Ethnic inclusion in medicine: the ineffectiveness of the 'Black, Asian and Minority Ethnic' metric to measure progress.

Jason Kwasi Sarfo-Annin

doi:10.3399/bjgpo.2020.0155

Abstract

The medical profession is a success story for ethnic diversity. Approximately 45% of hospital doctors and at least 32% of GPs in the United Kingdom are from minority groups.1,2 Fourteen per cent of the UK population is non-White, with a further 5.5% identifying as a minority White group.3 However, success is marred by problems of ‘inclusion’ of minority ethnic doctors.4 Inclusion is defined as ‘ the achievement of a work environment in which all individuals are treated fairly and respectfully, have equal access to opportunities and resources, and can contribute fully to the organisation ’s success. ’ 5 The King’s Fund, a health think-tank, has recently highlighted that senior leadership and managerial positions are predominately held by White British and male persons.6 There has been longstanding discussion regarding inclusion in medicine on the basis of characteristics such as gender and socioeconomic status.7,8 However, the events of 2020 — such as the death of George Floyd, the Black Lives Matter protests, and the impact of COVID-19 on ethnic minority groups — have led to a focus on race and ethnicity. The use of a ‘Rooney Rule’, a form of affirmative action to improve racial diversity and/or inclusion, has been touted as a solution to a lack of ethnic inclusion in British medicine. This rule was created in 2003 by the National Football League (NFL) — where at least one candidate from a minority ethnic group must be interviewed by an American football team for the head coach position.9 Affirmative action is a quick way to reduce — or attempt to reduce — racial inequality and exclusion. That does not necessarily make it the best or the only way. In 2003, when the Rooney Rule was introduced by the NFL, there were …

Highlights

The National Football League (NFL) has since amended the rule, implicitly acknowledging the rule’s failure to achieve the outcome desired.[11]
For a ‘Rooney Rule’ to achieve representative diversity, roughly 35–40% of leadership positions should be held by people of minority ethnic backgrounds
The step is to devise strategies to make sure that talented people from minority ethnic groups are noticed and given the opportunities they deserve

Summary

Introduction

The use of a ‘Rooney Rule’, a form of affirmative action to improve racial diversity and/or inclusion, has been touted as a solution to a lack of ethnic inclusion in British medicine. The NFL has since amended the rule, implicitly acknowledging the rule’s failure to achieve the outcome desired.[11] Affirmative action will likely fail in the long run if there is a failure to engage with the hard and complex work of making the structural and cultural changes required to improve racial inclusion.[10]

Results

Conclusion