From an early age I dreamt of becoming a paediatrician. It wasn’t the norm where I am from. Being of Black Caribbean heritage, a myriad of historical challenges within my community meant that, statistically, I was unlikely to achieve A-levels, let alone become a doctor. It therefore sometimes seemed like a far-fetched plan. I had never even met a Black doctor until I was 17 years old.
However, I was encouraged by my parents at every turn and clung on to glimpses of hope. The stories of Black clinicians throughout history often lay hidden and generally untold. I searched for inspiration through the likes of Vivien Thomas, a pioneer in the treatment of congenital heart defects, and Lord David Pitt, a London-based GP and past president of the BMA, to name just two. The knowledge that it was possible kept me focussed.
Not everyone was so supportive. I recall my high school careers advisor trying to dissuade me with comments like “not many people like you” get into medical school. She thought that nursing would be a “better fit” despite the fact that I was achieving the grades required to study medicine. Unfortunately, she wasn’t referring to me being a female or from Yorkshire, but the colour of my skin. The picture of Black nurses in the NHS is not uncommon. Their work is vital and admirable, but I didn’t want to be a nurse — I wanted to be a doctor.
A few years later, on day one of medical school, yes, very few people did look like me. But I was glad that the sea of faces was diverse. This had been one of the reasons I had chosen my university. Unfortunately, I soon learnt that visual diversity did not always guarantee a happier journey. More than one racial slur occurred in lectures. I was brazen enough to challenge one particular lecturer. Today, his comments would have caused social media uproar. Back then my Sony Ericsson flip phone didn’t have a camera and we thought the American exchange student was odd for using this thing called Facebook. Nothing more came of it.
I’m stronger nowadays, to fully tackle racism head-on, but there is still sometimes a narrative in our communities to “keep your head down and just get on with it”. On the other hand, the university had pioneered a widening participation programme. It was ahead of the times and gave many young people who had aptitude, but had been disadvantaged by social constructs, the opportunity to study medicine. The cohort consisted of students from many ethnic groups including a number of Black students.
The hope and optimism this brought was however sometimes contrasted with discouragement. In some cases, but definitely not all, entry requirements for students obtaining places through the access course were adjusted. Although I was not on this programme, the common perception arose that all Black students at the institution had entered medicine via this pathway. It wasn’t uncommon that I would find myself in a conversation where it was voiced that I had been “let in” to medical school. Some further implied or openly used it to generalise on our collective academic capabilities. In this environment, tainted by racism and unconscious bias, it was at times hard to feel that I “really belonged” in medicine.
Conversely, as time has progressed through my career as a doctor, I have met some truly wonderful people from so many varied backgrounds. I couldn’t imagine a more fulfilling job. I gain so much satisfaction treating children and doing a job I love every day. However, in truth, it is bittersweet. It would be a lie not to say that at times it has continued to be a lonely and isolating road. To date there have been only a few meetings or conferences I’ve attended with any Black speakers and I’ve commonly been the only Black doctor in attendance.
My race is an integral part of who I am but, equally, it is not my only story. Hopefully one day there won’t be a need to highlight the perspectives of a Black doctor — we’ll just be doctors.
This is certainly changing and there are an increasing number of Black senior clinicians across many fields. However, in the last decade, having rotated through over 20 hospital placements, I have still only worked in one team with a Black consultant. Again, I’m commonly the only Black doctor on the team and countless times — even as I’ve led a ward round — I’ve been mistaken for the ward clerk, nurse or cleaner, whilst the similarly female FY1/SHO has been presumed to be the consultant.
It has been hard to push past the weight that years of projected doubts and underestimations has put on me. Overcoming this to continue to pursue a dream that in reality you have hardly seen others like yourself achieve can be emotionally draining. Having links with a number of wonderful groups connecting and supporting Black medics including BCDN (British Caribbean Doctors & Dentists network) and Melanin Medics, to name just two, has helped me through.
I remain hopeful that change is coming and have been really encouraged to see the steps that the RCPCH have taken through the Putting Ladders Down report and the subsequent action plan which, among other points, aims to address the imbalance of underrepresentation amongst Black clinicians in voluntary and leadership roles within the College.
I have recently been appointed as the equality, diversity and inclusion representative for the RCPCH national trainees committee and I am committed to helping keep these ladders down for all paediatricians. I truly believe that having a representative workforce helps us to understand the cultural and social nuances that impact on the health of the populations we serve. It equally is a really important part of feeling welcome in the wider profession.
Despite the negatives, some of the most fulfilling experiences I have had as a doctor have come in relation to my race. Having the chance to change the visual picture that I had as a child is humbling. I once treated a child whose mother was so excited to be seen by me. She and her daughter had never met a Black Caribbean doctor before and reported how happy and inspired they were.
Furthermore, I have immeasurable joy when my 3-year-old daughter happily makes me “all better now” with her play stethoscope “just like mummy”. Knowing she will grow up with tangible role models in many fields is a real privilege. I’m very proud to be a Black British Caribbean doctor. I can finally and honestly say I do feel I belong in medicine and look forward to where the rest of my journey takes me.
Finally, it remains important to state that my experience of being a Black doctor in the NHS is simply that — my own experience. Unfortunately, society has forced many Black doctors to experience similar struggles. It has united many of us. However, each and every Black doctor, as with any other doctor, has their own very different background, story and journey.
My race is an integral part of who I am but, equally, it is not my only story. Hopefully one day there won’t be a need to highlight the perspectives of a Black doctor — we’ll just be doctors. Equal representation won’t be a target, but a reality, and certain struggles won’t be defined by race. However, we are certainly not there yet.
Dr Segn Nedd is a paediatric registrar at Imperial College Healthcare NHS Trust and the Equality, Diversity and Inclusion (EDI) representative on RCPCH’s Trainees Committee.
Originally published at https://www.rcpch.ac.uk on October 29, 2020.