The racism I experience as a doctor puts the NHS to shame

We must make a much greater effort to address discrimination in the medical profession, writes Dr Seema Haider. Prejudice against minority ethnic physicians should be called out in all its forms

As the daughter of two first-generation Pakistani immigrant GPs, I am no stranger to racism (PA Wire)

I find it hard to see myself as a victim of any kind, as I am acutely aware of the privilege I hold in comparison to vast swathes of the world’s population.

Nevertheless, research shows that as a minority ethnic doctor, I am more likely to face discrimination, the scale and complexity of which we are only just beginning to comprehend. Not only do we have a higher chance of being reported to the General Medical Council, but people like me are underrepresented in leadership positions, have poorer career-related outcomes, and experience more psychological distress.

I haven’t even told you that I am a woman yet, so we will need to factor sexism, including unequal pay, into this toxic mess. Things are not looking good for me, and sadly it appears that the odds have always been stacked against me.

As the daughter of two first-generation Pakistani immigrant GPs, I am no stranger to racism. My late father recounted that, on the day he took over a local GP practice in the 1980s, the receptionist walked out, informing him that she did not wish to work for a Pakistani doctor.

I was raised in one of the most ethnically homogenous boroughs in London. As a child, I can recall that we regularly noticed spittle on our doorstep, which coincided with the early morning paper round. My father asked a local police officer to keep an eye out for the perpetrator, who was promptly caught.

I remember coming downstairs one morning to see a teenage boy sitting in our house, with my father talking to him warmly and openly about race. I’ve been thinking about this incident more frequently, wanting to revisit this story and breathe new life and meaning into it.

I look back now, as a GP of a similar age to my father then, and I realise what he was trying to do: he was trying to reach this boy through tapping into their shared humanity. It was incredibly powerful: the hope that you can change someone’s trajectory through human connection and kindness, in the face of what was essentially the fear this boy felt at our “otherness”.

As human beings, we are hardwired for belonging and connection. Minority ethnic doctors are repeatedly told, in implicit and explicit ways, that we do not belong. We are told this by the institutions that train us and subsequently by the NHS. We experience it every time we fail to see doctors with the same background as us in leadership positions. We start to see ourselves as “the other”.

These institutions, or the individuals that make them up, may minimise, deflect or deny there is an issue, which adds further insult to injury. The BMA “Racism in Medicine” survey found that over 90 per cent of Black, Asian and minority ethnic doctors believe racism in medicine is an issue, compared with only 64 per cent of white doctors.

Minority ethnic doctors carry the trauma of land migration at first hand, or the generational trauma of those who walked before. Perhaps the most bitter pill we swallow is that we also experience discrimination from patients while we seek to deliver care. This painful friction further cements our feelings of marginalisation.

I cannot speak for all such doctors – we all have our individual experiences – but for me, personally, it’s the insidious nature of racism and the covert ways it manifests that leave me demoralised. When racism is overt, there can be no doubt, and we cannot be gaslighted or told we have misunderstood – bizarrely, this offers an element of psychological safety. Where racism is concealed, we start to question ourselves, and this can be highly destructive.

All these incidents accumulate into a series of microaggressions, so it is unsurprising that imposter syndrome ravages doctors like me. We are fed misinformation that we need to improve our self-confidence, read a plethora of self-help books, or attend self-development courses to rectify our issues. The prevailing idea is that if we just tried a little bit harder, everything would be ok.

There is very little accountability from the top for generating this workplace culture in which ethnic minority groups have been stifled and not allowed to flourish. We desperately need authentic leadership in the NHS, and not just catchy soundbites from those in positions of power. We need to obliterate the archetypal image of a leader, and rebuild it in its entirety.

Fundamentally, we must make the effort to see – and I mean really see – the prejudice Black, Asian and minority ethnic doctors experience in all its forms, and from all directions. We must hold space for their stories – only then can we truly stand together, united as a profession against all forms of prejudice.