BAME Staff and Racism in the NHS - Medical Interview Hot Topic Questions

You will need to provide some examples of hot topics you can apply during your medical school interviews.

Here you will learn everything you need to know about equality, diversity and race in the NHS workforce, including ethical implications and example medicine interview questions with model answers. A quick note on language: the term "BAME" (Black, Asian and minority ethnic) is now widely discouraged by the GMC, NHS Race and Health Observatory, the Office for National Statistics and the government, because it lumps very different groups together and is not well understood. The preferred terms are "ethnic minority", "minority ethnic" or, where possible, the specific ethnic group. We keep "BAME" in this page's title and URL only because that is what many candidates still search for, but use "ethnic minority" throughout your interview answers.

Combine your reading here with medicine interview tutoring to boost your answers and delivery.

Equality and Diversity in the NHS: Key Facts at a Glance

1. As of the 2024 Workforce Race Equality Standard (WRES), around 28.6% of NHS trust staff are from an ethnic minority background, well above the share in the general working-age population, but ethnic minority staff are disproportionately likely to be in lower-grade roles and under-represented at senior and board level.
2. Ethnic minority staff make up roughly half of all NHS doctors, but progression is uneven: ethnic minority representation falls from about 64% in non-consultant specialist (SAS) grades to around 41% among consultants, so ethnic minority doctors are concentrated in more junior and non-training posts.
3. BAME staff are disproportionately more likely to face discrimination, and less likely to receive adequate support when compared with white staff members
4. The COVID-19 pandemic disproportionately affected ethnic minority NHS staff, who fell ill and died at a higher rate than their white colleagues, exposing deeper structural inequalities in the workforce.
5. The NHS is currently undertaking various measures to attempt to address some of the issues faced by BAME staff in the NHS

👉🏻 Read more: MMI Medicine Interview Tips Guide

What do I Need to Know About BAME Staff in the NHS for Medical School Interviews?

What proportion of NHS staff are from an ethnic minority background?

Per the latest NHS Workforce Race Equality Standard (WRES) and government data (2024), ethnic minority staffing in the NHS breaks down broadly as follows:

Amongst doctors, the figures of senior vs junior doctors are:

👉🏻 Read more: NHS Questions at the Medicine Interview

What inequalities do ethnic minority NHS staff face? (WRES data)

Differential attainment and the GMC: a key interview angle

One of the most important concepts to understand for an equality and diversity NHS interview question is differential attainment: the persistent gap in exam pass rates, training outcomes and career progression between different groups of doctors that cannot be explained by ability alone. UK ethnic minority graduates and, especially, international medical graduates (IMGs) have historically had lower pass rates in postgraduate exams such as the MRCGP and MRCP, and lower rates of progression into specialty training.

The numbers are stark. As of the GMC's 2023-2024 reporting, the specialty-training attainment gap between IMGs and UK graduates stood at around 22 percentage points, and the gap in self-reported preparedness for Foundation Year 1 between white and ethnic minority graduates had actually widened, from about 7.8 percentage points in 2019 to 11.7 in 2023. The GMC frames differential attainment as a problem of the system and environment, not of individuals, and has set targets to close these gaps.

In my experience as a GP, this is the topic that separates a strong interview answer from a superficial one. Avoid suggesting that any group is simply less capable. Instead, point to causes such as less access to high-quality feedback and mentoring, bias in assessment, exclusion from informal support networks, and the additional pressures faced by IMGs adjusting to a new health system. This shows you understand fairness as a structural issue.

As has already been shown, doctors from most ethnic minority backgrounds are disproportionately less likely to be senior-grade doctors. However, doctors from all ethnic backgrounds face inequality in various forms across the NHS. The King’s Fund published an article featuring BAME staff sharing their stories which is well worth reading.

Some key points from this article, and other sources, include:

• Board inequalities: NHS boards remain disproportionately white. Ethnic minority board representation has risen to its highest level on record (around 11.8% of board members, and 16.5% of voting board membership, as of 2024) but still lags badly behind the roughly half of doctors and 28.6% of the overall workforce who are from an ethnic minority background. This skews the decision-making that affects all clinicians and patients.
• Fair to Refer?: The GMC's 2019 "Fair to Refer?" report found ethnic minority doctors were around twice as likely to be referred to the GMC by their employer for fitness-to-practise concerns, and doctors who qualified outside the UK around three times as likely, as white UK graduates. It identified causes such as ethnic minority doctors receiving less effective, timely and honest feedback when difficult conversations are avoided across an ethnic difference, and being treated as outsiders. As of 2025 the GMC reports this referral gap is narrowing and it is close to its 2026 target of eliminating disproportionate referrals, though differential attainment in training persists.
• Culture of blame: BAME doctors can be more likely to be blamed when things go wrong due to being seen as outsiders. For instance, Dr Bawa-Garba faced significant blame for a tragic outcome that resulted from mistakes being made by various individuals and the NHS trust, and race is suggested as being likely to have played a role in this.

