Racial equity in surgery

The British Association of Black Surgeons (BABS) held their second annual conference in November 2024, themed “Moving Beyond the Data.” BABS Chair, Miss Sarah Itam, welcomed attendees and thanked the platinum sponsor, The Royal College of Surgeons Edinburgh (RCS Ed). 

BABS is a registered charity committed to enriching patient care through diverse and inclusive leadership within the surgical landscape. Their core values—collaboration and community, advocacy, excellence, and mentorship—were highlighted throughout the conference. The challenges faced by Black medical professionals include: difficulties entering medical school, lower acceptance rates into foundation programmes of choice, less support during training, higher rates of exam failure, and slower career progression. To address these disparities, BABS has proposed an ABC approach: 

• Acknowledge biases within the system. 
• Benchmark current assessment, training and recruitment processes against equitable standards to ensure fairness, inclusivity, and elimination of bias. 
• Commit to piloting and evaluating solutions. 

Lord Simon Woolley Kt, Principal at Homerton College, Cambridge, delivered the opening keynote. He reflected on the formation of BABS during a global crisis: COVID-19, and the disproportionate deaths of ethnic minority healthcare workers. He emphasised the importance of unity, shared experiences, and reclaiming narratives to drive systemic change. 

He challenged Black surgeons to succeed despite the barriers: “Without you standing up and pushing through, how can others follow?” He also highlighted the role of allies - those who support rather than speak for Black professionals. 

Session 1: Racial Equity in Cancer Diagnosis and Outcomes 

Chaired by Professor Frank Chinegwundoh MBE, the panel examined disparities in colorectal, breast, and prostate cancer. Panellists: Mr Austin Obichere, Mr Jonathan Noël, and Miss Georgette Oni, highlighted the gravity of racial disparities:

• Colorectal cancer mortality rates: 3 in 5 Black, Asian, and Mixed patients compared to 2 in 5 White patients. 
• More aggressive breast cancer in Black women due to genetic predisposition. 
• Higher prostate cancer incidence in Black men (1 in 4 compared to 1 in 8 in the general population). 

Barriers to early diagnosis include cultural, religious, and linguistic factors, lack of symptom recognition, and fear of an incurable diagnosis. Proposed solutions include: GP endorsements, community initiatives, and culturally competent research trials. 

Session 2: Racial Equity in Training and Recruitment 

Sheila Cunliffe, HR and Organisational Development professional, researches racism in NHS recruitment. Her findings revealed that Black applicants had the lowest success rates in medical recruitment. For example in one trust, there were 418 Black applicants, but only 65 were shortlisted for interview and zero were offered a position. She suggested that institutional denial of racism is a major barrier to change in many trusts. 

Professor Katherine Woolf, a leading academic in differential attainment at UCL, highlighted that ethnic minority trainees report poorer experiences due to stereotyping, lack of trust, and imposter syndrome. She advocated for institutional solutions, including public commitments from leaders, training on differential attainment, and system-wide anti-racism initiatives. 

Professor Jon Lund, former Chair of the JCST, revealed gaps in ethnicity data collection. The JCST is now encouraging demographic data submission and hiring research fellows to enhance data collection. He encouraged Black professionals to apply for Training Programme Director and Specialty Advisory Committee roles. 

Jane Cannon, Programme Lead for Fair Training Cultures at the GMC, outlined their goal of eliminating discrimination in training by 2031. Ethnic minority UK graduates still face an attainment gap. Future strategies include: 

• Holding organisations accountable. 
• Exam support for minority UK graduates. 
• Collaboration with ethnic minority organisations and groups. 

Ms. Rantimi Ayodele, former Interim Chief Medical Officer at King’s College Hospital, described the challenges in her journey to becoming the third Black female orthopaedic consultant in the UK. She experienced racism, microaggressions, and isolation but used adversity to fuel her advocacy. Her leadership experience includes EDI roles, mentorship programmes, and policy influence. She emphasised: 

“We must create pathways… where equity is not the exception but the norm.” 

Professor Rowan Parks, President of RCS Ed, Platinum Sponsor: highlighted their commitment to inclusivity and advocacy. They acknowledged Black underrepresentation in surgery and invited Black surgeons to apply for roles on the RCS Ed council. 

Session 3: Emerging Technologies and their potential role in addressing health inequity 

Dr Shannon Shibata-Germanos, Head of Global Health at Proximie, showcased digital healthcare's potential in training 400,000 surgeons remotely. Key innovations include telepresence, cloud-based content management, and AI-driven insights. 

Mr Andrew F Alalade chaired a lively panel debate entitled, ‘Artificial Intelligence will tackle health Inequalities in the NHS’. 

• For: Dr. Olaolu Olabintan highlighted AI’s role in improving diagnostics and administrative efficiency. 
• Against: Miss Ope Sogaolu warned against potential AI bias, cautioning that flawed datasets could worsen health inequalities. 

Session 4: Medical Student and Junior Doctor Essay Prize 

Miss Louise Alder chaired this session, featuring essay winner Charlie Seymour (medical student) and runner-up, Dr. Kwaku Duah-Asante (FY2). Their presentations explored AI’s potential to reduce or exacerbate health disparities. 

Professor Bola Owolabi,’s closing keynote, empowered the audience to advocate for change. Data shows that patients facing the longest wait times are disproportionately from deprived, ethnic minority backgrounds. What must be done? 

• Break down the data to find and address inequities. 
• Navigate the complexity of patients’ lives with empathy.
• Use your voice as a tool for change - influence and advocate. 

The BABS 2024 conference in one word? Delivered. It delivered on ideas for improving equity in healthcare. It delivered on expectations by presenting frameworks to better support the Black community. Lastly, it delivered impactful speeches that left us wondering how we, the audience, can contribute to equitable change. As this charity moves from strength to strength, we look forward to their next endeavour.