Racial bias in medicine won't be stamped out overnight, warns GMC

GMC leaders say they are playing a 'long game' when it comes to stamping out racial bias within medicine - including tackling differential attainment in exams - as doctors call for a culture change across the healthcare sector.

GMC chair Dame Clare Marx
GMC chair Dame Clare Marx

The regulator is currently conducting a review into why a disproportionate number of black and minority ethnic (BME) doctors are subject to fitness-to-practise referrals, as well as examining the gap in attainment levels across different groups of doctors.

Speaking at the regulator’s annual conference on Wednesday, GMC chair Dame Clare Marx also announced plans to launch a new training programme to give doctors the confidence to tackle unprofessional behaviour in the workplace.

However, GMC chief executive Charlie Massey told delegates that issues with unconscious bias remained ‘an elephant in the room’, and delegates voiced concern that there was a long way to go before the problem could be fixed.

Unconscious bias

Speaking during a Q&A session, British Association of Physicians of Indian Origin (BAPIO) president Dr Ramesh Mehta said that, in his experience, unconscious racial bias was ‘unwanted’ but ‘very common’ in medicine.

Addressing the conference’s keynote speaker Megan Reitz - professor of leadership and dialogue at Ashridge Hult International Business School - Dr Mehta asked: ‘How do you suggest we get over [unconscious bias]? How do we change this culture?’

‘I think it’s a long game, it’s not something you can alter and switch quickly,’ Professor Reitz said. ‘The first thing I would say is can we at least have a conversation about it because one thing I’ve discovered is it’s just so politically incorrect to even suggest that race and gender might get in the way. [But] if we can’t even talk about it we are never going to start to alter it.

‘The other thing is that we start to actively associate different messages with different forms over time. For decades we’ve associated "white male" with "leader" in particular contexts. [Although] we are starting to alter that and alter experiences, it takes a long time... [We must] focus on how we can start having conversations about what labels and titles mean something in this organisation because at least then we can start figuring out together how we start to make those associations differently.’

She concluded: ‘Changing habits is no mean feat. We need to interrupt our automatic pilot… It’s not an easy task.’

Differential attainment

Addressing issues with differential attainment in a separate Q&A session, Dr Mehta said he was ‘at a loss’ over what the GMC could do.

This comes after data published by the RCGP in 2018 showed that - among trainees taking the applied knowledge test element of the MRCGP - white participants were almost 30% more likely to pass on their first attempt than their BME counterparts, with a pass rate of 86.8% compared to 60.7%.

Dr Mehta said that, although he was happy the GMC was ‘listening and changing’, he felt that the regulator had ‘sat and watched the horse bolting and now they’re trying to get it back'. He added: Differential attainment is not just exams, it’s the whole career progression.’

Another delegate at the Q&A session suggested the GMC take a role in ‘mandating additional exam support for BME groups’, while another called for greater levels of mentoring.

'A long game'

Closing the conference, Mr Massey assured delegates that the GMC was moving ‘from being a reactive to a proactive regulator'.

‘What that really means is trying to invest more of our resources, ultimately the bulk of our resources, in supporting doctors to be great doctors because we think that is the best way to protect patients and we don’t want to invest all of our resources in acting after the event.’

He added: ‘[Culture change] is always quite an elephant in the room and it is a long game but I think it is something that we must never take our eye off.’

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