A qualitative study exploring experiences of racism, inclusivity and diversity on career progression in pharmacy practice and education
Authors: Rathbone A , Hagos M 
Published: November 2022

Abstract

Introduction
Approximately 40% of pharmacists in Great Britain identify as part of minority ethnic group, however research has identified that these pharmacists are under-represented in senior management positions.1 Additionally, there is a well documented attainment differential in pharmacy education, suggesting disparity that extends beyond practice, to initial training and education.2 Further work is needed to explore career progression, racism, inclusivity, and diversity in pharmacy practice and education.

Aim
To explore experiences of racism, inclusivity, and diversity on career progression in pharmacy practice and education.

Methods
Six online focus groups lasting one hour were competed on Microsoft Teams with a convenience sample of 29 pharmacists, trainees and students recruited via email and social media. Automatic verbatim transcripts were quality checked then thematically analysed using NVivo Version 1.2 and a step-wise approach of familiarization, coding, and clustering to identify key themes that described participants’ experiences. Ethical approval was obtained by an institutional ethics committee.

Results
The main themes were Defining racism; Experiencing racism; Race talk; and Career progression. Participants defined racism as a combination of ignorance and malice, manifested in derogatory language, physical violence and judgement based on skin colour, accent, hair type, and clothing. Racism was experienced both overtly and subtly, by senior colleagues, contemporaries, patients, and staff members from other disciplines. Two white participants reported never experiencing racism. Engagement with race-related training or practice issues, such as addressing racist encounters with colleagues or patients, was limited by senior managers, who were perceived to prioritise economic interests (not losing customers) and protecting organisational branding. Talking about race (Race talk) was mostly reported as uncomfortable with managers from white backgrounds, as this led to misunderstanding and confusion, misrepresentation as “playing the race card” and minimisation. Equally, white participants reported feeling very uncomfortable and being afraid to talk about race. This meant challenging racist behaviours, attitudes or systems was difficult for all participants and had to pass a threshold to be ‘worth’ bringing up. This threshold was lower if racism was observed directed at somebody else, rather than at participants personally. Career progression was reported as limited due to racial biases by recruiting managers; with participants reporting “there is a certain point where pharmacists of colour can get to”. White participants reported no perceivable impact of their race on career progression.

Discussion/Conclusion
The aim of the study was to explore racism, inclusivity, and diversity on career progression in pharmacy practice and education. The results demonstrate racism in pharmacy practice and education which cuts across all levels of workforce education, training, and development, creating a perceived ceiling effect. A strength of the study is that participants were recruited from across social and ethnic groups in Great Britain. Although qualitative data are not generalisable, they may be transferable to other settings. Quantitative work is needed to assess the scale of these experiences across the profession.

References
1. Seston EM, Fegan T, Hassell K, Schafheutle EI. Black and minority ethnic pharmacists' treatment in the UK: a systematic review. Research in Social and Administrative Pharmacy. 2015;11(6):749-68.
2. OPM, Qualitative research into Registration Assessment performance among Black-African candidates 2016. Available from: https://www.pharmacyregulation.org/sites/default/files/qual-research-into-ra-performance-among-black-african_candidates_final_1.pdf accessed 6 June 2022