Friday, 11 April 2014

Moral victory for NHS GP trainees of black, chinese and asian ethnicity (BME)

Royal Courts of Justice April 8-10, 2014

It was a sad day for the NHS hospital consultants, junior doctors, GPs and GP trainees across Great Britain who had put hands in pocket and had raised £175,000 (in over 690 donations) to be able to ask the High Court for help with the actor CSA GP licensing exam with huge disparities in pass rates between white UK and BME (black and ethnic minority) UK GP trainees, between white UK and BME IMGs (international medical graduates) and between white IMGs and BME IMGs and were only given a moral victory over the Royal College of GPs and the General Medical Council, public authorities with a public sector equality duty to eliminate discrimination, advance equal opportunities and to foster good relations between persons who shared a protected characteristic and persons who did not. The differentials in pass rates based on ethnicities suggested to doctors of BME ethnicity that white skin colour was fairing better than non white and surely needed urgent addressing as this had been known for 7 years despite countless academic research studies commissioned by both the RCGP and GMC.

Approximately 1/3 of NHS GP trainees are from a black or ethnic minority or broadly speaking approximately 1000 out of 3000 each year in UK GP training. Asian doctors in the UK just lost a High Court judicial review of the controversial CSA GP licencing exam. It is a huge blow to the black, chinese and asian communities in Great Britain because these future GPs wanted to work in underdeprived areas of the UK, or serve immigrant UK populations, and speak tamil, urdu, hindi, chinese, etc. or were second or third generation ethnics, UK born, bred and schooled (believing they are British in all manner and form except for a non white skin colour) but were forced to sit an exit actor exam with more chance of failing than passing, or if BME British, a four times greater chance of failing than white British, with dire consequences of being expelled or released at the end of UK training despite passing up to 3,000 NHS multicultural patients' scrutiny each in regular feedbacks. The NHS is haemorrhaging GPs. We need all hands on deck!!!

All they ask is that unconscious bias be tested with the free online Harvard implicit association test and acknowledged in this predominantly white British actor role play 3 hour exam judged by 1 predominantly white examiner per station with no access to CCTV for fair appeals to challenge perceived discriminatory behaviour or marking. Those who score high preference for white race can then be eliminated as CSA actors or examiners and those who score no preference are the best suited and fairest in marking. (The same can be asked of High Court judges and barristers? It was a very surreal Mandela experience to watch a High Court consisting of a white male judge, white male RCGP and GMC barristers and lawyers, white female barrister and white lawyers for BAPIO, white court recorders judge black and ethnic minority doctors who could not give live testimonies and to hear the judge infer that foreign medical schools were not as good as UK (I am a US IMG) with no explanation as to why British BMEs fail 4x more than white Brits. How do doctors of colour feel when judged by 13 white actors and 13 white examiners behind closed doors over 3 hours without CCTV monitoring or recording? The courts say direct discrimination may only be pursued if an individual candidate can prove an examiner or actor was treating them unfairly. This is an impossible task as the Royal College of GPs erase the tapes after 2-3 days in the few rooms with a camera, do not release any videos for appeals and do not record all 39 examining rooms. How can a British black, chinese or asian  GP trainee be reassured that he or she did not fail CSA because of his or her ethnicity, skin colour, age, looks or accent if unconscious bias is not acknowledged and tested? How can a British BME pass CSA if a white actor does not speak for several minutes or withholds their underlying concern? GP trainees are NOT mind readers. The actor has to reveal at some point, sooner or later, but in 10 minutes, it ends up in a pass or fail as if shared later, these trainees then may have less time to formulate a shared management plan. Please now record all stations to ensure the predominantly white actors treat all GP trainees the same and release the tapes for fair appeals of a NHS GP licencing exam to ensure we are not failing good doctors or passing bad doctors. The public need full reassurances and the doctors undertaking these exams are entitled to a fair and open exam process and appeal.

Dwindling numbers of new Indian doctors register with the GMC each year means fewer to prop up the NHS. Without IMGs, the NHS may collapse.