Rammya Mathew: Racism in medicine—migrant doctors aren’t here just to “fill a gap”BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m483 (Published 12 February 2020) Cite this as: BMJ 2020;368:m483
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I sympathise with the pain this young GP has when reflecting on the experience of her parents. Although I cannot fully appreciate the nature of the barriers they encountered, it may be worth noting that the NHS they tried to build a career in during the latter part of the 20th century was challenging for many who entered the profession at the time irrespective of background. I qualified in 1980 after a state education at a grammar school. I was the first in my family to enter medicine and as white UK born child of the sixties might be regarded as inherently privileged. The training path for surgery was frankly brutal for anyone wishing to achieve consultant status.
I worked in 5 cities in the North and Midlands during my training and had to take up a post 50 miles from my wife during the first year of our marriage. After 2 HO and 3 SHO posts and a Registrar post of 4 years I attained senior registrar status 6 weeks after the birth of the first of our four children. Unfortunately this meant I and had to work 100 miles away from them for 3 months (my wife giving up work completely and never feeling able to return).
The post I commenced had a 1 in 2 rota which involved acute ophthalmic cover for the whole city of Coventry meaning very little time spent with our new family. We finally were reunited but the 3 years of work as a Senior Registrar for the Birmingham Eye Hospital was hugely challenging requiring intensive outpatient and surgical workloads and the simultaneous need to undertake clinical research along with regular out of hours surgical on call. I finally achieved Consultant status 10 years after qualification. Many colleagues at the time spent much greater time than me, often having to undertake fellowships and or MS or PhDs to create a CV sufficiently strong to even compete for a consultant post. No wonder then that these times saw many aspiring surgeons both UK trained and migrants never able to realise their dreams.
Mercifully the career paths in surgery have changed to allow for a better work life balance and judging from the quarterly list of new consultant appointments published by the Royal College of Ophthalmologists the diversity of the Consultant body is evident for all to see.
I'm sure my experience was not at all unique but might set in context the bitter struggle that Dr Mathew's parents had to face when arriving when they did in the NHS of the 70's,'80s and 90's.
Competing interests: No competing interests
The author has presented a polished and concise version of her parents' career and the challenges faced. As a person who had faced similar challenges, it is important to point out that the majority of people are fair, decent, hardworking and helpful. Without underestimating the struggles and challenges, many have achieved a lot in medicine improving patient care worldwide.
My firsthand take on this theme: 'Why can’t the world be colour blind? – My mosaic bird'
This is a mosaic bird measuring about 15x7cm. It is in the shape of a small woodpecker, crafted from wood and has little coloured mosaic tiles carefully stuck on it. Many may pass it by without a second thought. However, it is very special for me as every time I look at it, it brings memories and reflections. Special memories because it was made specially for me by a patient of mine who was registered blind and had been a British second world war veteran on the frontline in Burma. At a routine follow up appointment, he had the thoughtfulness and generosity to give me this remarkable piece of craftsmanship. In his world colour didn’t matter and he was able to have the vision and kindness of spirit.
Such a thoughtful gift reminded me of one of the reasons many doctors do what they do - the desire and ability to help others irrespective of race, colour, age or disability as envisaged by Hippocrates.
I am a British Asian surgeon and have been working for the NHS for more than 25 years treating more than 10,000 patients. Over the years, I have faced differential treatment and had interesting conversations with strangers and respected colleagues, including one time when I was asked by a random elderly lady when I was walking to work – ‘When are you going home?’ I replied ‘later that evening to my home Birmingham’. I also met a well-regarded, retired professor at a meeting in Oxford. I had read about his work as a student and was excited and humbled to meet him in person. After greeting him and telling him about my work and life, I was intrigued to hear his next question –‘When are you going home?’ I managed to answer him about going back to my home in Birmingham. However, in both of cases, I am not sure my interlocutors were especially concerned about my safe return to Birmingham.
Whilst these examples are anecdotal, many colleagues face differential treatment in training, exams and workplace despite various equality and diversity initiatives and workforce race equality standards.
However, when I look at the mosaic bird, it reminds me that the majority of my patients and colleagues are colour blind and that only very few respond with thoughts of repatriation or differential treatment.
The mosaic bird makes me to contemplate, ‘Why can’t the world be colour blind?’ I endeavour to shed my prejudices, as change can only happen when everyone reflects on what they can do to shed their prejudices.
Colourful world can be vivid and more beautiful when we are colour blind.
Competing interests: No competing interests