Dr Remi Odejiinmi was born in the United Kingdom during the time her parents had moved from Nigeria to study, once qualified returning home to work. She returned to the UK as a qualified doctor and spent her time in a variety of jobs whilst she was processed by the Professional Linguistics Association Board (PLAB) before being able to practice in hospitals. In her interview, Remi discusses the trials and tribulations of a career in health, racism, and activism.
Early Life and Childhood
I was born here, so I always say I was born in the United Kingdom, I was bred in Nigeria and then I returned as a qualified doctor in 1990.
Oh, so Nigeria was a British colony. And gained independence in 1970 I think it was, I might be wrong that needs to be checked. My parents came over here to study. My father started in Germany. My mother studied to be a nurse here in England, although she didn't finish her training and once they were qualified, they went back to Nigeria.
It's called the PLAB. Professional linguistics association board, something like that. II think it's a long time ago now, it's a regulatory body to ensure that doctors who are trained abroad have the same qualifications as those who are trained here in the United Kingdom and as expensive or was expensive, if you were a young, migrant so to speak, I think it was tough and I think it consisted of just a written exam. I can't remember such a long time ago, 30 years ago and fortunately I passed first time around which, which wasn't common, but fortunately I did.
So I think I was quite fortunate; I came in and we lived with an aunt and she was a supervisor of cleaners. So I took a cleaning job for two weeks, gave that up fairly quickly. I ended up working as an administrative Clark for the then Ilia, which was an education board for the local authority. And from there, I moved on to work with CPS and I also worked with the benefit offices. I actually in that one year did a lot. I also worked for army or the navy as a, I don't know what they call them now, shop assistant. Once PLAB was done, I was able to get a job. So I then started working in a hospital and I'm so sorry I've forgotten what the question was.
So for the first year it was okay worked in a very good hospital got very good training. It was a new area of medicine, which I hadn't originally thought I would do, but because my husband had opted to go in and do his, his first choice, which was obstetrics and gynaecology, I then decided not to do that and do something else so that we wouldn't have conflict, in terms of the impact that will have on our work life balance and we also had a young child to look after. So my first year was okay I didn't really have many expectations. I had my own home by now and, you know, I had a son, a husband and I was young and flexible. So, I was getting the training I wanted, it was okay. I worked in Kent and there were lots of, there was a lot of diversity put it that way. I was probably the only black girl or black person in the department, but there were, I think French, Italians and so it was quite a diverse group of junior doctors.
It wasn’t a sense of community, the hospital was extremely busy and so we worked extremely long hours, and your rest periods was your rest period. You went home and carried on doing what you had to do at home, and then you went back to work. So I wouldn't say there was a community, but we were all in it together working extremely long hours and trying to just, live. And that was what it was, you just go on. It's very different now *laughs*.
I suppose it goes in peaks and troughs. So, we have a great opportunity to look after people who are pretty vulnerable, and it brings out the best of humankind. You have to be kind, you have to be gracious, even when you're tired, because people are dependent on your decision making on your interactions with them, for their hope. So, it does give you that emotional set of characteristics. It also allows you to value the opportunity to make a difference and we spend most of our time at work so you know you're making a difference. It can also make you quite determined medicine is a tough call and there are lots of exams there's a lot of hard work involved in it you know, the hours are just not enough in the day to do what you have to do and you do have to become quite discipline and if you're not careful, you can become too disciplined, you may lose that emotional context because you become quite task oriented, you've just got to complete certain tasks, so the emotional bit can get lost. I think this season of COVID has made a difference to a lot of us because you need to have the grace to be able to look after your patients, they're looking at you for hope and it really does humble you because people are there. They're at the lowest points right now in this season. So, it brings up the best of who you are. It’s character building.
Professionally getting through the exams, those were challenging especially balancing doing exams with already having the first child, then ending up with a second child, which was planned. The way we train abroad, it's different to the way we train here, so it's being able to learn the techniques required to be able to pass an exam here in the United Kingdom. So, challenge is passing the exam, getting over it was learning how to present yourself and to be understood. I have to point when I started doing my professional exams, as an anaesthetist, rather than the PLAB and being the medical doctor, initially the exams were on structured, particularly the fiver exam so the face-to-face ones, so that could be difficult because there was always going to be a decent amount of subjectivity, between the interviewer and the person being interviewed and as such, if you didn't come across, properly, you could scupper your chances of getting through the past line. So that's one challenge.
