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Doctors' careers are being blocked because of discrimination based on disability, ethnicity, sexuality, and gender says a new report from the British Medical Association (BMA).

The report shows that discrimination is prevalent and widespread throughout the NHS and not enough is being done to tackle it. As the BMA opened its annual meeting in Llandudno with a theme of ‘diversity’, the Association is calling for zero tolerance towards all forms of discrimination.

The new BMA report: Career barriers in medicine: doctors' experiences, reviews published research on discrimination and focuses on in-depth interviews and questionnaire responses from twenty-five doctors from the following groups:

Minority ethnic doctors and doctors with international qualifications

Doctors with disabilities

Female doctors

Lesbian, gay and bisexual doctors

“Uncomfortable Reading”

Dr George Rae, Chair of the BMA Equal Opportunities Committee, said today: "The doctors who participated in this study have told us that not enough is being done in the NHS to combat discrimination. The report makes uncomfortable reading – doctors are facing barriers to their career progression every day of their lives because of their gender, ethnicity, disability or sexual orientation."

He added: "It is not acceptable for anyone to think this is someone else's problem. It is everyone's problem. We are all responsible for creating the current environment and it is only through our collective and individual actions that we can start to move forward. Attitudes must change first and by launching this report the BMA hopes to spearhead this change."

The report's key recommendations include the following:

The BMA should work with the health departments to develop a comprehensive 'zero tolerance' strategy for the NHS covering all forms of discrimination experienced by doctors

All medical schools should include diversity and equality awareness in the undergraduate curricula

Staff and associate specialist grades must have opportunities for career development

Trusts should ensure that there is openness and transparency within the clinical excellence awards system

Trusts, medical schools and primary care organisations must take action to ensure that they meet their legal obligations under the Disability Discrimination Act

Flexible working needs to be valued as a positive career option by everyone in the profession for both men and women

The BMA should produce guidance on sexual orientation to address some of the issues and concerns for doctors as employers and employees, in the light of new Employment Equality (sexual orientation) Regulations

Interviews transcribed in Career barriers in medicine: doctors' experiences provide an illustration of what is taking place in the NHS:

Ethnic Minority Doctors

Over seven out of 10 consultants are white whilst six out of 10 doctors in associate specialist and staff grades have medical qualifications outside the UK and EEA. Many doctors find that the staff and associate specialist grades provide no educational opportunities and no certainty of career progression. There are more complaints made against doctors from ethnic minority groups and they are more likely to be involved in disciplinary action.

The doctors from ethnic minorities who were interviewed all had international qualifications. Most had experienced obstacles like lack of information, poor recruitment techniques and the high cost of exams and registration. One respondent said: “When I first came here I wasn't provided with appropriate information...The information that I got back (from the GMC) was quite clear that my degree was recognised and I would be able to practise here. There was nothing in those documents suggesting that between the recognition of my qualification and starting to work, that there was an adjustment of taking the PLAB … so it was a shock when I went to the GMC and they said you have to take the PLAB.'

Disabled Doctors

Doctors who have a chronic illness or disability often face many difficulties. Inflexible working patterns, poor contingency cover, and colleagues who are "sympathetic until it affects them" often add guilt to an already difficult situation and leave doctors wondering whether they can continue working in a position that makes little allowances for their needs: As one disabled doctor put it: “I had a very good CV and was short listed for lots of jobs so I attended many interviews … I always arranged to visit early and meet at least one of the consultants on the interview committee beforehand. I kept being turned down at interview and on two occasions was asked to wait after the other candidates had left and was told I had been turned down because of my [disability]. Once the consultant who spoke to me told me that I should not be applying for clinical jobs at all and advised me to change career.”

Sex Discrimination

Seventy-six per cent of consultants in the NHS are men and sexist attitudes are still prevalent within today's medical profession. One woman doctor said: “I have encountered extreme obstacles in my career progression to the point where I frankly didn't really want to speak to you. My memories are very painful and very unpleasant, however, I suppose, for the good of the cause I felt it an obligation to do so. But I am sure there will be women whose experiences are so painful they will not be willing to even discuss it.”

Sexual Orientation

There has been very little research undertaken on the experiences of lesbian, gay and bi-sexual doctors but from the BMA report it is apparent that homophobia exists throughout the medical profession: One gay doctor said: “If I look at my friends who are gay doctors they don't have the freedom to be open about their sexuality, partially because their perception of the risk of being open about their sexuality is so great that they perceive it is going to stop their career progression. Or they are going to experience discrimination in the workplace or people aren't going to communicate with them, that they would rather stay closeted at work than come out.”

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