Indigenous physicians call for cultural reform in the health sector to address workplace discrimination

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Growing up in Milingimbi in the northeast of Arnhem Land, Yolngu man Dr Mangatjay McGregor was always drawn to a career in medicine.

“From an early age, I felt really in tune with how people felt and [that] naturally evolved into medicine,” he said.

Dr McGregor is the Mental Health Registrar in Melbourne and is believed to be the Northern Territory’s first Yolngu doctor.

While the 29-year-old has made great strides in his career, his journey hasn’t been without challenges.

During his career as a junior doctor, he said he faced bullying and discrimination from senior executives in the workplace.

“There are times when [the discrimination] is more overt and in your face, so there are times when it’s a bit more insidious,” he said.

“Often it comes from consultants, so they are specialists or registrars [who] are quite senior – there’s this power imbalance.”

The Medical Board of Australia says Indigenous doctors are important to keep in the healthcare system. (Photo by Ian Waldie/Getty Images)

One incident in 2017 – which took place while Dr McGregor was an intern – stuck in his memory.

While in an operating room, he said he was bullied by a surgeon in front of his peers.

A man looks at the camera as he stands in the hallway of a doctor's office and holds manuals.
Dr McGregor says some senior medical staff have made other Indigenous medical students feel ‘unsafe’. (Provided by: Peter Healy)

“I was in [the operating] theater with [this surgeon] many times,” he said.

“No matter what I did to try to help out in the theater or show off my knowledge when she asked questions…I just couldn’t satisfy her.

“She actually said to me, ‘You have to answer questions in a way that doesn’t make me want to punch you.'”

While seeking advice from mentors helped him cope with the incident, Dr McGregor said medical school had become “overwhelming” for some of his Indigenous colleagues.

“There was one consultant in particular…who was well known enough to bring medical students and young doctors to tears…that included some of my native friends. They felt really in danger,” he said.

Dr. McGregor’s experiences are not uncommon.

A recent national survey of over 21,000 doctors in training found that more than half of Aboriginal and Torres Strait Islander trainees, or 158 trainees, have experienced or witnessed bullying, harassment and discrimination in the workplace, compared to 35% of all interns.

The Medical Training Survey (MTS), in which more than half of all doctors in training participated, found that the group most often responsible for actions were senior medical staff.

Calls for cultural reform

The Australian Indigenous Doctors’ Association (AIDA) has described disproportionately high rates of workplace bullying and discrimination as ‘unacceptable’ and raised concerns it could drive First Nations trainees out of the profession .

“It’s something most of us have encountered when we did our own training,” said AIDA Vice President Dr. Simone Raye.

“We had hoped things would improve for the next generation.”

“This is very concerning because senior managers can actually set the tone for the culture of the organization in which they work.

“There really isn’t a way to solve some of these problems, especially when it comes to senior executives. [responsible].”

AIDA vice-president Simone Raye standing in a public garden, with trees and flowers in the background.
Dr Raye says urgent systemic reform is needed to tackle workplace discrimination. (ABC News: Hamish Harty)

Dr Raye said cultural safety training programs need to be implemented across the healthcare system to ensure “cultural competence within the workforce”.

She also called for the establishment of a nationally consistent reporting system across hospitals and healthcare organizations to ensure that incidents of bullying and discrimination can be adequately addressed, without that aboriginal physicians feel that they might be penalized.

“There is no established structure within the hospital system to deal with these kinds of issues,” she said.

“[We need to work with] senior managers and senior management of the hospital system in an attempt to provide cultural safety training.

“If we can drive this change at the upper level, we hope it trickles down to lower level staff and colleagues.”

“Work in progress” to fight against discrimination

The President of the Medical Council of Australia, Dr Anne Tonkin, stressed the importance of retaining indigenous doctors.

“It is very concerning that First Nations interns are experiencing higher levels of discrimination, bullying and harassment, as they are very important people to keep in the healthcare system,” she said.

“I would like the profession as a whole to take special care of these trainees, so that they thrive in the health system.”

Dr Tonkin said work was underway to fix the problem.

“The council is very well placed to talk to a whole range of health sector stakeholders and agencies, bring people together, agree that this is unacceptable and make plans to change that,” she said. declared.

“We are already starting this process.”

The Australian Health Practitioners Regulatory Agency (AHPRA) said it had put in place an Aboriginal and Torres Strait Islander Health Strategy, which provides a “framework to encourage health practitioners adopt a culturally safe and respectful practice”.

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