BMJ Leader

Over one-quarter of English National Health Service (NHS) staff are from black and minority ethnic (BME) backgrounds. Peer-reviewed research, grey literature and staff surveys consistently show that the NHS treats such staff less favourably than white staff in recruitment, career progression, bullying, discipline, referrals to professional regulators and the response when BME staff raise concerns.1 Such disadvantage may be compounded for the growing number of overseas trained staff and through intersectional disadvantage, notably for BME female staff. BME staff report exposure to 'microaggressions', racist stereotyping, prejudice and overt unfair treatment, and such experiences are associated with low employee satisfaction and greater staff turnover.2 These experiences are associated with emotional problems, somatic symptoms, low job satisfaction and long periods of sickness absence among this workforce.3 Race discrimination adversely impacts access to and the provision of healthcare.4 The NHS response to race discrimination within the NHS has been late, glacial and often performative. In the wake of the Macpherson Inquiry (1998),5 Ministers launched the Race Equality Action Plan (REAP)6 to address the striking absence of BME staff from senior positions. However, when The Snowy White Peaks of the NHS (TSWP) (2014)7 reviewed progress a decade later, there was almost none to be found. A decade further on this commentary considers the impact of that 2014 report. This surveyed London's NHS Trust leadership. 41% of London's NHS staff and 45% of the population were of BME heritage, but we found:

Roger Kline

Ten years on: The Snowy White Peaks of the NHS

十年之后：英国国民保健体系的雪白巅峰

Objective Examine relationships between religiosity, workplace discrimination, religious accommodation and related professional and psychological outcomes among UK Muslim physicians. Methods In 2021, a national survey of British Islamic Medical Association members was conducted. Statistical analyses explored associations between participant religiosity, sociodemographic characteristics and the specified outcome measures. Results Out of 104 participants with a mean age of 39, the majority were male (56%), Asian (81%), adult immigrants to the UK (56%) and wore a beard or a hijāb (73%). Workplace experiences revealed that 40% experienced discrimination primarily based on religious identity, with 44% facing regular discrimination since medical school. Notably, 38% reported current workplace discrimination, 15% encountered patient refusals based on religion and 56% felt heightened scrutiny due to religious identity. Most struggled with prayer at work (69%), and 28% felt inadequately accommodated. In multivariate models, religiosity was associated with experiencing discrimination from patients and struggle with prayer accommodation at work but increased the odds of perceiving religious identity to be accommodated at work. Notably, participants wearing hijāb or a beard reported higher job satisfaction and lower odds of burn-out and depression. Increasing participant age lowered the odds of burn-out but increased the odds of religious discrimination at the current workplace and over one’s career, as well as being passed over for professional advancement. Conclusion These findings underscore the urgent need for the National Health Service to address religious discrimination in the workplace by implementing policies that accommodate the workplace needs of Muslim physicians.

Laila Azam

Sohad Murrar

Usman Maravia

Omar Davila

Aasim I Padela

Religious identity-based discrimination in the physician workforce: findings from a survey of Muslim physicians in the UK

基于宗教身份的医生劳动力歧视：英国穆斯林医生调查结果

Background Residency training and parenthood are conflicting pursuits for many residents, as both often occur during similar years of life. Online policy about paid parental leave for residents is important for not only mitigating this dilemma, but also ensuring that the associated health benefits can be fully capitalised on. Purpose Investigate the extent of advertised paid parental leave for anaesthesiology residencies in the USA and to explore whether this had an association with the gender of the department chair for these programmes. Analysis of Canadian anaesthesiology residencies was performed to assess whether a nation with federally protected paid parental leave yielded disparate rates of advertised paid parental leave. Methods All accredited US anaesthesiology residency programme websites were reviewed to determine the gender of the department chair and the existence of advertised paid parental leave for residents. χ 2 analysis was used to determine if there was a statistically significant association between the gender of anaesthesiology residency department chairs and paid parental leave advertised. Rates of advertised paid parental leave were compared with those seen in Canadian anaesthesiology residencies. Results US anaesthesiology residency department chairs were 84% (137/164) men. Of the men-led programmes, 42% (58/137) advertised paid parental leave, while 70% (19/27) of women-led programmes advertised such benefits (p&lt;0.05). Overall, 47% of (77/164) of US anaesthesiology residencies advertised paid parental leave, while 76% (13/17) of Canadian anaesthesiology residencies advertised paid parental leave (p&lt;0.05). Conclusion In the USA, anaesthesiology residencies with department chairs held by women had a higher rate of advertised paid parental leave. Such findings call attention to the potential downstream effects of lacking diversity in leadership within medicine. When compared with the USA, Canada was found to have higher rates of advertised paid parental leave across their anaesthesiology residencies, potentially highlighting the impact of federal legislature on medical residents.

