Tuesday 29 October 2024
Emergency Medicine (EM) Consultant Edward Chinwendu Oforka has shared a short biography of his background and career achievements so far for Black History Month (BHM) and its Reclaiming Narratives theme. RCEM’s Equity, Diversity and Inclusion (EDI) Committee has shared a series of inspiring submissions from Black EM professionals throughout October.
I’m a Nigerian-born Black British Christian from a modest family background. I currently work as a consultant in EM at Queens Hospital Burton on Trent, part of the University Hospitals of Derby & Burton NHS Foundation Trust, and I am an Honorary Associate Professor at Leicester Medical School. I am married and blessed with three children and two grandchildren.
Early life and education
I was born and raised in Nigeria, where I became the first in my family to qualify as a doctor in 1985. My journey in Medicine began with postgraduate training in Plastic Surgery at the University College Hospital, Ibadan. However, in 1990, I made the difficult decision to move to England. This move was driven by the need for better training opportunities in microsurgery and the economic situation in Nigeria at the time.
Transition to EM
Upon arriving in England, I faced numerous challenges, including difficulties progressing in Plastic Surgery and the impact of racial barriers on my career. Despite these obstacles, I found my true calling in EM. I embraced this new path with an open mind, learning to navigate the system and not allowing barriers to define my narrative.
Career highlights
Throughout my career, I have achieved several milestones that I am incredibly proud of. I earned Fellowships with the Royal College of Surgeons and RCEM and became a member of the British Society of Surgery of the Hand and the European Society of Hand Surgery.
I started with introducing innovative clinical system changes, but my greatest achievement as Head of Department (HoD) was establishing a post-graduate and under-graduate specialist training programme in EM at Queens Hospital Burton. This initiative not only enhanced our department’s capabilities but also helped in recruiting and retaining talented staff. I also introduced Advanced Trauma Life Support (ATLS) and Advanced Paediatric Life Support (APLS) courses to the Trust, serving as a course director and significantly boosting our educational profile.
National and International contributions
I’m a long-standing member of the West Midlands EM School Board and currently the regional joint training programme director for EM Acute Care Common Stem (ACCS) training. I serve on two RCEM Committees, the Equity, Diversity and Inclusion (EDI) Committee and the Academic Committee. My international contribution to medical education has been mostly with Life Support Courses, which I have taught in many countries. Notably, I had the great experience of organising the team of instructors for the first ATLS course ever held in Shanghai, China. I have also had the privilege of teaching ATLS courses in exciting environments abroad, including having military teams from warring countries side by side on a joint course under the same roof.
Medico-legal work
Another area of my contribution, which I enjoy a lot, is working as a medico-legal specialist and expert adviser for my Trust. This role developed over time from my interest when I was HoD with responsibilities of reviewing potential negligence cases attending courts including coroners’ courts when necessary. I also teach medico-legal issues of interest in EM.
Contributions to Africa
I also work with non-NHS organisations that take healthcare expertise and technology to Nigeria and other disadvantaged African countries. This gives me the opportunity to facilitate access to private healthcare in the UK for these foreign patients when necessary. I acted as a consultant and medical adviser to a United Nations Millennium Development Goal project for the ‘Women & Children Centre’ in Lagos, Nigeria. As a foundation member of Nigerian Emergency Care Practitioners, I see it as my duty as a senior clinician and educator to continually engage in opportunities to provide educational and clinical support for EM in Nigeria. I take the opportunity to travel as a visiting consultant/lecturer to teaching hospitals in the Eastern states of Nigeria where I come from. This is my way of giving back to a country that provided me with my early education and medical training at minimal cost.
Recognitions and Awards
Throughout my career, I have been fortunate to receive several accolades and peer recognition. I have been honoured with awards like the Star Tutor Award from Leicester Medical School and the ‘Making a Difference Award’ from my Trust for my life-long contribution to education and learning. Despite starting in Burton without the expectation of joining the professorial cadre, my responsibilities for Leicester Medical School and medical education in general earned me the honorary title of Associate Professor of Medical Education from the University. I have truly enjoyed my career, and nothing has stopped me.
Challenges and Opportunities for Black Clinicians
When I think of Black clinicians in the UK, I always put my EDI heart on. This allows me to see Black doctors in two different groups with different challenges: UK Medical Graduates (UKMG) and International Medical Graduates (IMG). UKMGs have been here longer and understand the culture and clinical systems better than IMGs. As a result, IMGs need more support to enable a soft landing, as EM in many of their countries is not as developed as in the UK. The differences are often related to systems, cultural, and language/communication differences rather than clinical knowledge.
