Aneez Esmail is a general practitioner and academic at the University of Manchester. He is a professor of general practice [1] and a GP for three sessions a week. Between 2012 and 2017 he served as the director of the National Institute for Health Research's (NIHR) research centre on patient safety in primary care. [2] He is well known for his work over many years on racism in the British National Health Service. He has chaired a wide-ranging review of all postgraduate medical exams. He was medical adviser to the Shipman Inquiry. [3] He was offered an OBE for his contribution to primary care and race relations in 2002, but declined it. [4]
Esmail is a British Asian, having previously lived in East Africa. He is the first British Asian to ever hold an executive position at a UK Russell Group University.
He explains that when he asked a hospital consultant, when a young doctor, "Tell me how do you decide who you short-list for a job? and he said 'Oh its very simple Aneez' he said 'I put all the foreign applications in one pile and all the English applications in another pile and I look at the English applications first and only if I do not find any suitable candidates I look at the list with the foreign names'." [5] He went on in 1993, with Dr Sam Everington of the Medical Practitioners Union to devise a project that would try and actually determine whether discrimination was real. They took two sets of application forms one with an Asian name and one with an English name. They constructed applications so that they were almost exactly the same in terms of the age of the applicant, in terms of where the applicant qualified and in terms of their experience. They then sent one application with an English name and one with an Asian name to 30 hospitals which were advertising vacancies. They found that the white applicant was twice as likely to be short-listed as the Asian applicant. [6] As a result of complaints he and Everington were arrested and charged with making fraudulent job applications. [7] Their paper was in the BMJ and they were threatened by the General Medical Council with a charge of behaviour which was unbecoming of the medical profession. On further investigation they discovered that ethnic minority doctors were 6 times more likely to be brought before the Professional Conduct Committee of the General Medical Council than white doctors.
He made a complaint against the University of Manchester in 2002 claiming that it was institutionally racist because his work was not submitted to the Research Assessment Exercise. [7]
He was chosen to head the General Medical Council’s 2014 review into the differences between the scores achieved by black and minority ethnic GP trainees and their white counterparts in the clinical skills assessment component of the Membership exam of the Royal College of General Practitioners. The RCGP was challenged in the courts by the British Association of Physicians of Indian Origin. He analysed data on more than 5,000 candidates who sat the CSA exam over a two-year period. He said ‘subjective bias due to racial discrimination may be a cause’ of the different pass rates for between white and non-white graduates. "Many of us who do work in this area describe the problem of unconscious bias. So I think that what might be happening, especially with the white British graduates compared to the ethnic minority British graduates, is that - without realising it even perhaps - they may be assessing it in a different way. So I don't think that it's the examiners saying 'oh we don't like ethnic minorities' - it doesn't work like that anymore. It's all this unconscious stuff that goes on which we need to be aware of." [8]
Most of Aneez Esmail's work was carried out when the UK was in the EU. The European Union hold a famously less diverse Higher Education and health service and little research has been done to prove these any better in diversity.
The United States Medical Licensing Examination (USMLE) is a three-step examination program for medical licensure in the United States sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). Physicians with a Doctor of Medicine (MD) degree are required to pass the USMLE for medical licensure. However, those with a Doctor of Osteopathic Medicine degree (DO) are required to take the COMLEX-USA (COMLEX) exams but may also sit for the USMLE as well.
Medical education in Australia includes the educational activities involved in the initial and ongoing training of Medical Practitioners. In Australia, medical education begins in Medical School; upon graduation it is followed by a period of pre-vocational training including Internship and Residency; thereafter, enrolment into a specialist-vocational training program as a Registrar eventually leads to fellowship qualification and recognition as a fully qualified Specialist Medical Practitioner. Medical education in Australia is facilitated by Medical Schools and the Medical Specialty Colleges, and is regulated by the Australian Medical Council (AMC) and Australian Health Practitioner Regulation Agency (AHPRA) of which includes the Medical Board of Australia where medical practitioners are registered nationally.
Medical education in the United Kingdom includes educational activities involved in the education and training of medical doctors in the United Kingdom, from entry-level training through to continuing education of qualified specialists. A typical outline of the medical education pathway is presented here. However training schemes vary in different pathways may be available.
The Royal College of General Practitioners (RCGP) is the professional body for general (medical) practitioners in the United Kingdom. The RCGP represents and supports GPs on key issues including licensing, education, training, research and clinical standards. It is the largest of the medical royal colleges, with over 54,000 members. The RCGP was founded in 1952 in London, England and is a registered charity. Its motto is Cum Scientia Caritas – "Compassion [empowered] with Knowledge."