And remember, there are always going to be cultural differences. If people didn't understand your culture, you could come across as the angry black woman who actually is happy. (laughs). So, there wasn't that opportunity. There wasn't equality, diversity and inclusion in those days. So, people did not understand you. They didn't ask what was going on. You could do well, or you couldn’t do well. And you wouldn't know because you didn't get feedback. There was discrimination, I'd say quite a bit of it professionally, so you couldn't automatically apply for a job in just anywhere and expect to get it. I once applied as a registrar to a big hospital and when I got there, there were quite a number of applicants I think about 50 of us were being interviewed, but there was an assumption that I was going for a non, what we call a non-career post. It was just assumed, ‘Oh, you're coming for this interview rather than that one…’ Now I didn't get the job and within two days of that interview, I got two phone calls from two people on the panel telling me it was discrimination. So, it wasn't overt, but it was always there
I think discrimination still happens quite a bit. I think for me personally I wasn't aware of it coming from Nigeria so I didn't think about it. But as the years have gone by, you begin to look back and think, ’Oh, Hmm…’ And I think despite the fact that we talk about equality, diversity and inclusion, there's still a lot of discrimination so, I did an MBA and graduated last year and by my research was on career progression for BME nurses in my hospital, in my trust and this wasn't information that was readily available. Most BMEs were in the lower grades, rather than the higher grades and the higher you went up the ladder the less diverse, it was. So, if you looked at our board, you look at our executive team, you could, you could see that we weren't really diverse. Now why that is? I can't answer that question, but it's not uncommon to see that so if you look at big organizations and you look at their boards, considering the workforce that they have, they're not always reflecting. So there is still some degree of discrimination being unintentionally, intentionally practiced. It exists.
So I'd say that people tend to group themselves, so once you finished your training, I became a consultant in 2001, and I took a job that was what I wanted to do, but it was in an area where there were more, it was more diverse. So where I work, 60% of the medical field are actually from a BME background and this is a district general hospital. If you look at the teaching hospitals, you're not going to get that. So, we tend to go where we know unintentionally, unconsciously probably, to those areas and as such you're comfortable and you're not exposed to the culture. But when you I'd say that, when you look at opportunities to use your talent so as a professional, we have a very structured progression. So it’s all changed at once. You are a junior doctor in your training, you've got foundation years that are set, and then you go into your core training and then you go into your specialist training. So it's all quite well-structured and once you finished your specialist training, you become a consultant. You put on the specialist register. So it's structured and everybody's going along, the training's is all set. So you look particularly competent on paper and then the competition comes out what way are you going to go as a consultant? So professionally that's not an issue. Where the issues then arise is if you have other talents e.g. you're good at teaching, you're good at research, you're good at management. Then, how do you get into those places or who encourages you? Who coaches you, who sits with the owner and says ‘actually, you'd be good at doing this’, and there's not a lot of that out there with a particular focus to looking at BME people staff within hospitals. So you will find that non BMEs tend to take those positions of authority outside their professional realm.
Well, I suppose it was an expectation that the training for any medic is that you train and then ultimately you reach your peak which is a consultant. Now, there is a different training method which doesn't necessarily lead to being a consultant, which is usually left to non UK based doctors, and then that means that although you may have years and years of experience and be extremely competent, you are not recognized as being at your peak. But being born in this country, it is the expected pathway to take, which leads to being a consultant. So that was a no brainer, to be honest. You do your exams; you get your training and you become a consultant. But that's not the end of you because that's just one aspect of your profession there are other things that enhance that. So being able to teach and teach well, enjoy teaching is an aspect of our roles, there are some people who are extremely passionate about it that then tick even higher roles. On the other hand, people who like to do research to open new horizons for us, give us better understanding that will be aligned with your role, or people like me who are interested in managing, making a service work and perform to its best level with the resources that we have and so, you know, I chose to do management and also understood that in being able to do that, I could influence change within my environment. So that's the line I decided to take.
Yes, I do have plans for the future. What we didn't do was actually about my career pathway. So, I'm just going to highlight that because I think it's important so although I'm a consultant, I'm just going to give a quick run through my CV. I took a leadership role early on, so I led a particular service, and I did that for nine, seven, eight years, and then started to lead the whole service as a whole. So the anaesthetic division, as what we call the clinical director or division director, and I did that for seven years. I have not gone into a sub-active role as the clinical director of strategy and my reasoning behind it was, as I said to you earlier there not many BMEs at the executive level in the health service and so I wanted to push that boundary. It is tough, because you feel like you represent yourself, but you also represent the BME and so that's what I would like to do. I would like to get to the executive level, because I know that that will mean that the people behind see that there are opportunities for all of us in a fair society.
Yes. I don't know if I'm abnormal, but going into management, I feel it very strongly because when I first came back to this country at the age of 25, I didn't know anything about discrimination per se, and even until consultant level, it wasn't something that was obvious because it's been subtle. It's only when you reflect that, you think, ‘Oh, could that be what it is’. And as the years have passed, I've become more and more aware of some unfairness in the system and I think that it's hardened my resolve to push against that. So yes, I do feel that, and that is a pressure that I have chosen myself, bearing in mind I have another characteristic being female, so there’s gender discrimination, and then there's the racial discrimination that one has to deal with. And, and so yes, when I go to places, I feel that I not just represent myself, but I also represent my group as a BME. I will highlight that as a woman of faith, an older woman, I look at what my purpose is in life here on the earth and I use the opportunities that I have for more than myself. That's the way I see it. I think at 25, that wasn't on my radar. And through the years I was bringing up a family, but now I have the time to sit and think what's going on and what does life mean for me? and what am I doing? and at this point in my life, that's what I see. Now I had a coaching session once where someone said to me, sometimes you need to open a door to be able to get through and climb up that mountain. So you could start one level and you can talk about discrimination and you could talk about fairness, but sometimes you need to go through to the next, round to be able to influence that group, because they may have no understanding of it. And I, you know, and as such, so it's making me think about, ‘I need to be next’. Yes.