"For us, whatever we do is wrong, until we do something really good": a qualitative study of the lived experiences of doctors from minority ethnic backgrounds in Scotland

Abstract

Objectives: To evaluate the lived experiences of doctors from minority ethnic (ME) backgrounds during postgraduate medical training, in particular their experiences of discrimination (if any); any impact of intersectionality and perceptions on how ME doctors may be better supported in their learning and working environments.

Design: This was a qualitative study grounded in social constructivism, using semi-structured online individual interviews as the data collection method and an exploratory thematic analysis process.

Setting: Participants were recruited from postgraduate specialist medical training programmes within one Deanery (Scotland Deanery) in the UK.

Participants: Fourteen doctors in postgraduate medical specialist training, who self-identified as being from a ME background, were recruited into the study.

Results: Doctors from ME backgrounds faced: Barriers to authentic interpersonal connections, with a perceived lack of social inclusion in the workplace community. ME doctors faced challenges in earning others' trust and experienced microaggressions and exclusion behaviours that affected their self-confidence. Impacts on identity and sense of belonging, with perceived challenges in being understood across diverse cultures. Doctors felt negatively pre-judged (by patients and colleagues), with additional challenges of being pre-judged in contexts of intersectionality; and ME doctors felt they needed to conceal parts of their identity in order to assimilate. Unjust systems-a playing field that is not level, where doctors felt unsupported and unable to effectively report/challenge discrimination. ME doctors perceived a lack of appropriate adjustments to the learning environment (e.g., fuller orientation) as well as inequitable processes (e.g., job and academic opportunities for those requiring visas).

Conclusions: Focused interventions to address unjust systems as well as improve intercultural awareness and understanding between all doctors may help to address some of the current inequities in medical education. Any such interventions require appropriate evaluation to determine their efficacy.

Keywords: health education; medical education & training; qualitative research.