“We waited for our turn, which sometimes never came” : registrars negotiating systemic racism in Western Cape medical schools

Thesis(MA)--Stellenbosch University, 2014.ENGLISH ABSTRACT; In order for the transformation objectives of racial and gender diversity to be adequately reflected in the South African medical profession, it is crucial to understand how Black medical registrars experience the training environment. This qualitative study presents the experience of ten Black African medical specialists who completed their registrar training in the Western Cape in the past five years. Using both thematic and discourse analysis the study aimed to identify and describe the interpersonal, structural and institutional factors that may impede or promote Black advancement during registrar training. Participant experiences where contextualised in relation to discourses around the medical profession as a site of cultural reproduction that has been historically constructed as the exclusive domain of the White male. The analysis unearths experiences of systemic racism where the organisational culture of training institutions is experienced as alienating and unwelcoming to Black professionals. The findings raise the need for a more thorough evaluation of how transformations efforts are being received in specialist medical education. Key Words: Black doctors, Transformation in Higher Education, Systemic Racism, Medical trainingAFRIKAANSE OPSOMMING: Met die oog op die realisering van die transformasiedoelwitte rakende ras- en geslagsdiversiteit in die Suid-Afrikaanse mediese professie, is dit deurslaggewend om te verstaan hoe Swart mediese spesialis studente die opleidingsomgewing ervaar. Hierdie kwalitatiewe studie gee die ervaring weer van tien Swart Suid-Afrikaanse mediese spesialiste wat die afgelope vyf jaar hulle opleiding in die Wes-Kaap voltooi het. Deur gebruik te maak van beide tematiese- en diskoersanalise, poog die studie daarin om die interpersoonlike, strukturele en institusionele faktore wat Swart bevordering tydens professionele opleiding kan belemmer of bevorder, te identifiseer en te beskryf. Deelnemers se ervarings is gekontekstualiseer in verhouding tot die diskoerse rondom die mediese professie as terrein van kulturele voortsetting van wat histories as eksklusiewe domein van Wit mans gegeld het. Die studie ontbloot ervaringe van sistemiese rassisme, waarin Swart professionele beroepspersone vervreem en onwelkom voel in die organisasiekultuur van opleidingsinstansies.Die bevindinge beklemtoon die behoefte aan ‘n meer diepgaande evaluasie van hoe transformasie-pogings ontvang word in mediese spesialis opleiding. Sleutelwoorde: Swart dokters, transformasie in tersiêre opleiding, sistemiese rassisme, mediese opleidin

Race trouble : experiences of black medical specialist trainees in South Africa

CITATION: Thackwell, N., et al. 2016. Race trouble: experiences of Black medical specialist trainees in South Africa. BMC International Health and Human Rights, 16:31, doi:10.1186/s12914-016-0108-9.The original publication is available at http://bmcinthealthhumrights.biomedcentral.comENGLISH SUMMARY : Background: This research aimed to identify and explore the experiences of Black registrars in their training in the Western Cape’s academic hospitals in order to identify structures, practices, attitudes and ideologies that may promote or impede the advancement of Black doctors into specialist medicine. This is justified by the requirement for universities to work towards monitoring and evaluating efforts to create non-discriminatory and inclusive training environments. Methods: This study employed qualitative research methods. Ten Black African medical specialists were interviewed about their training experiences in two university training hospitals in the Western Cape Province, South Africa. Interview data was collected using open-ended questions and coded and analysed using thematic and critical discursive analysis techniques. Results: Four experiential themes emerged from the interview data, they included: 1) experiences of everyday racism during work hours, 2) the physical and psychological effects of tokenism and an increased need to perform, 3) institutional racism as a result of inconsistent and unclear methods of promotion and clinical competence building, and 4) an organisational culture that was experienced as having a race and gender bias. Conclusion: This is a pilot study and there are limits on the generalizability of the data due to the small sample. What is clear from our participants, though, is the strong experiential component of finding it challenging to be a Black trainee in a White-dominated profession. We are undertaking further research to explore the issues raised in more detail.Publisher's versio