Seeing is believing: the importance of diverse representation in medicine

Medical student Shakeela Brown shares her experience of being a female student of Sierra Leonean heritage and explains why we must improve representation of racialized minorities in medical education.

In my first year of medical school, I noticed there were no Black doctors and very few Black academics. This made me question whether I belonged in medicine. If you need to ‘see one to be one’ why had no-one noticed this before and done something about it? The lack of representation of doctors from Black/Black-heritage backgrounds made me doubt whether it was possible for me to succeed as a Black medical student.

I spoke with students, staff and members of the local community and found they’d also had few encounters with Black-heritage doctors. I knew I had to do something. I set out on a quest to find Black-heritage doctors and academics. So where are the Black doctors?

Using local and national connections I discovered a network of Black-heritage doctors with inspiring careers from a range of medical specialisms. I wondered, why the medical school hadn’t thought to connect students with these people? As the saying goes If you don’t ask you don’t get – so I asked the School of Medicine if we could have a mentoring scheme specifically targeted to Black-heritage medical students. They said yes! 

My vision was to create a mentoring scheme that involves doctors who are Black or of Black heritage as mentors for current Black/Black heritage medical students. I wanted mentoring to empower and inspire students. To facilitate a sense that they do belong in medicine and that they can succeed despite the current institutionalised racism (Woodhead et al., 2021; Tonkin, 2022). 

To help me understand how best to develop the mentoring scheme I researched existing mentoring programmes for underrepresented students from ethnic minority backgrounds in medicine and health. I was really surprised how little research had been published. The literature surrounding the topic of mentoring, race and ethnicity mainly focused on reverse mentoring! The majority of schemes were designed to help members of Faculty not students themselves! 

This lack of literature made me question does the race or ethnic background of the mentor even matter? On reflection, and in an ideal world, I’d say it does not. If mentoring for students is helping with social mobility and aiding with personal and career development, then an effective mentor could be anyone with the necessary skills and experience. I’ve spoken with students of Black-heritage who’ve had mentors and their mentors have all been of a different race. I’ve had mentors who are of a different race and can honestly say my mentors have been supportive, encouraged me to believe in myself and have confidence in my abilities. All the students, including myself, shared that they could not have asked for better mentors. So why is a mentoring scheme that matches Black-heritage doctors with students even needed?

Irrespective of how great the mentoring received was. Despite existing mentoring helping students to achieve certain goals. What remained was a sense of not belonging. We believe this sense of not belonging is directly linked to the lack of visual representation of people that look like us (Black people) in the positions that we aspire to fill. 

I’m proud that I’m now working with the School of Medicine to develop and implement a mentoring scheme specifically for students of Black-heritage. Being involved in the pilot means I’ll benefit from the experience of doctors who have been where I am and have gone on to succeed in their fields. But what about all the other students of Black-heritage across the School of Medicine who aren’t involved yet. What could I do for them?

With the support of Professor Bridgette Bewick, I’m leading on an ‘I belong@School of Medicine’ series specifically designed to increase the visibility of Black/Black heritage doctors. A chance to spread the word about the amazing work these doctors do. The feedback from people who’ve attended these events powerfully illustrates why meaningful representation and visibility matters. For example:

• “Although it was shocking to hear some of the racist experiences … I really appreciated them sharing this and talking about how they dealt with it. I also found it very encouraging that Dr …. said that she ‘wouldn't lose sleep over people like that (racist patients)’, as it showed me that it is possible to still enjoy your career and have peace of mind even if you end up facing these challenges.”
• “More representation is needed, and it is important to encourage those who are in the minority to achieve their goals.”

Seeing people who have succeeded despite the institutional racism in higher education and in the NHS matters. For me, connecting with successful doctors of Black-heritage matters. Thanks to doctors sharing their experience with me I now know that I do belong at Medical School and that I can have a successful medical career.

The purpose of the Black Mentor Scheme is to have Black-heritage doctors mentor Black-heritage medical students and through their lived experiences provide advice on how they might navigate the challenges of being a medical student and life as a doctor. It also serves as a visual representation that the goal of being a doctor as a Black person is not a far-fetched dream, but a realistic and attainable goal. 

Upon reflection the question ‘does the race or ethnic background of the mentor really matter?’ is not the right question. A better suited question is ‘does incorporating race and ethnicity into mentoring Black-heritage medical students help improve sense of belonging, academic performance, and career progression within medicine? This is a question that I believe the Black Mentor Scheme will help answer. 

For further information on the Black Mentoring Scheme or on the I belong@School of Medicine Where are the Black Doctors? series, please email the School of Medicine’s Equality, Diversity, and Inclusion (EDI) team via Med-EDI@leeds.ac.uk. 

References

Woodhead, C., Stoll, N., Harwood, H., TIDES Study Team, Alexis, O., Hatch, S.L., Bora‐White, M., Chui, Z., Clifford, N., Connor, L. and Ehsan, A. 2022. “They created a team of almost entirely the people who work and are like them”: A qualitative study of organisational culture and racialised inequalities among healthcare staff. Sociology of Health & Illness, 44(2), pp.267-289.

Tonkin, T. 2022. Racism an issue in NHS, finds survey. [Online].[Accessed 8 December 2022].