Discrimination in Healthcare – Moving Forward?


We have received correspondence/concerns/complaints about some of the ‘comments’ (below) this post.  We have posted a response to ‘any concerns’ HERE:



We have received two indirect complaints about the ‘comments’ section of the post from the 17th of August 2017, and concerns about our initial lack of moderation of this thread.  

By way of background, we wrote a brief commentary based on an article in the Guardian newspaper, the ACEM working group interim report, and our appreciation of the college’s leadership on the issues.  It should be noted we were asked to post on, and provide a forum for discussion of the matter by FACEM trainees.

Following these posts, we were inundated with (anonymous) comments on the site.  It should be noted that (on this hosting service) once an initial comment from an individual is ‘approved’ then their follow-up comments are automatically posted without our ‘sign off’.

This Website

Since 2013, we have tried to provide high-quality educational content. Furthermore, on occasion, the site has hosted ‘forums’ for discussion, and to some degree, a cathartic outlet for some individuals who can choose to remain anonymous when posting.

Regardless of the occasional forum, the main objective and function of this website remains as a Free Open Access Medication Education (FOAM) platform for a community of learners in Western Sydney.  

Apology to the Complainant(s)

From re-reading the Complainant(s)’ cited comments we realise that many of the statements crossed a line.  It is now clear that much of the anonymous commenting by individuals (external to our site) could be upsetting to individuals. The content of the anonymous commenting was concerning at the time but rather than moderating the comments we posted to request civility and professionalism.

While this is not an ‘excuse’ for our approach moderation of the thread (in regard to the use of pseudonyms) it should be noted that we did not understand all the comments. We offer an apology to those concerned that until this week that posts were not moderated.  

On the 4th of September, our initial action was to remove 10 comments which ‘named’ others (with pseudonyms) and referenced individuals and/or organisations.

Following this initial response it was the opinion of the complainant(s) that the remaining comments were inappropriate and that our response had not been serious enough (sic).

Regarding the latter, we will continue to do our best to respond in a satisfactory manner.

Regarding the former, our employer has asked us to remove the comments section and we have complied with this request.  

We offer a sincere apology to any readers that have been offended by any comments or content on this website at any time since 2013.

To Trainees 

From the other side of the ‘exam fence’ it is easy to look at trainees’ who have been unsuccessful in an exam with sympathy, but not necessarily empathy.  

If you do feel aggrieved about your experiences, they are YOUR experiences and therefore the feelings are valid.  The perceived uneven playing field, and not being able to get on with post-exam life, must be very difficult.  We wish all those involved with the discussion on the (now moderated) thread well for the future.  

The Future

We suggest online debate(s) about the ‘new’ FACEM examination may have to be elsewhere. In any future discussion threads on this site, we will request for professionalism and a reasonable ‘code of conduct’ in posting.  This will be enforced more fully and immediately . 

This site has received over half a million views overall and we hope had a positive impact from both a local and international point of view. We welcome constructive feedback and our ‘values statement’ can be referenced HERE.

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Original Post (August 2017)

“Bullying and discrimination of any kind has no place in healthcare.”

While we can (and should) take action when we see cases of discrimination when they are witnessed – it can be a challenge.

Firstly, there are many actions that can make individuals feel undermined, but without overt or clear evidence of intent we can sometimes be uncertain of what is the correct interpretation.  Secondly, where we witness ‘borderline’ behaviour(s), we may be fearful of the consequences of taking action.

Recent political events have shed a wider light on this issue.  In Australia, Doug Cameron showed last week the importance of calling out overt prejudice when we see it.

Is there denial that there is an issue?

Image result for racism scale facebook

Pass Rates Decline Graph

 (sent by e-mail from a candidate commenting below)

Group A – Trained in Aus, NZ, UK, Canada, USA etc.

Group B – Trained elsewhere (including Sri Lanka, India and Iran)


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General Comments

When witnessing an aberrant behaviour (by any individual, staff or patient) we need to act in the best way we can at the time. Options for ‘action‘ can take a variety of forms including directly calling out the behaviour, ‘reporting‘ or just staying silent.

In my opinion, we need more education and training on the possible courses of action that can be taken when we witness both ‘borderline’ behaviour as well as overt discrimination.  In addition, I believe that any ‘reporting’ process needs to protect the rights of all individuals concerned.  This is important in order to prevent a siloed culture or increased tension.  When it comes to emotive areas such as ‘high stakes’ examinations it could be easy for things to boil over and a ‘blame’ culture to develop.

As there is no certainty that we can change other individual’s behaviour, governing bodies such as medical and nursing colleges must take leadership in this area. As healthcare providers, we need support from our governing bodies and colleges to deal with larger cultural issues in healthcare (discrimination) in its various forms

The college of Emergency Medicine should be commended for their recent press-release:

Unfortunately, the recent article in the Guardian and the stats presented are very concerning… I think we all agree that harassment, bullying and discrimination are all unacceptable – but they appear to still be happening in Australian and New Zealand.

The Emergency Medicine college wants to hear your ideas on preventing and addressing this unacceptable behaviours in emergency medicine so please continue to support them with their efforts in this area. We look forward to your comments below…


54 thoughts on “Discrimination in Healthcare – Moving Forward?

  1. MODERATED COMMENT (potentially offensive to others) – please see statement at the top of post (4/9/17)

    (this post cited pseudonym ‘names’)

  2. MODERATED COMMENT (potentially offensive to others) – please see statement at the top of post (4/9/17)

    (This post cited names)

  3. MODERATED COMMENT (potentially offensive to others) – please see statement at the top of post (4/9/17)

  4. MODERATED COMMENT (potentially offensive to others) – please see statement at the top of post (4/9/17)

    1. MODERATED COMMENT (potentially offensive to others) – please see statement at the top of post (4/9/17)

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