Manifestations and negotiations of racism and ?heterophobia? in overseas-born South Asian GPs? accounts of careers in the UK

Abstract

What is known. A substantial body of qualitative and quantitative reports bears witness to the existence of racism in British medicine. . Migrant and minority ethnic doctors and aspiring doctors have been discriminated against when applying for jobs or entry into medical school, have tended to be concentrated in low-status medical specialties such as psychiatry, care for the elderly and general practice and in geographical areas deemed less desirable. More generally, they have faced racism in their working lives. . Progress towards addressing racism in the NHS has been slow. What this paper adds. Demonstrates the value of using oral history interviews to explore the experiences of overseas-born South Asian GPs. Doctors' narratives provide evidence of how certain BME and migrant doctors have historically been able to confront racism or avoid its manifestations. . A reframing of racism in medicine as racism and 'heterophobia', understood here as the fear of difference, which supports an engagement with the spectrum of behaviours and practices that the term encompasses and a more nuanced appreciation of the nature of racism. . A reflection on the ways in which BME and migrant doctors are able to operate successfully in a discriminatory environment. A suggestion that these insights have the potential to inform individual, collective and institutional strategies aimed at countering discrimination.

Boundary Creatures? Employed, Breastfeeding Mothers and ‘Abjection as Practice’

“…Beyond breastfeeding, abjection-as-practice offers potentially rich theoretical opportunities for enhancing understandings of how marginalization operates in organizations in relation to the ‘othering’ of minority groups of workers (see Fotaki, 2011). It transforms from intangible to demonstrable the manner in which some groups, due to ‘fear of difference’ (Simpson & Ramsay, 2014, p. 178), may be excluded from positions of influence in organizations. For example, gay workers, the chronically ill, and migrant and/or ethnic minority employees are shown to feel pressure from co-workers to minimize apparent ‘differences’, or bear the brunt of ‘negative reactions’ at work (Clair, Beatty, & Maclean, 2005, p. 79).…”

“…The notion ‘abjection as practice’ could, further, enable research on how clearer understandings regarding ‘fear of difference’ might assist in countering the ‘othering’ of migrant and/or minority ethnic workers such as doctors, who are obliged to invest time and energy resisting and managing abjection as practice at work, in order to perform their jobs effectively (Simpson & Ramsay, 2014).…”

“…It is acknowledged, here, that extant research (for example, by Bataille, 1934, in relation to outcast populations) has observed how certain forms of abjection may support the heterophobic (fear of difference) ‘othering’ of less-favoured populations through affirming the privileged status of constituent groups (see Simpson & Ramsay, 2014, in relation to migrant doctors; Tyler, 2013, in relation to asylum seekers, and Fotaki, 2011, with reference to women academics). The development in this paper of ‘abjection as practice’ as a theoretical approach (Figure 1) extends such important observations, offering a contemporary perspective for organization studies through enabling the explicit articulation of how abjection may be purposefully employed as an instrument of marginalization.…”

The challenges faced by early career international medical graduates in general practice and opportunities for supporting them: a rapid review

“…The literature described incidences of IMG GPs experiencing discrimination and marginalisation related to race, ethnicity or sex at the hands of patients and clinicians. 18,25,27,30 In one study, the authors argued that IMG GPs face not only racism but also heterophobia, namely a fear and rejection of difference or 'fear of the other,' which can lead to marginalisation. 27 South Asian female IMG GPs described suffering sexist discrimination from other IMGs.…”

“…18,25,27,30 In one study, the authors argued that IMG GPs face not only racism but also heterophobia, namely a fear and rejection of difference or 'fear of the other,' which can lead to marginalisation. 27 South Asian female IMG GPs described suffering sexist discrimination from other IMGs. 27 IMG GPs faced discrimination from white medical colleagues 25 and others in the NHS.…”