Diversity in Practice: Insights from Minority Ethnic Doctors’ Careers

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Mixed ethnic group of medical professionals walking down a corridor together in the North East of England. They are working a shift at a hospital and are dressed in scrubs. The women are carrying/using digital tablets.

By Professor Etlyn Kenny, Professor Joanne Duberley, Dr Chris Darko, Dr Ashok Patnaik (University of Birmingham) and Professor Dulini Fernando (Aston University)

What do the experiences of minority ethnic doctors tell us about workplace inclusion in the diverse field of medicine? A team of researchers from the University of Birmingham and Aston University is investigating the experiences of minority ethnic doctors to bolster support for minority professionals.

Minority ethnic people make up 16% of the UK’s population – ranging from 3% in Northern Ireland to 18% in England (House of Commons, 2023), with higher proportions in younger age groups and in some English cities. Over 40% of the population in cities like London, Birmingham and Leicester are minority ethnic (ONS, 2022). The importance of ethnic and racial diversity to the UK’s workplaces is widely acknowledged, yet despite significant progress, many high-status occupations lack the level of ethnic diversity you would expect to see. As researchers of organisations and working lives, between us we have produced a significant body of research, much of it aimed at understanding the perspectives of those experiencing under-representation in their organisation or profession. Hence, we are familiar with many of the arguments used to account for the lack of minority ethnic representation in many occupations, many of the solutions proposed, and many of the issues that remain unaddressed.

We are working together on ground-breaking research funded by the Economic and Social Research Council to address some of the unanswered questions on race and ethnicity in our understanding of contemporary careers.  We are focusing on the careers of minority ethnic doctors and how ethnicity is relevant to the way in which doctors move through the fixed stages of a medical career.  We were drawn to this topic partly because on the surface, medicine tells a different story to most other careers when it comes to workforce ethnic diversity. Fifty-one percent of junior doctors and 42% of consultants working in the NHS are from minority ethnic backgrounds (Stockton & Warner, 2024) – a much higher proportion than are in the working population. This figure is bolstered by the fact that 27% of doctors are international medical graduates from Asia, Africa, and other regions, (Baker, 2023), but medicine is the career choice of many UK-born minority ethnic people. We also see good representation of minority ethnic medical students – making up around 29% of those in medical school (Brown et al., 2023).

However, despite not being under-represented in the field, there remain issues for minority ethnic doctors when it comes to pay and progression to more senior levels of the medical profession (BMJ, 2023).  Some may say that this is a matter of time, and that with significant numbers in the pipeline these issues will self-correct. However, two things caution against this. First, there is a long history of minority ethnic doctors practising in the UK (partly driven by Britain’s historic links with India), but many were pushed into less popular specialties and prevented from making the progress that may have placed them in the most senior roles today (Esmail, 2007).  Second, issues remain with how the job is experienced. We know that there are many challenges in the current medical workplace, and as we saw during the Covid-19 pandemic, these issues can be experienced more acutely by minority ethnic doctors (Mahase, 2020). Although minority ethnic doctors report higher levels of job satisfaction, they report lower levels of support from colleagues (GMC, 2023) and experience higher levels of bullying and harassment (NHS, 2023). Hence there is a need to understand how being an ethnic minority impacts on how a medical career is experienced and progressed in the UK.

We have approached this task in stages. By examining existing literature and the UKMED database we are building a picture of what is already known about how race and ethnicity impact doctors’ careers.  We have run focus groups with minority ethnic Y13 students hoping to enter medical school to understand how that decision is shaped by schools and families, as well as their views of the relevance of ethnicity to the medical careers they hope to pursue.  We are currently surveying medical school students to understand the similarities and differences between medical students from different ethnic groups in their perceptions of medical careers.

To really understand how current doctors experience their careers, over the coming months we aim to interview 120 doctors from a range of minority ethnic groups about how they have progressed through a career in medicine. We are looking to hear from minority ethnic doctors from all backgrounds and all minority ethnic groups. We want to understand how British minority ethnic doctors, whether from state or independent schools, made the journey in and through medicine. We want to understand how minority ethnic doctors from overseas, entered and progressed through medicine in the UK. Our research will take into consideration how the narratives of doctors from different minority ethnic groups (including mixed ethnicity) may differ; and how the experiences of minority ethnic women working in medicine may at times diverge from those of minority ethnic men. We would also like to understand whether culture and religion have influenced the career experiences of some minority ethnic doctors.

To understand how ethnicity is relevant at different career stages, our research will explore how minority ethnic doctors have moved through the specific stages of a medical career. The interviews we conduct will cover the decision to study medicine, movement through medical school and through foundation and specialty training. We aim to interview doctors at all career stages – from foundation training to consultant to identify how ethnicity might operate in a medical career, and where this might be most acute. We also aim to interview doctors from a wide range of specialties to see if there are patterns based on the area of medicine pursued.

By understanding how minority ethnic doctors achieve their career goals, and how experiences and strategies might differ for doctors from different minority ethnic minority groups (and other intersecting identities), we can advance understanding of the contemporary role of ethnicity in medicine. We can use this knowledge to help improve the career experiences of doctors, tackle discrimination and support doctor retention. We can also use this knowledge to further our understanding of how to support minority ethnic professionals in other fields where they are not as well represented as in medicine.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of the University of Birmingham.

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