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Student voices championing inclusivity

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In the summer of 2020, student doctors used their voice to highlight areas that needed to be addressed in order to make the School a more inclusive environment. These included increased diversity within the curriculum, improvements to sharing concern processes and strategies to address inappropriate actions or comments from staff or patients.

The School’s leadership team met with course representatives and student societies, as well as with key figures from NHS trusts across the North West to gain further insight into the issues in play, and to begin to take the steps needed to bring about real change.

As the year comes to a close, we reflect on the progress of this work to ensure all student doctors feel safe and included, whether on campus or on clinical placement, including the launch of microaggressions training and awareness in partnership with the Anthony Walker Foundation.

Dean of the School of Medicine Professor Hazel Scott says, “Nothing is of greater importance to me than the safety and wellbeing of our student doctors. What was evident at that time was that as a School we had been unaware as to the prevalence of these instances of discrimination and the feelings of powerlessness students were experiencing in knowing how to handle them."

I felt privileged to be in a position where I could harness our students’ insights and lived experience and get the right people in the room to begin identifying solutions and actions we could take forward together.

Documenting a commitment to equality, diversity and inclusion

Student representatives helped create a new student charter to set out actions that would promote a safe and caring culture within the School community. These included developing an understanding and respect for cultural differences and beliefs, supporting each other to openly challenge discriminatory views and actions, and championing a zero-tolerance approach to discrimination or prejudice of any sort.

This commitment was reflected in initiatives throughout the year, with student societies powering these efforts through events and activities on themes around anti-racism and LGBTQ+ rights.

Societies such as BME Medics and MADSoc (Medics Against Discrimination) played key roles in this movement, and were joined by new societies such as Queermedics to help facilitate conversations and build communities in support of students.

Multiple societies came together in March 2021 to run an Approaching LGBT+ in Healthcare Conference (link) and societies including LMSS (Liverpool Medical Students' Society) worked to increase their diversity by creating new roles within their committees and examining their approach to communication and events. We look forward to working further with societies on the actions they identified against the charter.

Alongside this, an EDI work group was created, led by Dr George Ampat as School Lead for Equality, Diversity and Inclusion (EDI). The group opened up conversations in weekly student-led surgeries, and went on to put on activities including an event with Professor Cynthia Pine and Dr Paula Franklin in celebration of Black History month.

Actions were put into place in direct response to concerns raised by students in summer 2020, including making disposable surgical headscarves available to students as part of their medics uniform.

A rich and diverse curriculum

Alongside this, work began to audit all learning content against a new learning commitment within the curriculum, to ‘incorporate and cover material that reflect the diversity of the population, and where relevant, offer materials that reflect different healthcare needs in relation to all protected characteristics (age, disability, gender reassignment, marriage and civil partnership, race, religion or belief, sex and sexual orientation).’

Dr Viktoria Goddard, Vice Dean of Learning and Scholarship, has played a key role in introducing changes to the programme as well as developing learning opportunities for staff to be a part of.

In the summer of 2020 we heard from many of you that the medical education generally, as well as specifically here at the University of Liverpool, was not doing enough in relation to ensuring that equality, diversity and inclusion were on the top of our teaching agenda.

"Since then, we have been working hard towards this aim in the background, but I am aware this work may be ‘invisible’ to the student body. For example, students moving from one year to the next may not always get to see the impact of their feedback in taught content as it changes for the next academic year group.”

  • Liverpool Student Doctors can see an annual round up of the variety of actions that have been implemented following student feedback on the student intranet (link).

Dr Goddard outlines progress made so far as regards to diversity and the curriculum, “To date, our work in this area has included all staff working with the School auditing and updating their learning content in relation to health determinants and a student-led lecture audit to identify areas where we could improve inclusive teaching.

A student-staff co-produced session on the history of Henrietta Lacks and research into HeLa cells ran alongside staff training on inclusive LGBTQ+ language, new diversity sessions in year 2 and new sessions on supporting transgender healthcare in Year 5. Staff also took part in a series of consultations looking at how we improve equality, diversity and inclusion in all that the School does.”

