The Impact of Race and Gender-Related Discrimination on the Psychological Distress Experienced by Junior Doctors in the UK: A Qualitative Secondary Data Analysis

Author:

Hussain Niha Mariam1ORCID,Spiers Johanna2,Kobab Farina3,Riley Ruth2

Affiliation:

1. College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2SQ, UK

2. School of Health Sciences, University of Surrey, Surrey GU2 7XH, UK

3. Department of Social Work and Social Policy, School of Social Policy, University of Birmingham, Birmingham B15 2SQ, UK

Abstract

Almost half of NHS doctors are junior doctors, while high proportions are women and/or Black, Asian, and Minority Ethnic (BAME) individuals. Discrimination against this population is associated with poorer career-related outcomes and unequal representation. We aimed to qualitatively explore junior doctors’ experience of workplace racial and gender-based discrimination, and its impact on their psychological distress (PD). In this study, we carried out a secondary analysis of data from a UK-based parent study about junior doctors’ working cultures and conditions. Interview data was examined using thematic analysis. Transcripts (n = 14) documenting experiences of race and/or gender-based discrimination were sampled and analysed from 21 in-depth interviews conducted with UK junior doctors. Four themes were generated about the experiences and perpetrators of discrimination, the psychological impact of discrimination, and organisational interventions that tackle discrimination. Discrimination in various forms was reported, from racially charged threats to subtle microaggressions. Participants experienced profoundly elevated levels of PD, feeling fearful, undermined, and under-confident. Discrimination is associated with elevated levels of PD, whilst negatively impacting workforce sustainability and retention. This reduces the opportunity for more diversity in NHS medical leadership. We encourage NHS hospitals to review their policies about discrimination and develop in-person workshops that focus on recognising, challenging, and reporting workplace discrimination.

Funder

NIHR Research for Patient Benefit

Publisher

MDPI AG

Subject

Health Information Management,Health Informatics,Health Policy,Leadership and Management

Reference57 articles.

1. Health and Social Care Information Centre (2023, February 26). NHS Monthly Workforce Statistics from October 2022 in NHS Hospitals & Community Health Service (HCHS). Available online: https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics/october-2022.

2. General Medical Council (2023, February 26). The State of Medical Education and Practice in the UK: The Workforce Report. Available online: https://www.gmc-uk.org/-/media/documents/the-state-of-medical-education-andpractice-in-the-uk---workforce-report_pdf-80449007.pdf.

3. NHS England (2023, February 26). NHS Medical Workforce Race Equality Standard. WRES Indicators for the Medical Workforce. Available online: https://www.england.nhs.uk/wp-content/uploads/2021/07/MWRES-DIGITAL2020_FINAL.pdf.

4. (2022, March 25). UCL News 2019: Gender Pay Gap Review Finds Female Doctors Earn 17% Less. Available online: https://www.ucl.ac.uk/news/2019/mar/gender-pay-gap-review-finds-female-doctorsearn-17-less.

5. (2022, May 07). NHS Workforce: Ethnicity-Facts-Figures, Available online: https://www.ethnicity-facts-figures.service.gov.uk/workforceand-business/workforce-diversity/nhs-workforce/latest#by-ethnicity-and-grademedical-staff.

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