Overt discrimination remains a significant issue for ethnic minority NHS staff, and reported rates have been rising, whether because staff feel more able to speak up or because racism is genuinely increasing. Actual rates are likely higher than reported. The most recent NHS Staff Survey data feeding the 2024 WRES shows:

• Around 25% of ethnic minority staff reported bullying, harassment or abuse from other staff in the last 12 months, compared with about 21% of white staff (2024 WRES).
• About 15.5% of ethnic minority staff experienced discrimination from other staff (managers, team leaders or colleagues), compared with 6.7% of white staff, more than double the rate (2024 WRES).
• Discrimination rates were especially high for ethnic minority women in general management, nursing and midwifery, and in medicine and dentistry (around 17% in medicine and dentistry).

Just under half (48.8%) of ethnic minority staff felt their trust offered equal opportunities for career progression, against 59.4% of white staff, and in 80% of trusts white shortlisted applicants were significantly more likely to be appointed than ethnic minority applicants (2024 WRES). Around 51% of trusts also reported ethnic minority staff were over 1.25 times more likely to enter the formal disciplinary process.

What is the NHS doing to improve race equality? (WRES and GMC)

What is the Workforce Race Equality Standard (WRES)?

If you mention only one initiative in an interview, make it the Workforce Race Equality Standard (WRES). Introduced in 2015 and now mandatory for all NHS trusts, the WRES requires organisations to report annually against nine indicators of race equality, covering recruitment from shortlisting, entry into disciplinary processes, access to training and career progression, experience of harassment and bullying, and representation on boards. The data is published, which creates public accountability and lets the NHS track change over time.

The 2024 WRES data shows a mixed picture. Representation has improved markedly: ethnic minority staff now make up 28.6% of the trust workforce (up from 17.7% in 2016), and the number of very senior managers from ethnic minority backgrounds has risen by around 85% since 2018. But experience metrics have stalled or worsened: in 80% of trusts white applicants were more likely to be appointed from shortlisting, and ethnic minority staff remained more likely to face discrimination and to enter formal disciplinary processes.

A sophisticated answer recognises this tension. Headcount is rising, but the lived experience of ethnic minority staff has not improved at the same pace, which tells us that representation alone does not equal equality. The complementary WDES (Workforce Disability Equality Standard) and the GMC's equality, diversity and inclusion targets are worth naming alongside the WRES.

The NHS is committed to working towards improving the underlying present in its staffing system. Some of the key action being taken includes but is not limited to:

• Workforce Race Equality Standard (WRES): introduced in 2015, the WRES is the central mechanism. It requires every NHS trust to measure and publish nine race-equality indicators each year (covering recruitment, disciplinary action, training, harassment and board representation) and to act on the gaps, making progress publicly accountable.
• Targets and accountability: NHS England has set ambitions for ethnic minority representation across senior pay bands and board level, and the GMC has committed to eliminating disproportionate fitness-to-practise referrals and narrowing differential attainment, work it reports as close to target as of 2025.
• Health and wellbeing offer: A bespoke health and wellbeing package for BAME NHS workers was created that sought to address specific issues faced.
• Networks: The NHS is facilitating and working with networks of BAME staff to better understand and address the issues that they face
• Widening participation: Widening participation measures aim to increase ethnic representation at all levels of the NHS.
• Time: Today’s junior doctors are tomorrow’s senior doctors - strides that are made to increase the number of junior doctors from underrepresented ethnic groups will help to increase the number of senior doctors from those groups once they fully qualify.

Multiple strategies and targets are necessary to help to resolve the various issues faced by BAME NHS workers.

👉🏻 Read more: Common NHS Hot Topics

Key Ethical and Social Issues Related to the BAME Staffing in the NHS

What are the benefits of a more ethnically diverse NHS workforce?

There are a variety of advantages that come from having an NHS workforce with fair ethnic representation at all levels. These include (but are not limited to):

• Higher quality staff: The best quality staff possible will be ethnically representative of the broader workforce, and improving diversity ensures that the best possible staff are being recruited.
• More diverse knowledge pool: People from BAME backgrounds may face different health issues, or health access issues, than white people. A more diverse knowledge pool of people with lived experiences of these issues can better tackle them.
• Improved financial management: Studies have shown that, due to better quality staffing, financial management of ethnically diverse boards is better.
• Better patient experience: When patients have their needs catered to as described above, they are likely to have better outcomes in the NHS.
• Great public satisfaction: When the public feels more represented by the NHS, their trust in the NHS increases.

