Racism threatens to drive thousands of GPs out of their jobs, BMA poll suggests

Rampant racism has left the NHS facing an 'exodus' of doctors from ethnic minority backgrounds, according to a BMA poll that suggests as many as one in five GPs may have quit or considered quitting their job in the past two years over race discrimination.

BMA chair Dr Chaand Nagpaul
BMA chair Dr Chaand Nagpaul (Photo: JH Lancy)

Responses to a BMA poll of 2,030 doctors and medical students on racism in medicine found that 32% of respondents had left or considered leaving a job in the past two years due to racial discrimination - including 9% of all respondents who actually did quit.

Among doctors from Black backgrounds, 42% had left or considered leaving a job in the past two years, compared with 41% of doctors from Asian backgrounds, 28% among doctors from Mixed backgrounds and 27% among those from White non-British backgrounds.

Applied to the GP workforce, the figures suggest that around one in five of all GPs may have left or considered leaving a job within the past two years because of racism, analysis by GPonline shows.

NHS racism

The poll found evidence of 'institutional barriers to career progression, dangerously low levels of reporting of racist incidents, and a building mental health burden on ethnic minority doctors', and calls for a string of reforms to support for doctors, reporting and data gathering, training and policy reform.

More than three quarters of respondents had experienced racism in their workplace at least once in the last two years, the BMA survey found.

Three in five doctors who experienced racism said that it had negatively impacted their wellbeing, including causing depression, anxiety, and increased stress levels.

Racism was seen as a barrier to career progression by 60% of respondents from Asian backgrounds, 57% from Black backgrounds, 45% from Mixed backgrounds and 36% from White non-British backgrounds - compared with just 4% of White British respondents.

Reporting racism

An overwhelming 71% of doctors who had personally experienced racism did not report it to anyone - citing a lack of confidence that the problem would be addressed if they did, as well as concerns about being perceived as a 'troublemaker' and affecting relationships with colleagues.

Among those who did report incidents of racism, 58% found that doing so had a negative impact on them - including being made to feel it was their fault, overlooked for promotion, seen negatively by colleagues or accused of overreacting. A total of 16% of all respondents to the survey had taken sick leave due to racism.

Respondents highlighted examples of racist comments from patients and colleagues, and systematic unfair treatment.

One GP trainee responding to the survey, who is of Black African background, said: 'We are treated more harshly and there’s definitely a double standard. My behaviour is scrutinised twice as much - it’s as if people are waiting for me to make a mistake to leap upon it. Also I feel there is an automatic lack of trust and an expectation of incompetence. My plans will be questioned, whereas a white male, doing the exact same actions, will sail through with no resistance.'

Hostile patients

A medical student of Asian British background said: 'Unnecessary hostility from patients and refusal to see/speak to people of colour, yet having polite conversations with White members of staff. This was then followed by gaslighting behaviours and blaming the ethnic minority doctor of being "aggressive" and making the patient anxious, which was not the case at all.'

Other doctors cited experiences of being ignored during training by senior doctors, who behaved cordially towards other trainees who were White.

Another doctor of Black African background reported: 'Rapid and unjust escalation of trainees from ethnic minorities with no effort to communicate - often complaints from White members of staff or staff from different ethnic background.'

The BMA said the findings revealed 'systemic failure which will need every health organisation to work together bring an end to structural racism and rectify the disproportionate outcomes in careers and job satisfaction faced by different ethnic groups'.

Racial inequality

BMA chair Dr Chaand Nagpaul said: 'The NHS was built on the principle of equality of care for patients whoever they are, but this report shows that the NHS is shamefully failing in this principle for its own doctors, with those from ethnic minorities reporting alarming levels of unfair treatment and racial inequality at work.

'It is deeply concerning that so many of those surveyed did not report racism, either out of fear of recrimination, being labelled a troublemaker or a lack of confidence it would be properly investigated. This means that doctors are suffering in silence, and the true extent of racism is neither exposed nor addressed.

'What all this this adds up to is a tragic waste of potential as doctors of ethnic minority are held back, dragged down or simply walk away from the profession.

'Experiencing racism is extremely distressing, with nearly two thirds of doctors we surveyed saying their mental wellbeing had deteriorated as a result, with many suffering depression, low self-esteem and anxiety. There is evidence that incivility can affect the cognitive functioning of doctors, and consequently this is having an adverse impact on patient care.

Wrecking doctors' lives

'Racism is wrecking the lives of many doctors, affecting patient care and threatening services. The time for talk on this is over. Our report makes a range of clear recommendation for change which demand action across the health system, from government to NHS organisations, leaders and other institutions.'

The findings follow a warning earlier this year from the BMA that health service leaders had their 'heads in the sand' over widespread racism in the NHS. 

NHS England head of workforce race equality standard (WRES) Professor Anton Emmanuel said: 'No one should experience racism, discrimination or prejudice at work, it is completely unacceptable and NHS organisations should take a zero-tolerance approach to all and any form of discrimination.

'Since the first WRES report was published in 2021, we have taken decisive actions to address the existing inequalities and are making progress, but we know there is still more work to do.

'We are working closely with regulators, including the GMC and Health Education England, to reduce disproportionate representation in referrals and to focus on career progression and diversity in senior roles - as well as supporting NHS organisations to make quick inroads on tackling race inequality locally in areas such as recruitment and leadership development. We continue to work with the National Guardian’s Office to ensure anyone has the freedom to speak up on any discrimination they may face.'

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