Making it easier to report concerns

As the University introduced a new Report and Support tool (link), the School also worked to facilitate anyone wishing to share a concern with enhanced processes, readily available on the student intranet.

Dr Anna Balinger, Deputy Director of Quality, shares, “You have been sharing your concerns with us over the last year via the sharing concerns form (link). This comes directly to us and helps us to maintain a safe learning environment and continually build on our education standards and quality monitoring processes.

As with other medical schools, there has unfortunately been times when students have felt unsafe, discriminated against, harassed or undermined. What you have shared has helped highlight key areas where discrimination has taken place and have helped us address these as a School with individuals and placement providers."

As a result, we have seen considerable changes made at an individual, Trust and nationwide level.

"For example, the Medical School’s council has now set up a nationwide Equality, Diversity, and Inclusion Alliance network in response to our School contacting them about the issues you have raised.

When sharing a concern on this or other areas, we ask that you include your contact details where possible, in order for a full investigation to take place as the action we are able to take with anonymous concerns is limited. We will always treat what you share confidentially and sensitively. However, we can’t ask you more about what happened or even tell you what we will do, unless we know who has shared the concern.

Thank you for continuing to share these issues with us. We are grateful to you for the considerable professionalism you demonstrate and the positive change that continues to occur as a result.”

Tackling microaggressions

One such result has been the development of training to provide awareness around microaggressions, which the School is proud to have spearheaded in partnership with the Anthony Walker Foundation, Health Education England and NHS Trusts in Merseyside, Cheshire and Wirral and Lancashire.

Again, student doctors were fundamental to the creation of this campaign, supporting design of a video and training framework, based on a survey of their lived experiences within the NHS and the responses of over 100 students and NHS staff. The online training sessions, given by the Anthony Walker Foundation, are open to all clinical course students and NHS staff across the region and will run until March 2022.

Student Doctors Anthonia Adefolaju and Rhema Otache were part of the work group behind these efforts.

Rhema Otache is currently undertaking an intercalated Medical Sciences with Psychology degree at University College London. She is also an influential member of Liverpool BME Medics Society. “I was happy to participate in the project and enjoyed providing the student perspective on the materials for the microaggressions training.”

Year Four Student Doctor Anthonia Adefolaju says, “It’s been great to be a part of a project highlighting such important but unfortunately missed issues, both in and out of the hospital. I hope this is the first step toward making the Shool and working in the NHS a more supportive and equitable experience for everyone.”

Looking forward

In taking stock of where we are now, the recent announcement by UK Health Secretary Sajid Javid of a review into systematic racism and gender bias in medical devices (link) is a reminder to us all that there is much work to be done in this area.”

And, as has been so crucial to the advances made so far, it is our vibrant student community who through their insights and ideas can help not only shape but really define inclusive medical education not only here at Liverpool but beyond.

Dr Goddard says, “We know that you as student doctors are the future of medicine in this country, and globally. We are committed to doing better in keeping the student community up to date with our activity, and we want to involve as many of you as want to be involved, in this work.”

  • Students interested in being a part of this work are invited to contact Dr Viktoria Goddard at viktoria.goddard@liverpool.ac.uk with their name and year group.

Discover More

  • Learn more about the movement behind the creation of a new student charter at the start of the 20-21 academic year in this article (link).
  • Review how student feedback has positively impacted the course in the summary of 20-21 implemented actions on the student intranet (link).
  • Read the interview (link) with Dr George Ampat as he took up post as School EDI Lead.
  • Students seeking support regarding discriminatory experiences are invited to reach out to the School’s Wellbeing team at wellbeing.mbchb@liverpool.ac.uk.
  • Student doctors can share a concern by completing the form available on the student intranet (link). Any instances of discrimination, bullying or harassment can also be reported anonymously via the University's Report and Support site (link).