By Amber K Dhoot (BMA Representative Imperial) and Obioma Chima (BMA Deputy Representative Imperial)
What is the BMA Charter?
The BMA Racial Harassment Charter is a document produced by the BMA in order to aid medical schools implement strategies that facilitate prompt reporting of instances of racial harassment and effective ways to deal with this. A big part of this charter is also about empowering BAME students, of whom a third revealed in a BMA all-member survey that racial harassment was a problem at their medical school and that they lacked the confidence to report this.
There are four cardinal areas that the charter addresses:
- supporting individuals to speak out
- ensuring robust processes for reporting and handling complaints
- mainstreaming equality, diversity and inclusion across the learning environment
- addressing racial harassment on work placements.
What is the BMA Charter Task and Finish Group?
The Imperial College School of Medicine Board decided to adopt this Charter on the 7th of October 2020 and thus the work began. A BMA Charter Task and Finish group was formed and tasked with overseeing the smooth implementation of this Charter and dealing with any challenges that arise in the course of doing so. The core group members meet on Microsoft Teams roughly every 3 weeks with the addition of equally passionate individuals with expertise as guest members to discuss specific parts of the charter implementation plan.
Who is in the group?
The core group consists of both students and staff. It is chaired by Dr Chioma Izzi-Engbeaya, who is the Academic Lead for BMA Charter Implementation. The student representatives in the group are us as your BMA representatives – Amber K Dhoot and Obioma Chima – as well as your ICSMSU president, Muntaha Naeem and ICSMSU Welfare Chair, Natania Varshney.
Staff members of the group include Dr Sonia Kumar, Director of Primary Care; Ms Trisha Brown, Head of School of Medicine Secretariat & Administrative Lead for BMA Charter Implementation; Dr Sarah Essilfie-Quaye, Project Director for Faculty of Medicine Culture; Dr James Jensen-Martin, Director Quality & Student Experience; Dr Chris Harvey, Head of MBBS Phase 1 Academic Tutoring; Ms Kani Kamara, Head of Equality, Diversity and Inclusion Centre and Dr Mary Morrell, MBBS Phase 1 Director.
The group are also in the process of electing two lay members who will be members of the public.
What are the aims of the group?
The broad aim of the group is to implement the BMA charter in a way that complements our community and fulfils the needs of our students in all four areas: supporting individuals to speak out, ensuring robust processes for reporting and handling complaints, mainstreaming equality, diversity and inclusion across the learning environment and addressing racial harassment on work placements.
The group has agreed a set of guidelines to facilitate this implementation, with the meetings aiming to fulfil these steps. The aims of the Task and Finish group are to:
- Review, agree and prioritise the school actions required to meet the requirements of the Charter
- Work with central College teams to ensure the College is aware of the requirements of the Charter and identify opportunities to review and change policies/processes which support the aims of the Charter.
- Ensure that there is student involvement across all areas of the implementation plan.
- Engage with College and external experts to seek critical friendship to implementation and ensure that the culture and behavioral change is authentic and embedded into the School.
- Working with MBBS Phase Leads, review ICSM curriculums and advise the Medical School Board on how to ensure there is cultural competency in all undergraduate programmes.
- Working with the School of Medicine Secretariat, support discussions with our Trust and Primary Care partners to ensure they have and are using robust measures to tackle and prevent racial harassment.
- Ensure there are sustainable systems in place to keep BMA Charter active.
So, what has the group achieved so far?
The group has achieved a number of actions so far which is positive, considering that the Task and Finish Group was only set up this Academic year. This includes officially signing up to the BMA charter in October 2020 which signalled the school’s commitment to tackling this massive issue. We have also been working on putting together an action plan for the rest of the year.
Specific work has been carried out to improve the Raising Concerns policy and process, with adaptation underway to tailor it towards a clinical environment. There have also been additional meetings and guest members present in the group meetings to talk about anonymous reporting, which is soon to be implemented and recognised as a key element to understand the scale of the problems in ICSM.
The Charter adoption has also been discussed centrally with agreement and support given by the Assistant Provost for Equality, Diversity and Inclusivity, which increases our cross-college collaboration and relationships to make the Charter adoption a success.
Focus groups were run at the beginning of the year, which were useful to inform and support the compliance mapping and implementation of the Charter. However, the reception of the focus groups was mixed, as some students felt these had been inaccurately advertised in the Bulletins – more as an opportunity to ‘have a voice’ rather than critique our compliance map.
What other actions is the group working on right now for the future and what do we think about them?
The group is currently working to fulfil actions in each of the four areas set out by the charter as follows:
- Supporting individuals to speak out
Summary of actions: code of conduct, guidance document, trained contacts for BAME students, EDI training, further student feedback activities.
In this area, the school is looking to fulfil a code of conduct which will be published and advertised via the school bulletin. The code of conduct will include appropriate behaviours and languages and case study examples of good and unacceptable behaviours. Importantly, students will be updated via bulletin on specific actions the School has taken to implement the code which will increase transparency between the School and its students regarding this issue. There will also be a guidance document for all staff, students and visitors to further detail the School’s zero tolerance stance towards racial harassment.
