Thriving in Medicine

 As a medical student, every eight weeks I rotate through a new specialty in a new hospital or health service. This means every eight weeks I flick over to a new chapter in my textbook, learn a new set of medical lingo, meet a new team of doctors, and a new cohort of patients. As a person of colour however, this translates to something far more challenging yet predictable. It means responding to ‘where are you from?’ followed by ‘but where are you really from?’ when the answer fails to adequately explain my brown skin. It often means responding to ‘your name is too hard to remember; do you have a nickname?’ with something conveniently anglicised for my supervisors to remember. It means constantly dispelling the notion that anything other than a white culture is homogenous; no I don’t love cricket and no my mum does not exclusively cook curries. It means feeling confused when my white colleagues can simply introduce themselves as medical students and be judged in a professional capacity while I am frequently in the background still justifying the colour of my skin.

To many, these conversations may sound perfectly benign and even well intentioned. They don’t make your skin crawl and your stomach churn like blatant racial attacks. I could write about the patient who insisted I leave her room during morning rounds because she only speaks to white doctors. Or the patient who demanded my Muslim colleague remove her hijab before beginning a consult. Or the patient who asked me if I could even speak English while I wrote in his chart. While these experiences are traumatising, overt racism is paradoxically easy to distance oneself from. We let ourselves simply implicate the ignorance of individuals, rather than challenge the overlooked systemic nature of implicit racism.

I have always thought that racism stems from ignorant assumptions. In my experience, overt racism seldom occurs amongst educated health professionals. But implicit systemic racism persists, impenetrable to the protections of a higher education or the health system.

My most hurtful experiences as a person of colour have come from medical colleagues far more learned than me. From the residents, registrars and consultants who reject the notion that they can be racist, because they assume that racism is about subscribing to the idea of biological white superiority, which they do not. And from my white colleagues who feel the need to assure me that racism plays no part in medical workplaces or medical schools.

Morally rejecting the idea that white people confer biological superiority to non-white people is not enough. There is a general lack of acknowledge that white privilege is omnipresent in medicine; that naïveté alone acts to discriminate against people of colour. In fact, if we do not understand racism as a social construct underpinning our everyday behaviours, we continually underdiagnose what it means to be racist. We continue to be complicit, through our daily actions or inactions, in the reproduction of systemic racial inequity.

Daily actions like staying silent when our colleagues face racial slurs from patients, or defining our colleagues by their skin colour before their medical skills and accolades. Daily actions like forming generalisations about racial groups and leaving it up to members of those racial groups to prove otherwise or defend themselves.

I recently sought guidance from an Indian-born physician on how to succeed through these daily challenges that grind away at my professional and emotional sense of worth. I thought that given his success in medicine, he could offer some advice. My heart sank when his response was to simply ignore it.

I refuse to ignore the racism masked within the foundations on which our medical workplaces operate. We all deserve a work environment in which we can feel truly accepted and thrive – a work environment where we stand out for our professional abilities rather than our perceived otherness.

But people of colour cannot succeed alone in quiet defiance. Our voices require the amplifying volume of the majority. Everyone must acknowledge and challenge everyday implicit racism and break the silence of white complacency in our workplaces whether they be medical schools, hospitals, general practices or other community health services. And when I feel safe to attach my name to my views without fearing career repercussions or racial vilification – I know we will have achieved this.

Anonymous final year medical student.