I’m an ST8 in Neonatal Medicine, and hold some voluntary roles within RCPCH. I’m extremely proud to be part of the Recruitment and START Executive Boards, and regularly help guide and mentor juniors both informally and on careers days. I love encouraging junior doctors to join paediatrics and help them find a career they’ll enjoy and excel at. Designing questions and scenarios for interviews is a great challenge - and an opportunity to meet colleagues and share ideas for how to meet the many challenges we face in paediatric recruitment, training and service design.
As a result of my contributions to RCPCH initiatives, I have been honoured to be invited to contribute to other College events. However, on occasion I have felt like "the token BAME" (Black, Asian and Minority Ethnic) person. Responses to my concerns left me feeling that equality and diversity was being addressed at times as a box-ticking exercise. As a result, I’ve declined to work with some groups in RCPCH. If you’re going to ask me to do something, then use all of me – my experience, insights and concerns. My value goes deeper than my ethnicity.
The same issues exist in wider paediatrics. I have had direct experience of racial micro aggressions, assumptions, and frankly unacceptable behaviour. I know I’m not the only one. I’m not going to “name and shame”, and don’t believe it would be productive to do so. But recent discourse sparked by the murder of George Floyd has once again made me reflect on my own ethnicity, identity and role within medical and wider society. I feel compelled to speak up.
Those who know me know I can be outspoken about racism. Yet even I find it hard to call out or believe tangible change is possible. After some reflection, I’d like to propose some suggestions for how we as a College can move forward.
The important thing is to own mistakes and learn from them.
Firstly, we need to break the taboo and talk about race and racism. For too long, white people who mean well have been afraid to talk and ask questions and learn for fear of “getting it wrong” and being permanently labelled racist. In healthcare we try to engender a culture of “learn not blame”, and within certain limits, I believe this applies here. Conversations allow learning, but we must accept that people will sometimes “get it wrong”. The important thing is to own those mistakes and learn from them.
But please don’t expect people from BAME groups to teach you everything – they are not the cause of these issues and should not be seen as the whole solution. There are a multitude of excellent books, blogs, movies and documentaries that are rich sources of learning. Please use them.
Of course, in the context of racism, a “learn not blame” culture does not mean everything is justifiable. Some behaviour needs calling out and correcting. But calling out racism is difficult to do when there is often a power gradient between victim and perpetrator, leading to a very real fear of repercussions for the person raising concerns. I am certainly not immune to these fears. I would call on RCPCH and other institutions to sign up to a Race & Equality Charter – one that sets out what is acceptable, and gives College backing to people so they feel safe and confident in calling out racist behaviour, and ensure that appropriate corrective and disciplinary action is taken.
Secondly, we as a College must, as always, put the child at the centre of our initiatives. We must work to address and reverse factors causing the severe health, educational and socioeconomic inequalities affecting BAME children and young people, with publication of data, allowing progress to be monitored. Only by addressing these can we truly believe ourselves to be advocates for every child and young person.
If we can’t support and advocate for our own members, what credibility is left in terms of representing children and young people?
Thirdly, we must address the inequalities in academic, educational and career attainment and representation at senior levels for those from a BAME background. I strongly advocate publication and regular monitoring of data so RCPCH can demonstrate its achievements and commitment to progress. After all, if we can’t support and advocate for our own members, what credibility is left in terms of representing children and young people?
Finally, teams throughout paediatrics and RCPCH need to look at their organisational structures. How many of your team are BAME? What are you actively doing to listen to them and use their insights? How can you improve things for every member?
It is time RCPCH once again stands and takes a lead role, as it has for other issues, and demonstrates that paediatricians truly are advocates for all our patients.
It’s time to talk frankly about race.
Dr Kunal Babla is an ST8 in Neonatal Medicine in London, and is on Twitter @kunbab