ICSM will also seek to ensure access to trained, confidential contacts and department support advisory contacts who are sensitive to the needs of BAME students. We think this is a vital action to fulfil this area of the charter and look forward to this being done as quickly as possible. Indeed ICSMSU and the School have begun to implement various types of training such as unconscious bias, active bystander and EDI sessions for students and staff respectively. However, on the student side this has been an exercise reserves mostly for Club and Society Captains and Student Representatives/Officers, when realistically the School needs to offer training to the whole student body in order for ICSM to really start to change.
- Ensuring robust processes for reporting and handling complaints
Summary of actions: anonymous reporting process, project piece on student concerns about future, student journey process map, student feedback activities.
Going forward, the Task and Finish group will work on establishing the anonymous reporting platform to all students. Currently its release has been slightly delayed to the summer term because of the need to ensure contacts have been sufficiently trained to deal with the anonymous reports. We are really excited about seeing this reach the student body very soon as we know it will make a huge difference to all the students who would like to report an incident but may not feel secure enough currently to do so.
The School will also aim to conduct a project piece on concerns around the impact on assessments and future careers that students have when they want to report an incident, which we think will be useful as there are mainstream concerns amongst the student body that lodging complaints can damage future prospects.
A student journey process map will be created to highlight how complaints are dealt with and the time frames for responses/outcomes. This will be extremely helpful for students to understand exactly what goes on behind the scenes when they report something, however we also feel this needs to be very comprehensive and mapped for a variety of student pathways to ensure that it reaches its full potential.
- Mainstreaming equality, diversity and inclusion across the learning environment
Summary of actions: mentor research piece, EDI focus group, “School of Medicine Values Charter”, student societies “spotlights”.
We believe that a communal effort is required to achieve real change – in other words, no matter what plans our plans are they will fall short if everyone is not committed to making change. This is why we are looking into a “School of Medicine Values Charter”. As a name suggests, this would be a document disseminated across ICSM (to students and faculty alike) which would reinforce values of equality, diversity and inclusion in the form of actions e.g. “As an Imperial School of Medicine Student I commit to ensuring…”. This serves to remind all members of ICSM that EDI is at the heart of everything we do, as well as fostering a spirit of solidarity and unity.
As well as implementing a “School of Medicine Values Charter” to current members of ICSM, these values should be shared on the Medicine Admissions page as well as offer-holder material. Sending out the message to potential students that they are entering into a community that extols the virtues of equality, diversity and inclusion will reassure students in a big way! Speaking as former applicants and now students, it would be extremely comforting to be secure in the knowledge that you would become part of a university that not only upholds these values but also vocalises it and makes it known.
As well as these new actions, the School should make bystander and EDI training available to everyone and make this compulsory rather than having it exclusively for staff – this is something everyone can benefit from. Additionally, staff training should be made more comprehensive, for-example by including case-based or scenario-based teaching. A good way to improve compliance with the Charter, could be introducing EDI values into the curriculum as have been done for Phase 1b and 1b students.
- Addressing racial harassment on work placements Summary of actions: School to work with Trust and GP placement providers to improve processes, guidance for medical students who have experienced racial harassment.
The School of Medicine plans to set clear expectations of placement providers to tackle racial harassment, microaggressions and discriminatory behaviour and will monitor and actively address any issues.
This School aims to achieve this in the following ways:
- The School will highlight this during Governance and Monitoring Visits to Trusts by requesting assurance of a named individual(s) that would deal with problems on site.
- The School will request that the process for reporting acts of racial harassment on Trust placements be confirmed at all induction days at Trusts if not already, particularly covering “how do deal with a racially abusive patient?”
- The School will highlight processes to General Practice sites as part of their “education packages” from the Department of Primary Care by requesting assurance of “who would deal with problems on site?”
This work is planned to start this year (2021) for NHS Trusts.
The School also plans to provide guidance to medical students about what to do if patients are racist or abusive. This will include how to report an incident of racial harassment while on placement. There is currently a Medlearn page on how to raise an incident of racial harassment (https://medlearn.imperial.ac.uk/med-students/wp-content/uploads/sites/52/2018/06/How-Do-I-Raise-a-Concern.pdf) but this is outdated and will be updated in due course. The new curriculum students (Phase 1) have a different page altogether, on Kaizen through which they can access these resources.
We hope this article was helpful in communicating the work that has been going on behind the scenes to tackle an issue that so many of us are passionate about and have been affected by. Please do not hesitate to get in touch with any questions regarding the BMA Racial Harassment Charter – our shortcodes are ad417 (Amber) and oc5118 (Obi) – we are also happy to help and try to find out more for specific queries if needed.
In addition, if you would like to read some more about the BMA Charter and the work we are doing, feed free to browse these webpages: