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Supporting black pharmacy students: how can we improve?

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Students sitting their preregistration exam


The latest report from the General Pharmaceutical Council on the preregistration exam is disturbing reading for all pharmacists, employers and academic staff. It shows large differences in pass rates for minority groups, such as black candidates — a trend that has been allowed to continue for too many years in my opinion. To put this into context, for the exam in June 2018, the gap between pass rates for white and black candidates is 26.3 percentage points.

A GPhC investigation in 2016 found various possible reasons for the differences in performance in black candidates in the preregistration exam, such as feelings of isolation, greater family responsibilities and examples of “explicit prejudice” reported by candidates. However, as pointed out in a recent editorial from The Pharmaceutical Journal, it is vital that the route into pharmacy is fair and that every candidate can have faith and confidence that they will be supported to do their best. It is clear this is not happening for many black pharmacists — and this should be a wakeup call for our profession.

I am wary of making sweeping statements about any particular minority group. BAME (Black and minority ethnic) groups are often banded together as one (and not just in the world of pharmacy). This can be often misleading and considerably distort the reality and truth around the issues that individual minority ethnic groups actually face, and perhaps nowadays more so amongst the black African and African Caribbean communities. Similarly, as with any ethnic grouping, black pharmacists are very diverse and heterogeneous in composition, often presenting much complex and deeper issues than one would originally perceive.

Of course, there is more needed to learn, understand and to provide the necessary support for black pharmacists — both at undergraduate and foundation level and beyond through to senior levels as one progresses through their career path. But after more than two decades teaching pharmacy students from a range of backgrounds, it is clear to me that pharmacy as a profession (which I’m forever proud of) has some hard questions to ask itself, particularly around graduate and preregistration training. And I intend to ask some of them here from a personal viewpoint.

For instance, do academic and pharmacy tutors truly understand the needs and challenges of their black students, and if they do, are there the resources and tools to provide the necessary support for them? Perhaps it is time to admit the generalised support system is not working and to look at a more tailored and structured support system for all students, with possibly more intensive support at an earlier stage for black students.

How many pharmacists and academics have undergone the often online or otherwise mandatory training programmes for equality and diversity, and importantly how many remember it and put it into practice regularly? Perhaps we need to be more imaginative and have a BAME champion academic pharmacist at every department/school of pharmacy instead and encourage universities to recognise excellence among BAME students by assigning champions to each academic year.

Do black students access and even manage to secure voluntary placements in pharmacies in holiday periods as much as others? And what about hospital placements? All these can prove vital in terms of consolidating pharmacy knowledge and building up confidence levels. It must be possible to work with the larger multinationals and hospital trusts to ensure those of BAME origin are offered at least one week long placement in the year. Again perhaps to have a BAME pharmacy champion in the different sectors. Admittedly, this may not guarantee to level the playing field but it would at least be a start and a foundation to build upon.

Will we ever see a black pharmacist at any of the national RPS boards or even as president? Why not? The RPS continues to strive actively to support its members and perhaps at times there needs to be a more broader understanding that may even involve starting from grass roots level to show what it takes to become a worthy candidate to stand as a board member and even as the president – emphasising that there is no gender bias and it is open to all. Perhaps all boards should hold a regular one-day clinic in their local areas for those of BAME groups to meet and discuss leadership roles and holding positions of higher responsibilities. Some highly successful black pharmacist role models are out there in different disciplines – can we also develop a means of sharing their learning wider to organisations such as the Local Pharmacy Forums for example and ask them to actively consider and recruit those of black minority origin where there are none identified? Perhaps there is an opportunity for structured mentorship?

These are just some ideas about how to tackle this problem, and I am sure that some will disagree with some (if not all) of what I am suggesting. I don’t claim to speak for pharmacists who are black, or even pharmacists of my own South Asian Indian ethnic origin, so I would be very keen to hear differing views on this topic. However, I felt it was important to start the discussion; to begin to talk about how as a profession we approach this issue – the elephant is not just in the room, but also throughout the whole career pathway.

Finally, is it time for other healthcare professions perhaps also to look at their landscapes in a similar light?   

Mahendra Patel

Mahendra Patel is an academic and pharmacist. He is a a fellow of the National Institute for Health and Care Excellence and principal enterprise fellow of pharmacy at the University of Huddersfield. He is also an adjunct professor of pharmacy at Wilkes University Pennsylvania, USA; honorary senior lecturer at the Academic Unit Primary Care Medical School at the University of Sheffield; an ambassador for NHS Evidence and board member of the Royal Pharmaceutical Society.



