#OperationEqualAccess - Ms Panchali Sarmah Interview

Ms Panchali Sarmah is a Higher Specialty Trainee in General Surgery at Health Education East Midlands, and also President of The Dukes' Club.VB PS

Vittoria Bellato (VB): Thank you very much Panchali for agreeing to this interview. I believe change develops from knowledge, therefore I think that the role of an international society in promoting diversity should start in highlighting different measures around the world to start a proactive exchange of information. As President of The Dukes’ Club, what is your vision for creating a better and inclusive environment for our fellow colleagues and our patients?

Panchali Sarmah (PS): There is an ever-expanding body of evidence showing that a diverse workforce results in better outcomes for both businesses and their clients, and this pattern is also seen in healthcare for care providers and our patients. As a surgeon; having a more inclusive environment for my colleagues means allowing individuals with different backgrounds and experiences to contribute to the care of my patients. Diversity brings about new ways of seeing things, new perspectives on how to achieve an aim, new approaches to tackling a problem and, as a trainee, new methods to learn. For our patients, this translates to us being more likely to appreciate what’s important to them from their perspective rather than our own medical views and so being able to offer better personalised care.

To create this environment, we need to first recognise its importance - talk about it and actively facilitate change where it is needed. It is important we ensure a safe space for all voices and opinions to be heard and for us to support those taking their first steps into pre-established spaces that can sometimes feel intimidating. We need to show we’re open to all and that we support standing up to bias, bullying, harassment, micro-aggressions.

VB: In daily situations when you see bias in action, how can you support your fellow doctors and how do you handle unfair situations?

PC: I think everyone has experienced the bystander effect at some point in their training, whether you’re the one being targeted or the one standing by. The bystander effect is where the presence of others discourages an individual from intervening for the victim. Inaction can be a result of the belief that you’re not witnessing any wrongdoing, or the want to self-preserve by not speaking up.

We thankfully now have a wealth of information to help us go beyond this and become active bystanders, where we intervene rather than standing back. First, notice what’s going on, and if you see something potentially unfair ask yourself if you’d be ok if this was happening to you or a family member. The next step is to do something about what you’ve seen. You can do it in the moment by using simple phrases like “that’s inappropriate” or “I’m not comfortable with what you’re saying”. But if you’re not comfortable with doing that, it’s just as important after the moment to support the person who was the targeted, to escalate what happened or to speak to the perpetrator and explain why it wasn’t appropriate. While there are some people who will know they are crossing boundaries, there may be others who don’t know one exists because they have not experienced bias themselves or have not been part of a diverse environment. We need to educate ourselves and our colleagues on how our actions can impact others, and we need to be open to learning how to improve the environment we all work in.

VB: When I completed my fellowship in the UK, I really appreciated the safety net that the NHS provides to all employees. I first noticed that your mandatory training includes many chapters on diversity and equality and that there is a dedicated office to whom people can refer regarding those matters. I was also impressed with how the conversation about these topics was constantly raised with posters, screensavers and flyers. Therefore, I personally think that NHS is taking some action on fighting inequality. Which areas can be improved and how?

PC: In the surgical fields in the UK, the publication of the Kennedy report (a review into diversity of surgical leadership and in the Royal College of Surgeons of England) was a wake-up call. It really highlighted individual experiences, with some of the testimonies making for painful and upsetting reading. As a result, more people have begun sharing their experiences. However, despite this early momentum, and the resources you mentioned, we still have a lot of work to do in the UK. We’ve been good at recognising visible diversity such as gender and ethnicity, but we still have work to do to improve inclusivity for non-visible diversity such as LGBTQ+, less-than-full-time, international medical graduates and disabled colleagues, amongst others.

The Dukes’ Club has invested in becoming more inclusive and open for all our members and colorectal trainees over the years. We have an equality, diversity and inclusion policy visible for all, have continued to use closed voting and anonymised applications for prizes, courses and committee positions, and ensure our diversity principles are applied to selecting speakers, topics and locations for all our events.

VB: Thank you very much for your time!

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