Student activism drives decolonisation in medicine

Calls for the decolonisation of medicine from medical students in the UK have grown stronger since the covid-19 pandemic further exposed systemic racial inequalities. The process of decolonising medicine relies on grassroots organisations challenging the dominance of Eurocentric influences and the dismantling of power imbalances in the structures and policies that uphold racism and other injustices that persist after colonialism.1

Students have emerged as powerful advocates for decolonisation and in holding the medical profession and its institutions accountable for enabling racism and other injustices. In the UK, medical students are actively addressing mistrust within ethnic minority communities towards the medical profession, notably in the context of the covid-19 response and failures.

A motion proposed by UK medical student Safia Khan and passed by the BMA’s 2022 annual policy setting conference, asked the profession to recognise this mistrust. It called for collaboration between doctors and the health service to build trust among patients, families, and health workers from ethnic minority communities.2

The medical profession has a complex global history of harming these communities. Abuses include the unethical Tuskegee experiment, in which black American men with syphilis were denied medical treatment, leading to severe health consequences.3 Mistreatment of black and brown people is ongoing, reflected in the UK government's failure to respond adequately to the disproportionate effect of covid-19 on ethnic minority communities. The BMA’s medical students committee has emphasised that deeper collaborative decolonisation efforts by the profession are crucial to understand and resolve these biases and injustices and prevent further widening of systemic health inequalities. A good example is provided by UK medical students Luamar Dolfini and Samar Babike, who translated covid-19 guidance into different languages to increase accessibility.4

All UK doctors are mandated by the regulator (the General Medical Council) to understand how diversity in patient populations affects health behaviours and outcomes.5 Students have criticised the medical school curriculum, demanding more ethnically diverse learning materials and a culturally sensitive approach to prepare them for different patient populations. The BMA's racial harassment charter, initiated by its medical student committee in 2019 and supported by over 40 UK medical schools, offers recommendations to promote anti-racism. This includes mainstreaming equality, diversity, and inclusion (EDI) teaching in schools and setting expectations for clinical placements on tackling racial harassment.6 The committee continues to support students and their medical educational departments to work collaboratively, reviewing progress and sharing best practice.6

The burden of fighting discrimination and harassment often falls on the students who are directly affected, which can lead to short lived initiatives. The sustainability of the decolonisation movement therefore relies on organisations such as the BMA to provide ongoing and vocal support, resources, visibility, and access to networks.

As UK doctors’ largest trade union and professional association, the BMA has unmatched position and influence to recognise and challenge racism. It is rightly vocal in calling out doctors’ experiences of racism and other health inequalities rooted in the colonial era.7 However, in calling for an anti-racist society, it must show leadership in calling formally for decolonisation and lead by example. Professional associations like the National Education Union8 and media outlets such as the Guardian9 have pledged to decolonise their practices and scrutinise their histories. Similarly, the BMA must examine its history and current structures and policies through a decolonial lens. The association was established during the era of the British empire and may have benefited from historical exploits in colonised countries as well as crown investments in the transatlantic slave trade. In addition, the UK medical profession it represents has been entwined with a history of research and practice that has exploited black, brown, and indigenous peoples, devalued their traditions, and ignored the needs of ethnic minority communities.

The medical students committee urges all doctors to reflect on the profession’s role in perpetuating structural biases and injustices. We need to encourage more medical institutions to commit to decolonise, examining their own histories, structures, and practices, and increasing support for grassroots efforts. As the BMA evolves to become a truly decolonised medical association, it will become a more powerful force for change not only in the profession but also in broader fights against racism and other bias and injustice in healthcare and wider society.