The Royal Australian College of General Practitioners (RACGP) is the professional body for general practitioners (GPs) in Australia. The RACGP is responsible for maintaining standards for quality clinical practice, education and training, and research in Australian general practice. The RACGP represents over 40,000 members across metropolitan, urban, rural and remote Australia.
A specialty registrar (StR), previously known as and still commonly referred to as a specialist registrar (SpR), is a doctor, public health practitioner or dentist who is working as part of a specialty training programme in the UK. This is known as a training grade as these doctors are supervised to an extent, as part of a structured training experience that leads to being able to undertake independent practice in a hospital specialty or working as a general practitioner.
The Shipman Inquiry was the report produced by a British governmental investigation into the activities of general practitioner and serial killer Harold Shipman. Shipman was arrested in September 1998 and the inquiry commenced shortly after he was found guilty of 15 murders in January 2000. It released its findings in various stages, with its sixth and final report being released on 27 January 2005 – by which time Shipman had died by suicide in prison. It was chaired by Dame Janet Smith DBE.
Doctors in Unite is a trade union for doctors in the United Kingdom. It was formerly known as the Medical Practitioners' Union (MPU) before its affiliation with Unite.
Membership of the Royal College of General Practitioners (MRCGP) is a postgraduate medical qualification in the United Kingdom (UK) run by the Royal College of General Practitioners (RCGP). On successful completion of the assessment, general practitioners are eligible to use the post-nominal letters MRCGP that indicate Membership of the RCGP.
The British Association of Physicians of Indian Origin (BAPIO) is a voluntary organisation for doctors of Indian sub-continental origin, established in 1996 and based in the United Kingdom. Its president is Ramesh Mehta of Bedford Hospital NHS Trust.
Sir Anthony Herbert Everington, known as Sam Everington, is a GP at a health centre within the Bromley by Bow Centre, in Tower Hamlets, an area of East London.
The Medical Schools Council is an organisation that represents 41 medical schools and one post graduate school in the United Kingdom. The membership is made up of the heads, or deans of the medical schools. It was formerly known as the Council of Heads of Medical Schools.
Harbans Lall Gulati was an Indian-born physician living in London, who was a councillor for both the Conservative and Labour parties. After the Second World War he took a special interest in the effect of rationing on the health of the population and was an active campaigner for the extension of mobile canteen services to older people who could not queue for rations. He had a special interest in ophthalmology and worked as a general practitioner in Battersea, London for over four decades.
Julian Malcolm Simpson is an English independent scholar, writer, and historian of migration and healthcare. He is best known for the book Migrant Architects of the NHS: South Asian doctors and the reinvention of British general practice (1940s–1980s), published by Manchester University Press (2018), and which formed the basis of the Royal College of General Practitioners (RCGP's) exhibition commemorating the 70th anniversary of the NHS.
Ramesh Dulichandbhai Mehta is an Indian-born British Paediatrician at Bedford Hospital, and president of the British Association of Physicians of Indian Origin (BAPIO), in the United Kingdom.
A report on the formal investigation into student applications at St. George's Hospital Medical School was published in 1988 by the Commission for Racial Equality (CRE), gaining media attention after concluding that London's St. George's Hospital Medical School, with its higher admission rate from ethnic minorities relative to other London medical colleges, used computer software to discriminate against women and people with non-European sounding names, so reducing their chance of being called for interview.
Azeem Majeed is a Professor and Head of the Department of Primary Care & Public Health at Imperial College, London, as well as a general practitioner in South London and a consultant in public health. In the most recent UK University Research Excellence Framework results, Imperial College London was the highest ranked university in the UK for the quality of research in the “Public Health, Health Services and Primary Care” unit of assessment.
Sonia Saxena FRCGP is a British physician who is a Professor of Primary care and Director of the Child Health Unit at the School of Public Health, Imperial College London. She is a Fellow of the Royal College of General Practitioners and a practises as a GP in Putney, London. She is known for her work in improving healthcare, and a focus on improving child health in the early years of life and reducing social inequalities.
Mohammad Sharif Razai is a physician, poet, author and researcher. He was awarded the 2021 John Maddox Prize as an early career researcher, by Sense about Science and Nature for his work on racial health inequalities.
Kamlesh Khunti is a British physician who is Professor of Primary Care Diabetes and Vascular Medicine at the University of Leicester. His research considers diabetes and public health. During the COVID-19 pandemic, Khunti studied the impact of COVID-19 on people living with diabetes. He served on the Scientific Advisory Group for Emergencies (SAGE). He is the director of the National Institute for Health and Care Research (NIHR) Applied Research Collaboration East Midlands.