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Into No 10: King's students address ethnicity in medicine

Little did Elohor Ijete know that when she went to an NHS awards night, it would lead to a chance meeting with Mr Nero Ughwujabo, the Special Adviser on Social Justice, Young People, and Opportunities and ultimately a visit to Number 10 Downing Street.

Now in her final year at King’s, Elohor noticed from the beginning that there were low numbers of Black and Minority Ethnic (BAME) doctors in London, despite the city being so diverse. As a result, she got together with some of her peers to start mentoring BAME students applying for medicine in order to help diversify the profession.

Indeed, around the world, there is a concern that students in medical school do not reflect the socio-demographic diversity of the home nations. Medical Schools are working to redress the balance. The largest and longest-running course of this type, the Extended Medical Degree Programme (EMDP) at King’s, has been designed to widen participation in medicine. It provides a six-year course that spreads the first year of the medical degree over two years. 90% of students from the EMDP are from a BAME background compared to around 50% on the standard programme. 

Following a discussion with Mr Ughwujabo at the awards evening, Elohor led a group of 13 other medical students from King’s College London and St Georges University to 10 Downing Street for a round table discussion. They talked about ways to increase the number of BAME medical students.

We spoke to the students about their experience at No 10 and their motivations in working towards a diverse and representative profession.

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(Back row left to right: Ellie, Amisha. Front row left to right: Jess, Eniola, Lizzy)

What motivated you to become a doctor?

Ellie: My mother is a medical doctor, a Forensic Psychiatrist. She also has a physical disability, which has led to her using a wheelchair. I have been her carer since I was 10 years old. This personal life experience of understanding physical disability and its impact on the person, their family and society inspired me to study medicine so that I could provide holistic care.

Jess: I have always liked a challenge and when I didn’t get into medical school the first time, it was a challenge. I took a gap year to work as a Healthcare assistant and from caring for patients on a daily basis, I could see myself in a position of helping them in the future. I also have first-hand experience of how medicine helps improve the quality of people’s lives – if it wasn’t for IVF treatment, my three siblings and I wouldn’t be here today.

Eniola: I have always wanted to be caring for people in some way. During school, I volunteered at a care home and since then I have also worked as a healthcare assistant giving me first-hand experience of the positive impact healthcare professionals have on patients’ lives.

Why is ethnic diversity important in medicine?

Ellie: Our patient population in the UK is ethnically diverse, especially in London. A patient’s culture and ethnicity can influence how they experience illness, adhere to medical advice and respond to treatment. Doctors who are from a similar culture or ethnicity as their patients can understand these cultural factors and therefore provide a better care experience. Learning about different cultures and ethnicities from interacting with other medical students from a variety of ethnic backgrounds is more effective than learning from cultural competency courses as it is hard to become culturally competent solely by reading textbooks and listening to lectures. Increasing the numbers of BAME medical students will help with this. Patients will also benefit from having doctors who may not be from the same background as them but who are more culturally competent. This will ultimately help address health inequalities in the UK.

Lizzy: Doctors from different ethnic backgrounds can serve as role models to younger students who are from a similar ethnic background and increase their belief that they also can achieve similar heights in the profession. In addition, when doctors understand your culture and where you’re coming from, as a patient you might feel more comfortable and open up more leading to better care.

Amisha: Health inequalities are unjust and avoidable differences in people's health across the population and between specific population groups. Increasing ethnic diversity in the multidisciplinary team would further reduce the extent of health inequalities currently present within the NHS. There also needs to be ethnic diversity in medical leadership as this is where policies get made. With more ethnic diversity we get better performance, an increase in creativity and problems can be viewed from different angles.

Eniola: The NHS workforce should reflect the diversity of the British population at all levels. This is important not only for patients and their level of comfort when being treated but also for the healthcare professionals themselves. The majority of BAME students don’t see themselves represented in these roles and this is one of the reasons why increasing the number of BAME medical students (and thus, doctors) is so important.

