Intersectionality & Sexual harassment as a Minority Ethnic Female Surgeon

As a trainer, I have even taught women from certain cultures (who may find this level of contact difficult), that this is ‘normal’ in surgery. After reading the editorial and letter of response, in the Royal College of Surgeon’s Bulletin, [1] I have to think again about what I teach. I have taken for granted that surgeons have some sort of moral standing. Maybe I should be explaining also what they should not be tolerating. Even as a female surgeon, often at cultural gatherings, I feel I am perceived differently by women from my cultural or ethnic background, even if they are medical professionals themselves. I feel ostracised as being the woman who is playing with the men at their game. The younger generations however do applaud it, and I see more and more young women have a fervour for surgery. I feel now I want to protect them from this misogyny and sexual harassment more than ever.

Tackling Workplace Bullying for Minority Ethnic Doctors

Workplace bullying, undermining and microaggressions are a reality for many, and although the prevalence may vary, there is no environment that is free of such hostile interactions. The healthcare workforce is focussed on empathy, kindness and caring, yet the daily experiences of many are in stark contrast to this. Although awareness of these issues exist, incidents of bullying are still grossly under-reported. Bullying and undermining behaviours stem from a gradient of power and lack of appreciation of the societal advantages of diversity. In keeping with this, the experience of particular sub-populations are disproportionately worse, such as for women, minority ethnic groups, those with disability, LGBTQ+ and those from deprived backgrounds. There have been campaigns and initiatives to change workplace behaviours, with mixed successes. A less explored role is that of organisations whose declared mission is to stand up for equality, represent the voice of the minorities and the under-represented, akin to self-help groups and advocacy. This article explores workplace bullying from the perspective of the minority ethnic doctors and proposes the potential benefit of their representative organisations in helping to balance the inherent workplace disadvantages.

Breaking Barriers

Breaking Barriers - session

Reducing Violence against Health Professionals

There is a rising trend of violence against healthcare professionals across the world, especially after the COVID-19 pandemic. Many countries report between 43-75% of professionals experiencing at least one incident in any annual survey. The most recent incident of doctors and healthcare staff in a Manchester City General Practice raised alarms. As the healthcare infrastructure and services are severely stretched following the disruption of 2020, there are more reasons for disquiet and frustration from the public. The media and political portrayal of primary care physicians as not caring enough to provide face-to-face appointments in the UK is believed to increase the public angst. There are protests from professional organisations but this is not heard by the public. In any violence prevention strategy, a multi-system approach is critical. While tackling misinformation is essential, so is the tackling the root causes, the waiting lists and a balanced information to the public. Political and organisational leaders need to be visible and vocal in explaining why the healthcare infrastructure is beyond breaking point. This will justify the additional resources needed and reduce the frustrations of the public, in need of care. There is also a vital need to help new doctors and nurses as well as all frontline staff in violence dissipation techniques, self-preservation. The Voluntary community organisations including those that support professional groups have a vital role to play. The NHS People Plan has recommended that VSCEs should join robust and reliable partnerships with Integrated Care Organisations in developing strategies and interventions. There is more work to be done. This article is a call for action and invites all VSCEs interested in the reduction of violence against staff to join with employing organisations to set up collaborative working groups with specific actions to implement. This is essential to reduce harm and reduce the demoralisation of an already burnt-out healthcare workforce.

Bridging the Gap 2021- Report

Bridging the Gap- Workshop series 2020-21 This is the full report and discussions in the consensus building workshops and highlights of the thematic synthesis.

Impact of COVID-19 on Mental Health of Adults with Autism in India

Background: This study focuses on the direct and indirect implications of the COVID-19 pandemic on adults with Autism in India. This study took into account the social isolation during the global pandemic in 2020 and its effect on the emotional well-being of the community. Methods: We designed a survey involving Indian residents. Part I involved questionnaires for different cohorts: 1) educated, 2) employed and 3) unemployed. The questions were based on proposed life models to maintain the heterogeneity according to the preferences of the target group. Part II of involved online interviews conducted in English. Qualitative and quantitative analyses were performed. Findings: The analyses of participants’ responses (N=10) stipulated that the impact of the COVID-19 pandemic on autistic people's mental health has been variable. Participants encountered both positive and negative emotions. Factors such as disrupted schedules, fear of job loss, poor domestic support system and inconsistency in transition were important. These were associated with development of new or worsening of pre-existing psychological as well as behavioural conditions including depression, anxiety, panic attacks and high-stress levels. At the same time, reduced interactions with decreased social insistence led to an improvement for some participants. Interpretation: Our results illustrate the deterioration of mental health and well-being for Autistic adults due to the impact of the COVID-19 pandemic. These findings emphasise the need for the development of innovative approaches and investment in the creation of support systems to address mental distress in this population.

