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Diversity matters: the other doctor within the Dutch academic healthcare system
  1. TTT Tweed1,
  2. CV Maduro2,
  3. NH Güneș2,
  4. M Poeze2,
  5. J O Busari3,4
  1. 1 Department of Surgery, Zuyderland Medical Centre Sittard-Geleen, Sittard-Geleen, Limburg, The Netherlands
  2. 2 Department of Surgery, Maastricht UMC+, Maastricht, Limburg, The Netherlands
  3. 3 Faculty of Health, Medicine and Life Science, Maastricht University, Maastricht, The Netherlands
  4. 4 Pediatrics, Dr Horacio E Oduber Hospital, Oranjestad, Aruba
  1. Correspondence to Drs. TTT Tweed, Dept. of Surgery, Zuyderland Medical Centre Sittard-Geleen, Sittard-Geleen, 6162 Limburg, The Netherlands; th.tweed{at}


Introduction Over the past year, there has been a worldwide increase in the focus on systemic discrimination and inequitable practices within different societies, particularly concerning race and ethnicity. The inherent (experience of) inequity in racism is notonly limited to individuals but also found in different domains of societal structures, including healthcare and academia. In academia and healthcare organisations, junior Black and Minority Ethnic (BAME) doctors and students regularly find themselves caught between the leaky pipeline phenomenon and hierarchically dependent positions in academic healthcare settings. Voicing their experiences after such encounters is neither an option nor a choice they can do without repercussions. The prejudices, stigmas, implicit biases present within these environments result in segregated practices, where BAME doctors become the ‘other’ doctor (otherism), and based on their religion, ethnicity, migrant background or physical features are boxed into a specific group or category.

Reflections & recommendations The outcome of this exercise (re-) emphasised that more improvement in the Dutch healthcare systems concerning stigmas and biases towards race and ethnicity are needed to promote the inclusion of future BAME doctors and students. A pivotal turn is urgently needed to repair the racial stigmas and biases that have distorted the image of BAME doctors/students, limiting their academic and professional progress. By structurally implementing focused strategies to promote inclusivity, the current gap within healthcare and the participation between non- BAME and BAME-doctors/students can be bridged, inevitably leading to better healthcare services, safer learning environments and a balanced representation of our multicultural societies in healthcare.

We argue that increased self-reflection from such critical inquiry will ultimately result in clear and objective understandings of (pre) existent inequitable practices in our societies.

  • clinical leadership
  • health system
  • improvement
  • medical leadership

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  • MP and JOB are joint senior authors.

  • Twitter @jobusar

  • Contributors TT and JB planned the study. All authors conducted in-depth reviews of the available data and shared a personal case. TT, CM and NG contributed to the first draft of the study. JB and MP conducted the first review of the manuscript. All authors contributed to the review of the subsequent drafts of the manuscript and approved the final version for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.