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(Ellie at Number 10 Downing Street)

Why was visiting number 10 and meeting with Mr Ughwujabo important? What did you get out of it?  

Ellie: The meeting at No 10 gave us to chance to get advice from someone in government about how we could improve our efforts to increase the number of BAME medical students in UK medical schools. Overall, I found the experience of visiting No 10 Downing Street to be very inspiring. I learnt that we should strive to give back wherever we can and that in order to do this effectively, we would need to undergo a program of self-development by attending leadership and public speaking courses as well as strive to attain positions such as medical directors where we could effect meaningful change.

Eniola: I learnt from Mr Ughwujabo that our readiness to help others on to the career ladder as we climb up rather than pulling it up when we reach the top is important. He emphasised the importance of us sharing our experiences directly with younger BAME students and encouraging those applying to medical schools by mentoring them. He challenged each of us to help at least five students get into medical school.

Amisha: Initially it was strange to be at no 10 Downing Street. However, Mr Ughwujabo ensured that the meeting generated an open discussion and enabled opportunities for all members to discuss personal experiences and express opinions. I learnt that there are very few BAME medical directors in the NHS and that it was important to take up positions of leadership in the future, as this is where we would be able to influence policies from the top and effect change that could potentially deal with some of the race disparity issues that had been raised in the conversation.

Jess: One of the insights I gained at the meeting was the importance of attending NHS board meetings, even as medical students. This way, we can learn about policies that could potentially deal with some of the race disparity issues that we currently face. I am really happy that I had the opportunity to talk directly with someone high up in government and the advice given will ultimately have a positive effect on future patient care. At No 10 Downing Street, each of us had our names at our assigned seats, which solidified that feeling for me: “I’m supposed to be here”.

So, what are the next steps?

Ellie: We are part of a peer support group called Inception and our goal is to continue to support BAME students by assisting them with the application process to medical school. With advice and guidance from senior doctors, we intend to support newly qualified BAME doctors up until they become Consultants

Jess: Since the meeting, I have also been a part of Inception and I have encouraged current BAME medical students at King’s (by word of mouth) to join. Alongside this, I currently work with the Widening Participation Department at King’s as a Student Success ambassador, which focuses on increasing the number of underrepresented students applying to university. In my role, I interact with a range of BAME school students and encourage them to think about careers in medicine.

Amisha: We intend to work as a team to generate methods to increase the number of BAME students, and individually mentor and support keen students interested in pursuing medicine as a career. We also want to further extend ways in which BAME junior doctors can be supported through their career progression.

Lizzy: We want to not only support students applying for medical school and those who are already in medical school but doctors all the way up to Consultants. I intend to continue to help other students get into medical school. I might also get into policymaking and perhaps do a masters in policy and management after medical school.

Eniola: We had all been mentoring other students individually but have now come together to pool resources. Ultimately, I will be doing all I can to help with the target of helping five students into medical school. We want to expand our network throughout the rest of the UK.

Ellie: It was very exciting to be at No 10 Downing Street! This was a place that I had only seen on television or from a great distance from behind gates and to see it up close and go through the black door is something I will always remember. We got very useful advice from Mr Ughwujabo, some of which we have started applying - such as having a support group for BAME students in medical school. We are looking forward to exploring other sources of support and advice from the university in order to increase the number of BAME medical students at Kings and other medical schools in the UK.

As Dean of GKT School of Medical Education, it is heart-warming to me to see the commitment of our current medical students to support others along with this demanding, but fulfilling path. The GKT School of Medical Education has a strong commitment to attracting and educating a diverse student body, who will, as our doctors of the future, help to ensure an NHS that is accessible and equitable for all members of our population. Near peer support and mentoring are among the most powerful tools for encouraging talented young people from a range of backgrounds into medicine.– Professor Tim Lancaster, Dean of Medical Education
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Left to right: Elohor Ijete and Amisha Vastani are final year medical students, Elizabeth Adefuwa is in her fourth year, Jessica O'Logbon is in her third year and Eniola Williams has just started her first year of medical school.

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