Complementing awareness with action: a collaborative effort for change in medicine

Ololade Tijani, Student, Leicester Medical School

The importance of inclusivity in medicine cannot be overemphasised and is increasingly acknowledged by individuals (medical students) and organisations (medical schools). Due to this, a plethora of attempts to mend identified gaps have been implemented and are still currently being implemented. Yet, we can’t truly mend the problematic gaps without minding or being aware of the gap. In our active bystander training that we get as medical students in our pre-clinical and clinical induction, the first step in being an active bystander is to notice. Although this may appear a seemingly basic concept, the practical element may be much more challenging than you would think. How do you notice what doesn't apply to you especially when you've not heard anyone around you mention something about it? I certainly didn't notice or think my hair could pose any challenges to my experience in medical training (at least not in the early stages as an aspiring medic).

The issue

As I was tapping through Instagram stories, one post highlighted potential issues that could be faced from a patient perspective. This post featured an admirable hairstyle which would not impede clinical practice in anyway (needless to say); however, the post said, a patient made a comment referring to this medical student as 'scary spice' alluding to their feelings towards the volume of her natural hair. I was concerned about the prevalence of incidents such as this as well as what perceptions were being upheld regarding natural hair within the medical/healthcare setting. 

With nowhere near the same volume of hair (although I would love to), I didn’t realise my hair would impact my experience in clinical environments such as in theatres. We had been given a timetable for our surgical placement so I had an idea what to expect and was planning to schedule times when I would attend theatres; planning to adapt my hair to fit into the scrub caps. However, after our ward round, the consultant asked if we would like to go to theatre; an offer which I was very ecstatic about considering the fact that I had never been in one before (evidently not motivated by the opportunity to wear scrubs and look like a surgeon). Thus, not thinking about my hair I bounced off to theatre looking forward to maximising this opportunity. I was ready to go and after changing everything else, all I needed was just put on my scrub hat and go - at least that's what I thought. Shockingly, what started with a huge smile ended with me having netty knickers on my head as that was the only thing they could find to fit my hair. Thus, making my first theatre experience a very different one to what I had anticipated. Moments later, another theatre practitioner saw what was given to me as a hair covering and gave me a larger scrub hat that which I did not have access to on my next theatre visits.

Raising awareness

The fact that this affected my theatre attendance made me realise certain practices within the healthcare setting such as this have an adverse impact on the education we receive and should be addressed on a larger scale. Thankfully, I was able to raise my concerns with the MedRACE group (previously BMA Racial Harassment Charter Working Group. Having mentioned this, our staff leads, Dr Shameq Sayeed and Dr Kate Williams were very supportive and keen to ensure this was not a narrative propagated along our medical education. The staff leads mentioned that they would not have recognised this as an issue if it hadn’t been raised but once it was highlighted, action could be taken. Consequently, they raised this with senior members of the medical school including our head and deputy head of school who were thankfully receptive to the matter and sought to provide a solution. Acknowledging that trustwide change was not going to materialise within a quick time frame, the medical school opted to purchase more inclusive scrub hats for students. We were aware that scrub hats suitable for larger hair volumes existed and having had a conversation with my friend, Hazel Owusu-Yianoma (a 3rd year medic at the University of Liverpool), I shared a picture she sent to me featuring a medical student who was wearing a scrub scarf which enabled her to cover her hair appropriately. This prompted us to contact the student who signposted us to where these inclusive scrub headwear could be obtained. Further discussion on this also resulted in me contacting Olamide Dada, Founder and CEO of Melanin Medics, who signposted us to a company called WarwickMed who were providing inclusive scrub hats. We were able to obtain samples from Medline and WarwickMed.

Taking action

Following this, the samples were made available to students to try on and rank them in order of suitability, providing comments to help ascertain the most appropriate scrub hat to purchase for clinical medical students as shown in the pictures below. We made efforts to ensure that a variety of students were involved in this process to make the chosen scrub headwear representative of the medical school population.