In her blog post for South Asian Heritage Month, Dr Yasmin Jeelani Drabu talks about the discrimination she’s faced during her career in the NHS.
I am of British Kashmiri origin. I came to the UK in 1959, when Asians were a novelty, and being ‘different’ was seen as ‘exotic’ and ‘special’.
My father, a doctor, was my inspiration for pursuing a career in medicine. He came to the UK in 1957 on a 2-year scholarship from Pakistan, after leaving Kashmir in 1947 at the time of partition. He could not return to Kashmir, so he brought his young family to England in 1959. All four of his children become healthcare professionals: three doctors and one dentist. His legacy continues in the form of the RCP Jeelani Drabu Palliative Care Programme started in 2019, developed by the RCP for Pakistan and Kashmir (India), and recently featured in the November edition of Commentary magazine.
I went to Manchester Medical School (1969–73), and 1969 was the first year of UCAS. I did not achieve the required admission grades, however due to a computer error by UCAS, I received an admission offer instead of my sister, who had achieved the grades. My sister and I were summoned to see the dean, who towered over me, finger pointing, and told me that I did not deserve this place and I was not good enough to be a doctor – total humiliation! However, despite this, he said he could not reverse the computer error! Starting university, I found that many of my white counterparts had much lower grades than me, but had got into medicine due to family ‘contacts’. This was the start of my journey in recognising tribalism.
Our year group was very diverse, both in age ethnicity and social class. However, as students we continued to witness subtle discriminatory acts. Certain teachers would always give low grades to the ethnic minority students. After graduation, jobs were given to ‘local’ white candidates who were less qualified, and I was openly told that ‘we have to give jobs to our own first’. This was the accepted reality; it was not seen as discrimination, but as supporting your own people – tribalistic behaviour.
I decided to train in microbiology, as I worked with two amazing female role models, Elizabeth Shaw (Australian origin) and Soad Tabachali (Iraqi origin). Both were powerhouses of order and influence. I saw them lead in controlling outbreaks, manage other high-profile clinicians, and they were politically astute in their dealings. Their backgrounds were diverse, however both worked for the advancement of the department and the institution. It was an amazing experience.
As a female trainee in a male-dominated team, I had to listen to sexist remarks and innuendos by some of my consultants and peers. This was taken as normal behaviour and accepted as such; it was not personal. My overall training was excellent and I hold my trainers in high regard. It was almost seen as baptism to becoming a good doctor to be made tough and thick-skinned.
I became a consultant microbiologist and went on to become medical director at my trust at North Middlesex Hospital from 2000 to 2006, and then was appointed medical director at Queen’s Hospital Romford.
I saw more tribal behaviour as a medical director. There was a general feeling among the physicians and surgeons that they were a superior group to the ‘support’ specialties of radiology and pathology, who were seen as lesser mortals. Anyone who had become a medical manager was seen to have crossed the divide and gone to the ‘other side’. Clinicians would support their ‘tribe’ – be that their own specialty or their own ethnic background – when appointing new consultants and awarding clinical excellence awards. Private practice was a major player in decision-making, and sometimes lesser candidates would be prioritised for appointments, if they were seen as less of a threat to the private practice. Investigations into performance issues were also affected by both private practice and tribal issues. Clinicians were sometimes unwilling to highlight poor practice, as it affected their private practice or a person from their ethnic background. Internal referrals were made to less able clinicians because of tribal loyalties, leading to disastrous consequences. Tribal behaviour also had positives; the loss of clinical teams (tribes) was, and is still, mourned by many of us.
My final year of work was a secondment at the Department of Health, where I saw the disconnect between the governing body and the shop floor; the lost tribe! I was also a non-executive director in the Medical Protection Society for the last 10 years of my career. This was one of my most educationally rewarding posts, not only professionally, but also in seeing how effective teams and boards work in providing leadership to an organisation.
I was awarded an honorary fellowship by the RCP and won the Asian Professional Woman of the year prize in 2004 for my work in the NHS.
Life is never perfect. I am grateful to those who taught me – they were not perfect but they were good people. I am grateful to those who those who supported and advised me in difficult times, because they had the wisdom to see what was best for all of us. We will always live in ‘tribes’, and these may be based on ethnicity, personal interest, or what we call ‘common values’. We need to recognise this as such and not get fixated in labels of racism, because I believe that misses a bigger picture that affects us all.
Always be comfortable in your own skin, have self-belief, stay determined and keep an open mind; sometimes you get the best advice from your worst enemy. The piece of advice I remember often is to ‘always give your adversary a ladder to climb down’.