Ofodile Morah

Faisal Khosa

Impact of department chair gender on paid parental leave across American anaesthesiology residencies

美国麻醉住院医师培训中部门主任性别对带薪育儿假的影响

Background Despite efforts to advance equity, diversity and inclusion, women face gender-based barriers in research, including in neurology. Compared with men, women are less likely to hold leadership positions and be senior authors. Gender disparities in grant funding within neurology have yet to be investigated. We examine gender disparities in Canadian Institutes of Health Research (CIHR) funding for Canadian neurology divisions and departments. Methods Data on CIHR grant recipients and metrics (grant contribution, duration and quantity) within Canadian neurology divisions and departments between 2008 and 2022 were acquired from the CIHR Funding Decisions Database. Gender identity was determined by a validated application programming interface. Gender-based differences in CIHR grant contribution amount, duration and prevalence within neurology were calculated. Subgroup analysis was conducted for Canadian-licensed neurologists and Project Grant awards. Results 1604 grants were awarded to Canadian neurology divisions and departments between 2008 and 2022. Compared with men, women received less funding (p&lt;0.0001), shorter grant durations (p&lt;0.0001) and fewer grants (41.5%) annually. Women comprised the minority of recipients (45.5%) and were less likely to be awarded grants (p&lt;0.001) annually relative to men. Differences were consistent in subgroup analyses, except for equal grant durations observed across genders in Project Grant awards. Conclusion We report gender disparities in CIHR grant funding to Canadian neurology divisions and departments. Women receive lower contribution amounts, shorter grant durations and fewer grants than men. Future recommendations include addressing gender differences and continuing to evaluate CIHR funding to provide equal opportunities for women in research and funding.

Brendan Tao

Chia-Chen Tsai

Catherine Wang

Amir R Vosoughi

Esther Bui

Kristine M Chapman

Susan Fox

Gender disparity in Canadian Institutes of Health Research funding within neurology

加拿大神经病学领域加拿大卫生研究院资助的性别差异

Buddhika S W Samarasinghe

Ross Millar

Mark Exworthy

BMJ Lead

Bridging the divide? Why the integration of standardisation and individualisation of care remains paramount during turbulent times

弥合鸿沟？为何在动荡时期，护理的标准化与个性化整合仍然至关重要

Background Paediatric professional scarcity and uneven distribution is acute in underdeveloped regions, exacerbated by COVID-19’s workload surge and burnout, highlighting the need for strengthened prevention and response measures. Aim Propose an effective talent management model to address the challenge of paediatric medical personnel shortage and lack of management experience in Underdeveloped cities of developing countries. Methods A crisis management plan has been implemented in a paediatric hospital in Henan, China, with a talent framework to ensure a skilled, stable workforce. Results An advanced talent management system is vital to address paediatric talent scarcity. Leveraging the national Children’s Regional Medical Center, fostering international cooperation, sharing knowledge and harnessing regional policies are key to effective paediatric talent management through leveraging, promotion, and driving initiatives. Conclusions Efficient talent management methods have a significant positive impact on addressing the paediatric talent crisis, enabling departments and institutions to effectively manage medical talent through scientific strategies, ultimately contributing to the alleviation of medical resource deficiencies.

Xingxue Yan

Jinshi Yu

Peng Zhang

Jinrui Zhang

Shuying Luo

Yingying Yu

Innovative management strategies for addressing paediatric medical staff shortages in underdeveloped cities in developing countries

发展中国家欠发达城市应对儿科医务人员短缺的创新管理策略

短名	leader
Journal Impact	1.67
国际分区	HEALTH CARE SCIENCES & SERVICES(Q3)

ISSN	2398-631X
h-index	15

涉及主题	政治学法学经济医学心理学经济增长公共关系管理医疗保健社会学医学教育计算机科学业务哲学护理部社会心理学病理生物物理地理工程类历史内科学认识论数学社会科学考古
出版信息	出版商: BMJ Publishing Group，出版周期: ，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 2017，原创研究文献占比: 93.02%，自引率:11.80%， Gold OA占比: 27.60%

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Ten years on: The Snowy White Peaks of the NHS

Religious identity-based discrimination in the physician workforce: findings from a survey of Muslim physicians in the UK

Impact of department chair gender on paid parental leave across American anaesthesiology residencies

Gender disparity in Canadian Institutes of Health Research funding within neurology

Bridging the divide? Why the integration of standardisation and individualisation of care remains paramount during turbulent times

Religious identity-based discrimination in the physician workforce: findings from a survey of Muslim physicians in the UK

Ten years on: The Snowy White Peaks of the NHS

Gender disparity in Canadian Institutes of Health Research funding within neurology

Impact of department chair gender on paid parental leave across American anaesthesiology residencies

Innovative management strategies for addressing paediatric medical staff shortages in underdeveloped cities in developing countries