Experiencing MD Viva during lock-down and thinking about racism by Alicia Vedio

I am a postgraduate research student for a Doctorate of Medicine in Public Health, and a physician in the NHS. I started part time PGR studies in 2014 in the School of Health and Related Research (ScHARR) at The University of Sheffield, studying the role that healthcare practitioners have in access to healthcare and submitted my thesis early in January 2020.

My viva was initially planned for March 2020, but the university workers’ strikes, and later COVID 19, delayed this. It was finally arranged for the end of April during the lockdown in the UK. Having a viva during lockdown meant this had to be online and I did not know how would this affect the experience. I had a mock viva using Blackboard Collaborate with both my supervisors that was really useful but I noticed my connection was not strong due to being far from the modem at home. I made sure that on the day of the viva I was in my dining room where the modem is and asked everyone at home to find something to do so, as not to be interrupted – not an easy task during lock-down but it worked well, and I felt more relaxed!

It was a relief that the experience was enjoyable mainly because both my examiners were as interested in the subject of inequalities in access to health care as I am and I was pleased to receive some useful and also complimentary feedback. But of course, it was not all positive. Before the viva, I knew there was a significant gap in my thesis and I wanted to draw attention to it by naming it here. The gap was a lack of discussion of racism theory. I had been made aware of this and had been expecting to receive comments about this in the viva feedback. I did. It was not easy to realise that I had such a serious blind spot and that perhaps I, even if unwittingly, had avoided entering into a deeper analysis and discussion of the subject of racialisation and racism within health care. I really hope and expect that my experience will resonate with other researchers. The many discussions and meetings I attended that reflected the work of the Health Equity and Inclusion theme team made it easier to direct the work I needed to do.

Since my viva, I have learnt a lot about racism theory, and not only about academic work in relation to health care related to my viva feedback. A month after my viva, George Floyd was brutally murdered in the US because he was black – one of a long line of shocking murders of people of colour that has been happening for centuries – and that it was made globally public due to being shared widely within social networks. It sparked a strong worldwide response and has also highlighted some really important resources on the work white people need to do to build a society that is fair to people of colour by dismantling racism. Systemic and structural/organisational racism are useful concepts that help to research and discuss barriers of access to health care services. Understanding structural racism is important but I (we) also need to work on our own blind spots to generate real changes in our lives and where we work. Most importantly, personal realisations are hard to confront. Knowing that I grew up in a white-dominated society with racist structures, organisations, and daily messages and education makes clear why I failed to name such an important issue but is deeply uncomfortable. My only consolation is that I am one of millions of white people in this society with the same problem to tackle. Intent and impact comes to mind, and impact is what we need to focus on. These two concepts refer to how we need to look at the effects of our actions and of the society structures. Intent may be positive but this is not relevant to the detrimental impact it has.

In conclusion, I have learnt that we can only work towards anti-racism and, for me, incorporating this in my thesis is only one of many steps. However, seeing racism and naming racism, is essential for in-depth change and this is why I wanted to tell my story here. Like everyone, my identity is an important part of my life. I am white, despite being of mixed indigenous, Black and Jewish descent, but I am mostly from white-mixed European descent, and I am myself a migrant descending from migrants. My own life experience and that of my ancestors impacted who I am today.

I now realise that the deconstruction required to eliminate racism is life-long work regardless of age and it is essential. In my study and work I look into addressing the role practitioners have in facilitating or hindering access to healthcare for a particular population. I explored the impact myself and other practitioners have, approaching it with an inequalities lens trying to address the imbalance of power between practitioner and individuals. My work now is to link societal, structural and personal racism to understand its role in creating barriers, in influencing personal development and in impacting the work of the NHS.

I also wanted to share some of the excellent resources I have encountered in my search for understanding.

The Great Unlearn” and “Do the Work” by Rachel Cargle provides many examples of how white supremacy and white privilege work and gives frameworks that help examine how organisations can respond to this problem.

Me and White Supremacy” by Layla Saad names many of the barriers to dismantling racism and these are well structured and clearly explained. You can also find her in YouTube describing her book in four steps.

I particularly found “Mindful of Race” a book by Ruth King (2018) helpful- this is a journey through an understanding of racism with a mindfulness framework and helps understand this oppression more clearly. Ruth King uses Buddhist concepts and shares her own experiences in helping organisations become more inclusive, diverse and anti-racist.

There are many more anti-racist resources available; these are some of the ones that have helped me greatly. I would encourage you to explore these or other resources to ensure that, together, we have a collective impact on dismantling societal and structural racism.

Alicia Vedio

Infectious Diseases Physician, Postgraduate Researcher Public Health, School of Health and Related Research, The University of Sheffield – abvedio1@sheffield.ac.uk

Publications:

https://onlinelibrary.wiley.com/doi/full/10.1111/jvh.12673

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017- 4796-4

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