Proper clinical induction and support with initial issues like finding accommodation, schools for children, and opening bank accounts should be available to IMGs. Unfortunately, the support varies across the country, and some of healthcare is still providing minimal induction, setting doctors up to fail. The support for IMGs should be robust and standardised across healthcare.
Beyond settling in, systemic issues, cultural dynamics, and the unique nature of the specialty pose significant challenges to both groups of Black doctors. While things are moving in the right direction, racial discrimination and bias still exist. Implicit bias in the workplace can manifest in various forms, such as questioning the clinical skills of newly employed IMGs despite their rigorous exams and checks before registration by the General Medical Council (GMC). This treatment can distress competent doctors, affecting their confidence and clinical practice.
Another challenge is the underrepresentation of Black clinicians in senior roles. Disparities in career advancement start with the hurdle of getting into training. Many good doctors struggle due to interview techniques, language, and cultural differences, leading them to take non-training jobs as a means of survival. The financial pressures are significant, especially for those supporting families back home. The differential attainment in career progression has delayed the availability of visible Black role models and mentors in the specialty.
Workplace stress and burnout are challenges for everyone in EM, but they can be worse for Black clinicians due to additional stress from navigating discrimination and barriers to career progression. Witnessing racism or bias directed towards colleagues or patients can also be a trigger.
Opportunities for advocacy
Despite these challenges, there are significant opportunities for Black clinicians to advocate for health equity. On the shop floor, we can highlight and challenge systemic biases that affect patient care. As policy makers, we can bring vital perspectives to the table about addressing disparities in patient care. Our respected position as clinicians allows us to build and gain the trust of Black patients regarding how their care is delivered.
We should also take up mentorship and representation opportunities to serve as mentors and role models. Our visibility can inspire the next generation of Black clinicians training in EM. Programs like the NHS Workforce Race Equality Standard (WRES) focus on mentorship and can help Black clinicians in leadership positions advocate for more inclusive policies, better working conditions, and training programs that address diversity and equity.
We are also getting more non-Black allies in all walks of life. RCEM in the UK is an example of an organisation committed to moving towards real equity and inclusion, recognising the contributions of Black and other ethnic minority doctors in the specialty. I recognise the progress, but a lot more needs to be done.
Advice to my younger self
Reflecting on my journey, I consider myself lucky to have navigated the system to where I am today, though I made various avoidable mistakes along the way. If I could advise my younger self, I would emphasise the importance of proper preparation for the UK’s harsh weather, as I fell a few times in the snow due to inappropriate footwear.
I would also caution against upsetting people by doing things beyond my job’s scope, even if I felt capable. Starting again as a ‘house officer’ in the UK after being a registrar in Nigeria was challenging. I struggled with ‘judgement and communication’ affecting my ARCP outcomes. For example, I got into trouble for suturing a facial wound without referring to specialists even though, as an ex-plastic surgeon registrar, it was competently done with no complications. This experience taught me the importance of understanding cultural differences and the need for trainers to handle such situations with empathy.
I would advise asking career questions earlier and preparing for a career in medical education by obtaining relevant qualifications during training. I was fortunate to be sponsored late in my career for a Master’s Degree in Medical Education as a Consultant, which I found invaluable.
Finally, I would heed the advice I received in 1992 to transition to EM sooner. Although I initially hoped the system would recognise my potential in Plastic Surgery, I eventually found my path in EM in 1998, thanks to the guidance of former RCEM President Alistair McGowan.
Final reflection
As a young African boy, Nelson Mandela’s resilience and perseverance deeply inspired me. His release from prison and subsequent presidency symbolised hope and the possibility of overcoming oppression. Mandela’s qualities of forgiveness and strength guided me through my own challenges in healthcare, reminding me that success requires perseverance and resilience.
Over the decades, the narrative of Black history has evolved from focusing solely on oppression to celebrating the achievements, creativity, and strength of Black communities worldwide. Movements like Black Lives Matter have highlighted ongoing struggles against racism and inequality, while the digital age has revolutionised information dissemination, ensuring that Black history is more accurately represented.
We now see more non-Black allies and organisations like RCEM working towards real equity and inclusion. The dialogue continues to evolve, addressing contemporary issues and ensuring that the history and experiences of Black people are comprehensively represented.
Thank you for taking the time to read my story. I hope it serves as an inspiration and a reminder of the importance of reclaiming our narratives and celebrating our achievements. Now I am enjoying more time with my wonderful family, especially looking after my incredible grandchildren.
Read about another BHM EM Champion:
