Intended for healthcare professionals

Letters Tackling sexist inequality in medical school

First the words, now the actions: a proactive approach to tackling sexism in medical school

BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n3034 (Published 13 December 2021) Cite this as: BMJ 2021;375:n3034
  1. Rebecca Farrington, senior clinical lecturer,
  2. Enam Haque, senior clinical lecturer
  1. University of Manchester, Manchester, UK
  1. rebecca.farrington{at}manchester.ac.uk

We are heartened that our students feel empowered to speak out about sexism1 and that our institution takes it seriously.2 As equality, diversity, and inclusion (EDI) leads for the bachelor of medicine, bachelor of surgery degree, we can report actions triggered by these letters and pre-existing activities that make positive change.

Discussion was quickly initiated between medical teachers and learners in clinical debrief sessions,3 attended by all students in years 3 and 5. This aimed to raise awareness of sexism and develop skills in allyship. Misogyny is not the only pervasive issue. We invited the student authors to our existing EDI student committee. Students and faculty have co-produced curriculum changes and contribute to tackling all forms of discrimination at personal and institutional levels, including removing stereotypes in written cases; incorporating reflection on diversity and lived experience in portfolio entries; providing dermatology resources for diverse skin types; and contributing to active bystander training. Our programme approved Muslim Student Guide, created by students supported by the university chaplain, is a template for other faith based and minority community guides.

Harassment is under-reported nationally,4 with power differentials well recognised. We are reviewing reporting procedures with students, developing diversity champions as supportive role models, and explicitly creating inclusive clinical learning environments in primary and secondary care. Communication skills teaching will cover harassment in clinical settings. We propose improving international students’ experience, helping them settle into new learning cultures, and are exploring the avoidance of deadnaming transgender students at graduation ceremonies.

Our curriculum will integrate more health inequalities and behavioural and social science, particularly around domestic abuse. Diversification of simulated patients will better represent the racial, gender and sexual orientation of local communities.

National collaboration with Diversity in Medicine and Health and the Medical Schools Council EDI Alliance has been essential to share best practice and support long term change. Promoting cultural humility will serve staff, students, and patients well.5

We ask students to continually hold us to account. Their active involvement will make meaningful change to their experiences, and those of their successors.

Footnotes

References