A call for reflection, together

Chiemezie Okorocha

Following the events of June 2020 and the reports of the disproportionate effects COVID-19 had on the Black and Minority Ethnic (BAME) community, a spark ignited the resurgence of the Black Lives Matter movement. This prompted many individuals to reflect on their understanding of racism, inequality, and the interpersonal and institutional effects of it. As a result, organisations were moved to look internally at their structures in leadership, recruitment, and training to improve equality, diversity, and inclusivity (EDI).

One of these organisations includes The Royal College of Surgeons (RCS). In March 2021, they released a report following an independent review into the diversity of the leadership of the surgical profession and of the college (commissioned by Professor Neil Mortensen, President of RCS England in 2020). Key issues were identified and summarised in a 16-point plan with a timeframe of five to ten years.

The Society of Cardiothoracic Surgery (SCTS) in March 2021 also released a statement about how strategies were being taken to address areas of inequality within cardiothoracic surgery. The main aim is to provide equal opportunities, diversify the workforce and introduce an inclusive environment for those embarking on developing a career in cardiothoracics.

SCTS EDI action points were detailed in seven key areas. Although a timeframe for implementation was not detailed, the society is doing well to effect change within its structures.

The RCS EDI plans are summarised below, mirrored to the SCTS strategy and with personal commentary:

RCS Strategy

Commitment to RCS England Vision, putting diversity at the heart of College strategy. The objective of the reform is to ensure the society becomes more diverse and inclusive.

Commit to The Reform Target: Leadership, Presidency, Vice and Council will reflect the diversity of the wider medical workforce in 5 – 6 years with voting-in of candidates.

Reform Election for the Three Vice-Presidential Roles by the membership. If the two candidates with the highest votes are male, the third VicePresidential place should go the woman with the highest votes. This should be in place for 10 years only, to shift the dial on equality in leadership.

‘Women in Cardiothoracic Surgery’ (WICS) mentorship programme launched to support career progression for women in the specialty.

Develop a clear SAS Strategy Work with the SAS Forum to create an overall action plan to give due recognition to the role of SAS practitioners. Launch of the Trust Appointed Doctors Mentorship Programme, ensuring support and increased opportunities are provided for these doctors.

FLAGSHIP PROJECT –Taskforce to support Parents in Surgery.

WICS aims to allow support of achieving a work-life balance, working less-than- full-time, working during pregnancy, and returning to work following maternity leave.

SCTS Strategy

Committed to encourage the diversity of applications for leadership within the society.

Launch Two Annual Research Fellowships into Surgery, Diversity, and Inclusion. Several medical fellowships available through SCTS.

Support Diverse Grassroots Medical Organisations with Seed Funding - Provide seed funding and/ or support to grassroots organisations or collective efforts that seek to address diversity, equity, and inclusion issues in surgery.

Data Collection, Monitoring and Career Tracking. SCTS recently released a survey to all its members to understand the issues they face.

Training: The Council and staff in the College will need training on how to implement the Report and how to conduct anti- discriminatory recruitment and interviews.

SCTS have been running engagement events and providing bursaries in collaboration with other organisations, to increase access to the speciality as a career.

SCTS stated their policy and documentation will reflect the societies stance for equity and removal of unconscious bias.

In conclusion, making structural changes and advocating equity within established institutions is a challenge that takes time, joint endeavours and is multi-faceted. The first step is to recognise there is room for improvement and SCTS have done so with transparency.

For Black History Month 2021, RCS England discussed the progress they had made since the report, the hurdles impeding completion and welcomed critique from members as part of their steps to openness and accountability.

The 2022 SCTS meeting would be a prime opportunity to hold panel discussions for a review of the progress made since the release of the report. It will ask for collective accountability to ensure maintenance of trust and inclusivity of all its members – ‘One year on, SCTS reflects together’.

I look forward to seeing how the society’s structural changes and progression will become an example for other organisations to follow. n

Commentary

Encouraging to see that this is stated from the outset.

The timeframe and details of methods of action would ensure equity in leadership and aid objective monitoring of progress.

A bold stance for the College to make. With the WICS program, I foresee SCTS being able to do the same in their structural leadership.

SCTS have gone a step further in the development of this program. An assessment of the tangible impact on career progression and development will steer the program to optimum improvement.

Although SCTS through WICS are aiming to support mothers, the diverse genders of parents are to be considered. The College’s Taskforce is possibly one that SCTS can take the opportunity to emulate.

If SCTS were able to support one cardiothoracic fellowship with the focus on increasing black trainees, reasons for disparities within the profession can possibly be identified and resolved.

Commissioned articles by SCTS that journey with BAME 6th formers and medical students through to securing an NTN, would be testimonial to the widening participation schemes.

Participation in surveys can prove a challenge, but engagement is often encouraged if clear targeted consultations, goals, and actions are followed through.

To improve on this, SCTS can ensure all staff and committee members are skilled to be public allies and champions for equality, diversity, and inclusion.

References:

Royal College of Surgeons England, 2021. RCS England Diversity Report. RCS Standards and Guidance. [online] London: Royal College of Surgeons England, pp.3-5, 36-39. Available at: https://www.rcseng.ac.uk/-/media/files/rcs/ about-rcs/about-our-mission/rcs-englanddiversity-report- 11-august.pdf.

Scts.org.2021. Equality, Diversity and Inclusion. [online] Available at: https://scts.org/ professionals/equality_diversity_and_ inclusion.aspx.