are more likely to be reported to the GMC (3), and have a significant pay gap compared to their white counterparts (4), the system becomes clearly framed as one that is deep-rooted in racial inequality. All of this gives a subliminal, subconscious message to BAME medical students that you must be willing to sacrifice more in order to reap fewer rewards.

As a final year medical student who had previously hoped to dedicate 40 years of service to the NHS, I am now considering other career options. Who wants to play a rigged game? When, in 1912, Harold Moody was rejected from multiple jobs on racial grounds, he decided to set up a private practice in Peckham (1). If, in 2020, the NHS continues to disadvantage BAME doctors, it may force a similar movement from the public to the private sector in the search for fairness and equality.

Profound, deep change would have to occur in the NHS to win back my trust and that of my BAME colleagues. Having said that, the fact that this continues to take place 27 years after the initial report (5) was published does not fill me with hope.

Kind Regards,
Sagar Mittal

(1) Oddo-Lodge, R., 2017. Why I’m No Longer Talking to White People about Race. Pages 16-17. Bloomsbury Publishing.
(2) Public Health England, 2020. Disparities in the risk and outcomes of COVID-19. PHE Publications, pp 39-49.
(3) General Medical Council, 2019. Fair to Refer? Report
(4) Appleby John. Ethnic pay gap amongst NHS doctors. BMJ 2018; 362: k3586
(5) Esmail A, Everington S. Racial discrimination against doctors from ethnic minorities. BMJ 1993;306: 691 - 2.

Competing interests: No competing interests

06 June 2020
Sagar Mittal
Medical Student
Jasen Soopramanien, Kirthi Shamanur, Lakshya Soni
King's College London
Chorley, Lancashire