Personal views and observations

Academic and pharmacist of South Asian origin



Readers' comments (1)

  • Thank you Professor Mahendra Patel for having the courage to start a most needed and overdue conversation. How refreshing to read a well written blog on a topic that cannot and must not continue to be ignored. Thank you for leading the way.
    While Professor Patel’s comment refers mainly to undergraduate black pharmacy students, I would like to extend the topic to post-graduation experience.
    I am an overseas, black Afro-Caribbean hospital pharmacist who have worked in the UK for more than twenty years. As result, I have an informed opinion on the topic of racial inequality and lack of inclusion in the workplace which I like to share in response to Professor Patel’s blog.
    For many years I suffered in silence racial discrimination at my work of place, because it is what we often do to survive, succeed and advance our careers. However, I now know that it was the wrong thing to do.
    Mental Health and Staff engagement of Black Pharmacy Professional
    Keeping quiet when you are discriminated against or when others are discriminated against for being different it is wrong and a sign of character weakness. “Playing it safe” and “keeping the head under the radar” has consequences. Actions such as bulling, harassment and undermining of authority who were directly related to racial discrimination in the workplace caused me personal and professional isolation and hardship in the past. I am aware of other BAME (Black, Asian and Minority Ethnic) pharmacy staff who have had similar experiences. Our wellbeing and career aspirations have often being compromised by others in position of power that fail to understand the beauty of diversity. Unavoidable, the consequences of inequality and discrimination in the profession are not only negative to the individual victimised but to the patients they serve. Staff that feels under-appreciated could potentially fail to fully engage with the work they are doing if their mind are troubled by this type of conflict at work.

    Do we need UKBAPA?
    Looking at the current work the WRES (Workface Race Equality Standards) team from NHSE is doing nation-wide, the climate is just perfect to start the “race, equality and inclusion” debate in the pharmacy profession. I am of the opinion that it is about time liked minded black and Asian pharmacy professionals, who are passionate and committed to enhance and improve the experience and career pathway of BAME in the profession came together. A network of BAME for BAME; aimed at supporting, guiding, mentoring, coaching and celebrating BAME from undergraduate studies through different career pathways is needed. It is vital that we make talking about BAME personal experiences and achievements a priority and the norm.
    I would like to hear the opinion of pharmacy professionals about coming together to form a “UK Black and Asian Pharmacy Association (UKBAPA)” to drive this agenda forward. Change needs to come and BAME have an important role in making it happen with the support and guidance of the General Pharmaceutical Council, our professional regulator.
    Acknowledging diversity
    Professor Patel on his blogs refers to differences between BAME groups and I applaud him for recognising so. Black and Asian experiences are different in many ways. The reality is that blacks in society, in education and in the workplace tend to experience the worst. As a black female professional, I have had to defend myself to the teeth when I have been described and treated as a “black angry woman” for being passionate, enthusiastic and saying no to the unacceptable. I cannot change my ethnicity and I don’t want to change my gender so I will always be a black woman. However, when I have earned the right to be angry, I have also earned the right to ascertain myself without being racially profiled. The effect that such action has on individuals is very damaging. Sadly this type of stereotyping is happening in our profession.
    Black - Leadership under-representation
    Bias views as described above and lack of understanding of cultural differences maybe two of many factors responsible for the lack of black representation in top leadership positions within the profession. It must be a real challenge for blacks starting in the profession to identify themselves with role models that look like them. At the time, it was a challenge for me, as I did not know of anyone in a leadership position that was like me who I felt I could talk to, relate to or aspire to be like. I had to look for coaching and role models that looked like me outside the pharmacy profession. Their guidance help me to self-empower to move forward and overcome the rock blocks that were put on my career path. It is obvious that most needs to be done to develop, promote, invest and support black talent within the profession.
    It was only last week that I was talking to a black, male, African hospital pharmacist who told me that after twenty years of working as pharmacist and having completed his certificate, diploma and Master in clinical pharmacy, he still cannot move from a band 7 position after attending nearly 100 interviews over the years. Meanwhile, he keeps witnessing less qualified and skilled staff being promoted above their expertise. This pharmacist, who loves working in the hospital environment, rightful feels under-utilised and frustrated.
    Unfortunately, I have more questions than answers and in my own personal and humble way I am doing my bit to advance the equality and inclusion agenda within the profession. It is encouraging to hear the thoughts of Professor Patel because it re-assures me that I am not alone in this journey.
    I hope other professionals come out publicly and join the conversation. I also hope that together, BAME and non-BAME, we can start acting to make tangible interventions to change the future experiences of BAME pharmacy professionals for the better. A paradigm shift is needed and I believe it will make our profession stronger.

    By Elsy Gomez Campos, Hospital Pharmacist

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