British doctors of BAME origin and overseas-trained medics working in the UK 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 with white British-trained medics.
Doctors also experience “discrimination and disadvantage” in their efforts to progress medical careers because of a hostile “culture” in too many parts of the NHS, it said.
The report, by the GMC’s chief executive, Charlie Massey, is intended to stamp out discrimination.
In his foreword, Massey points out that the makeup of the medical workforce across the UK is changing. More than half of all the doctors who joined the GMC’s register last year were trained overseas – international medical graduates (IMGs) – and “the demography of UK graduates is also 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 latter years, issues of inequality are persistent and pernicious.
“This unfairness is deep-rooted and longstanding. It undermines doctors’ morale and ability to perform at their best. And it shames our health services.
“Fair treatment is not the preserve of a select few – it is the right of all doctors, regardless of who they are.”
The report provides a detailed update on the targets the GMC set in 2021 to tackle “persistent areas of inequality”. It set them in response to persistent criticism of the disproportionate number of UK-trained BAME doctors and overseas-trained medics who were being referred to it for alleged breaches of their code of conduct.
Progress against those targets has been made, the report finds. For instance, the number of bodies such as NHS trusts or health boards across the UK found to have referred a disproportionate number of doctors to the GMC for investigation, based on their ethnicity or place they qualified, has fallen from 5.6% to 3.2% from 2016 to 2023.
Similarly, the difference in rates of employers’ referral of medics to the GMC between ethnic minority and white doctors fell from 0.28% to 0.13% between 2016 and last year.
As well as the “sustained signs of improvement” in such referrals, the “attainment gap” in how IMGs fare in their careers when they start training in their chosen medical speciality is also “narrowing”.
Massey told the Guardian that too many “cultures within which doctors work are not inclusive enough”, especially given the NHS’s increasingly diverse medical workforce. The enduring gaps between white doctors and their British BAME counterparts and IMGs are “shaming” and “unacceptable”, he added.
However, he lauded the efforts of some NHS employers, such as the Hywel Dda health board in Wales, to help IMGs in particular settle in the UK through support with finding homes and schools, and at work through tailored induction programmes.
Massey urged more NHS bodies to learn from such examples and avoid the situation where a doctor newly arrived in the UK is “thrown on to” a medical rota with little preparation.
The British Medical Association urged the NHS to move quicker to end discrimination and make UK medicine a more welcoming and inclusive environment for doctors who are not white.
Prof Philip Banfield, the BMA’s chair of council, said: “The GMC recognises, in its own words, the ‘persistent and pernicious’ inequality that ethnic minority doctors and our colleagues from overseas are still forced to endure over the course of their entire careers.
“While there may be signs of progress in some areas, we will not be satisfied until doctors of all backgrounds are afforded 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 everyday interactions in their workplace with colleagues and patients, and in the very way the GMC conducts itself and treats doctors undergoing fitness-to-practise proceedings.”
The “disparities” disclosed in the GMC’s report are unacceptable, the Department of Health and Social Care said.
“We are proud the NHS is one of the most diverse organisations in this country but these disparities in career paths are clearly unacceptable. This report shows that while progress is being made it is vital we go further and faster to address these inequalities,” a spokesperson said.
“As we fix the broken NHS and deliver our 10-year plan for health we will seek to close these gaps. We are committed to supporting NHS England’s Equality, Diversity and Inclusion Improvement Plan, which sets out targeted actions to address the prejudice and discrimination – direct or indirect – faced by healthcare professionals.”