Bridging the Gap 2021- Summary Report

Differential Attainment Healthcare professionals are among the most respected, valued members in any society- and also the most regulated. It attracts some of the most talented, innovative and resilient individuals who are keen to do good. Respect, job satisfaction and autonomy are fundamental to the experience of any professional, and often valued above financial or material reward. Doctors are no different. Education and training of the healthcare workforce is a lengthy and resource intense process. No nation-state can be truly self-sufficient. Hence workforce migration is a reality where various pull and push factors lead to professionals moving across countries and continents, in the service of populations. Society is divided along many lines and steeped with structural inequalities. Many of these are the result of thousands of years of history, legacy and societal wrongs. Healthcare services and professionals reflect similar patterns of the 'big society'. The phenomenon of differential attainment (DA), which is the subject of this report is simply a manifestation of such structural inequalities. DA or differential outcomes for doctors due to their age, race, gender, sexual orientation, ethnicity, disability, socio-economic deprivation or influenced by migrant status - rather than motivation, ability, effort or enterprise. DA is fundamentally unfair. Those affected by DA are either unaware or unable to counteract the influence on their careers. DA leads to demoralisation, disengagement and poor outcomes for professionals and their patients. It takes its toll not only on careers but on lives and livelihoods. DA leads to a huge under-utlisation of human resources- a true waste of talent and enterprise. This report- BTG21 focuses on DA in the medical profession exploring the career cycle through the themes of recruitment, assessments, career progression, research & academia, leadership roles, awards and professionalism. BTG21 is people-centred and in tackling inequalities offers solutions on career fulfillment and wellbeing- by an ideological shift of hearts and minds. Thematic Synthesis BTG21 summary report is the culmination of a thematic synthesis of evidence covering the full spectrum of medical careers. It presents lived experiences (collected through mixed method approaches) capturing patterns in peoples experiences through an online survey, and in-depth qualitative interviews with a purposive sample of professionals from across the career cycle, range of ethnic heritage, medical specialism and country of origin. Followed by consensus developed through workshops by a triumvirate of experts, stakeholders and grassroots professionals. There are 5 primary causes of DA- bias, social class & deprivation, immigration status, geographical and individual factors and impacts every stage of medical professional careers. The thematic synthesis reviews are published in the Sushruta Journal of Health Policy. Recommendations The Workshop discussions, recommendations (the 10-point plan) include policy enablers, immediate actions and research questions in the following areas; Tackling bias Embracing diversity & inclusion Celebrating the contribution of migrants Leveling the playing field Inclusive leadership & accountability Removing structural barriers Review-Reform-Rethink assessments Redefining professionalism Disaggregation-intersectionality-benchmarking of data Support-flexibility & Wellbeing

Reflections of a Psychiatrist by Shailja Chaturvedi,

Review of a book by Shailja Chaturvedi, Psychiatrist, Published by Xlibris 2021

Impact of COVID-19 Pandemic on Global Healthcare Systems and the role of a new era of global collaborations

The Covid-19 pandemic has changed the world, socially, economically and politically. There have been many positives in global scientific information flow, collaboration, speed of translation of research, technological innovation and its diffusion has been phenomenal. However the cost to human lives and livelihood has also been catastrophic. In the post-pandemic world, the ambition to provide a well-resourced and universal health infrastructure to populations has become a challenge even for wealthy nation-states. The access to routine and elective healthcare has become severely compromised. In poorer nations, this has affected basic healthcare needs particularly for children, women and those on or below the poverty line. Yet health is a fundamental human right, one that is guaranteed by the treatise on ‘Declaration of Health for All’ to which most countries are signatories. However, could the impact of this pandemic be mitigated by global health initiatives and collaboration? In this context, it is pertinent to analyse the existing global health framework and conventions to identify how we may prepare for future challenges.

What's in a Name? Why it is of vital importance to get the pronunciation right?

Health services across the world are on the one hand the most regulated of all professions, the workforce planning is the most advanced and the restrictions on licence to practice most stringent, especially across borders- yet the workforce is dependent on the ability of large scale movement of professionals across nation-states. The UK NHS has over 41% of its doctors and a quarter of all nurses who were born / trained overseas. This is not much different to many other advanced health systems. It is also recognised that patient outcomes, recruitment and retention of healthcare professionals who are in great demand depends on autonomy, job satisfaction and a sense of value, equality and a just environment. A fundamental tenet of equality, celebrating diversity and inclusion is how organisation or society deals with the immigrant professionals or ‘foreigners’. The ability to correctly pronounce ‘foreign’ names is one of the fundamental and most obvious demonstration of respect one accords to a fellow human. There is a long standing practice of transfiguring foreign sounding names to anglicised or westernized versions for ease of use. The westernization of foreign names is predominantly imposed by the dominant segments of populations on those considered inferior. There is clear evidence of social inequalities linked to one’s race, ethnicity, immigration and gender. Transfiguring one’s name is a clear example of such discrimination, microaggression and a form of bias. It is time that we understood the impact of such microaggressions of colleagues and our patients. It should be vital for all professionals to take the time and attention needed to get the pronunciation right and in the process understand the cultural diversity, identity and demonstrate due respect and equality. It is also imperative on those of us with foreign sounding names that we help colleagues navigate the rich heritage of our culture and identity and do so with humility. It can only then be a win-win for all.