Two stalwarts in the medical profession in the United Kingdom (UK) are under fire over a serious allegation.
A leading medical practitioner has claimed that hundreds of Black, Indian and Asian trainee doctors have been racially discriminated in the UK, putting an end to their promising careers in the field.
The Royal College of General Practitioners (RCGP) and the General Medical Council (GMC) have been accused of breaching equality laws, according to the British Association of Physicians of Indian Origin (Bapio). GMC acts as the regulatory body of doctors.
Bapio claimed that the Membership of the Royal College of General Practitioners (MRCGP) examination is discriminatory against minority ethnic candidates. The MRCGP is the college's membership exam set by the RCGP which doctors must pass to be allowed practice as general physicians or practitioners (GPs) in the UK.
The Clinical Skills Assessment (CSA) has become building block for these doctors who have undergone three years of training without having received any complaint during that time, according to Dr. Ramesh Mehta, Bapio president.
"We do not want to compromise the quality of doctors who pass this exam, we want to make sure the best professionals are providing the best professional care. The system of assessment is extremely unfair and has nothing to do with patient care," Dr. Mehta said.
A British Medical Journal (BMJ) report, Academic performance of ethnic minority candidates and discrimination in the MRCGP examinations between 2010 and 2012: analysis of data, showed significant differences in the number of trainee doctors between minority ethnic candidates and white candidates based on a series of studies. The report by Professor Aneez Esmail of General Practice and Professor Chris Roberts of Biostatistics has been published in September 2013.
"Black and minority ethnic graduates trained in the UK were more likely to fail the clinical skills assessment at their first attempt than their white UK colleagues...Black and minority ethnic candidates who trained abroad were also more likely to fail the clinical skills assessment than white UK candidates...For candidates not trained in the UK, black or minority ethnic candidates were more likely to fail than white candidates..." the report said.
The report also concluded that subjective bias brought about by racial discrimination in the CSA may be a cause for UK-trained candidates and international medical graduates to fail.
The BMJ report likewise said that changes to the CSA could improve the perception of the examination as discriminatory against black and minority ethnic candidates. It added that difference in training and other cultural factors among candidates could also impact the outcomes of the CSA.
The studies involved 5095 candidates who took the MRCGP examination between November 2010 and November 2012 and carried out further analysis on 1175 candidates not trained in the UK but who went to take the English language capability test (IELTS) as well as the Professional and Linguistic Assessment Board (PLAB) examination. The IELTS and PLAB are requirements for full medical registration.
The RCGP, however, firmly denies the allegations of Bapio that the exam is biased, saying the examiners are well-trained on equality and diversity issues as well as the actors playing as patients. It threatened to file a legal action against the BMJ and said that another report that looked into Esmail's report has found no discriminatory evidence. Esmail, meanwhile, criticized the college for refusing to recognize the problem discovered in his findings.
Twenty-five east London doctors are under Bapio's wings in support to the employment hearings related to the said examination.
"The result of the hearing, if the decision goes in our favour, will mean that good quality medical graduates, regardless of ethnicity, can continue to become fully practising doctors giving the overly stretched NHS a welcome boost," said Atty. William O' Neill, Bapio's lawyer and a partner at Linder Myers Solicitors.