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How did COVID-19 affect ethnic minority NHS staff?

BAME staff are disproportionately more likely to fall ill with and die from COVID-19. The racial inequality here amongst NHS staff is even higher than it is among the population more generally. Underlying genetic and physiological factors are not sufficient to explain the full extent of the gap.

Various factors have been suggested for this, and the NHS is continuing to investigate this problem and trying to address the underlying issues. Some of the suggested factors include:

• PPE: It is possible that there was lower PPE access in areas with more BAME doctors
• Frontline discrimination: It is possible that doctors from BAME backgrounds were more likely to be placed in dangerous, frontline roles and less likely to be protected
• Underlying issues: Underlying factors such as the number of hours worked may also have been contributing factors to this particular inequality

Top Tips for Equality and Diversity NHS Interview Questions

You could get questions about any of the above topics, or diversity in the NHS more generally, in your medical school interviews. Some top tips to consider are:

1. Acknowledge the various reasons why increased ethnic diversity in the NHS is so important.
2. Recognise the complex, various forms of discrimination faced by NHS staff - it’s not just about the numbers of who works where.
3. Consider intersectionality - discrimination is also faced by staff on the grounds of gender, disability, religion, sexuality, and other characteristics, and these interact with each other and race in complex manners.
4. You should weave your understanding of this issue into other questions where it is relevant, as it will often impact other things that you are discussing.

👉🏻 Read more: MMI Medicine Interview Tips Guide

Example Medicine Interview Questions and Answers on BAME Staff in the NHS

Q: What can the NHS do to improve conditions for BAME staff?

A: BAME staff in the NHS face various different forms of discrimination and challenges, to a disproportionate extent when compared with their white colleagues. Addressing these requires a complex combination of different strategies, but I think that there are a few key steps that need to be taken.

First, it’s important to improve diversity at high levels in the NHS - such as on boards and management teams. This can be done by encouraging more BAME people to apply and looking at how BAME people’s applications are considered to limit the effect of discrimination at this stage. Management training programs are another important consideration that may really help here. Quotas are also something that I think could be considered, where appropriate.

Second, I think that measures need to be taken to address the active discrimination faced by NHS staff - from their managers, colleagues, and patients. It’s important to have proper diversity training for all NHS staff and to screen them at interviews with questions just like this one. There must also be appropriate sanctions for NHS staff who engage in racist behaviour, including of course termination.

Third, more needs to be done to look into the significant inequalities during the COVID-19 pandemic where BAME NHS staff were far more likely to become sick and die. This laid bare some ugly systemic issues within the NHS, and it’s only by fully understanding them that we can begin addressing them. Similarly, I think that engagement with networks of BAME staff would also be helpful.

Of course, these measures are only a starting point and must be part of a larger strategy - but I do think that they are an important strategy to addressing racial inequality in the NHS.

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Practice Equality, Diversity and Racism NHS Interview Questions

How to structure an equality and diversity NHS interview answer

Equality and diversity questions are common at both panel and MMI interviews, and they are usually testing your values and self-awareness as much as your factual knowledge. A reliable structure is: define the issue clearly (using correct, respectful language), give one or two concrete pieces of evidence (the WRES headline figures or the Fair to Refer findings work well), acknowledge the complexity and any competing views, and finish with balanced, realistic solutions. Always relate it back to patient care, since a workforce that is fairly treated and well represented delivers safer, more equitable care.

Two pitfalls to avoid: do not use the term "BAME" as though it were neutral or current (explain that it is now discouraged), and never imply that any ethnic group underperforms because of ability. If you are asked how you would personally respond to witnessing discrimination, draw on the same principles you would use clinically: speak up safely, support the colleague affected, and escalate through the appropriate channels.

1. What inequalities do you think BAME NHS staff face?
2. What do you think are the biggest sources of discrimination against BAME NHS staff?
3. Why were BAME NHS staff disproportionately likely to die from COVID-19 during the pandemic?
4. To what extent do you think that the NHS workforce is ethnically representative of the wider UK? What about doctors specifically?
5. What is the NHS currently doing to improve conditions for BAME staff?
6. What are the benefits of a more ethnically diverse NHS workforce?
7. How can we increase the presence of BAME NHS staff on boards and in management roles?
8. What is the impact of ethnic diversity in the NHS on public perceptions of it?
9. Do you think that the NHS is a fair employer for BAME staff?
10. What role do you think widening participation measures should play in medical school admissions?

👉🏻 Read more: 280 Common Medicine Interview Questions

Conclusion

Overall, BAME staffing in the NHS questions can provide a valuable opportunity to reflect on the ethical challenges that can arise in medicine and to demonstrate your ability to think critically about these issues.