British doctors of BAME descent and foreign-trained medics working in Britain experience “persistent and pernicious” inequality throughout their careers, the medical regulator has warned.
The General Medical Council (GMC) said too many doctors are still being reported by their employers for alleged misconduct compared to white, British-trained medics.
Doctors also experience “discrimination and disadvantage” in their attempts to advance medical careers, due to a hostile “culture” in too many parts of the NHS, the report said.
The report, prepared by GMC CEO Charlie Massey, aims to eliminate discrimination.
In his foreword, Massey points out that the composition of the UK medical workforce is changing. More than half of all doctors who joined the GMC register last year were trained abroad – international medical graduates (IMGs) – and “the demographics of UK graduates are also becoming increasingly diverse”.
But he said: “Yet for too many doctors, medicine is a story of discrimination and disadvantage. From the early days of education and training to the leadership positions of recent years, issues of inequality are persistent and pernicious.
“This unfairness is deep-rooted and long-standing. It undermines doctors’ morale and their ability to perform at their best. And it puts our healthcare system to shame.
“Fair treatment is not the domain of a select few – it is the right of all doctors, no matter who they are.”
The report provides a detailed update on the targets set by the GMC in 2021 to tackle “persistent areas of inequality”. It comes in response to ongoing criticism over the disproportionate number of British-trained BAME doctors and foreign-trained medics referred to BAME for alleged breaches of their code of conduct.
Progress has been made towards these goals, the report notes. For example, the number of bodies such as NHS trusts or health boards in the UK that have referred a disproportionate number of doctors to the GMC for investigation, based on their ethnicity or place of qualification, has fallen from 5.6% to 3, 2%. 2016 to 2023.
Similarly, the difference in the number of doctors referred to the GMC by employers between ethnic minority and white doctors fell from 0.28% to 0.13% between 2016 and last year.
In addition to the “continued signs of improvement” in such referrals, the “performance gap” in how IMGs are doing in their careers also “narrows” when they begin training in their chosen medical specialty.
Massey told the Guardian that too many “cultures in which doctors work are not inclusive enough”, especially given the NHS’s increasingly diverse medical workforce. The continued divide between white doctors and their British BAME counterparts and IMGs is “shameful” and “unacceptable”, he added.
However, he praised the efforts of some NHS employers, such as the Hywel Dda Health Board in Wales, to help IMGs in particular to establish themselves in Britain through support in finding homes and schools, and in employment through through tailor-made introductory programs.
Massey urged more NHS bodies to learn from such examples and avoid the situation where a doctor who has recently arrived in Britain is “thrown” onto a medical roster with little preparation.
The British Medical Association urged the NHS to take faster action to end discrimination and make British medicine a more welcoming and inclusive environment for doctors who are not white.
Professor Philip Banfield, chairman of the BMA board, said: “The GMC recognizes, in its own words, the ‘persistent and pernicious’ inequalities that ethnic minority doctors and our overseas colleagues continue to face over the course of their entire career. .
“While there may be signs of progress in some areas, we will not be satisfied until physicians of all backgrounds are given the same opportunities, free from discrimination and treated with equal respect and fairness.”
He added: “This must extend throughout their training and career development, be reflected in the day-to-day interactions in their workplace with colleagues and patients, and in the way the GMC behaves and treats doctors who have a ‘fitness to-practice’ procedure.”
The “disparities” revealed in the GMC report are unacceptable, the Department of Health and Social Care said.
“We are proud that the NHS is one of the most diverse organizations in this country, but these differences in career paths are clearly unacceptable. This report shows that while progress is being made, it is critical that we go further and faster to tackle these inequalities,” a spokesperson said.
“As we fix the broken NHS and deliver our 10-year health plan, we will look to close these gaps. We are committed to supporting NHS England’s Equality, Diversity and Inclusion Improvement Plan, which sets out targeted actions to tackle the prejudice and discrimination – directly or indirectly – faced by healthcare professionals.”