The cultural fainting scandal has breathed new life into the conversation about racism in the Swedish healthcare system. Shortly after the trial began, a thousand doctors and med-students signed an open letter describing their experiences of racism in med-school and at work, and proposed a number of potentially useful measures that might help tackle this widespread problem. At around the same time, a PhD thesis on med-students' experiences of sexism and racism in med-school was completed—confirming that both issues were common even at the least racist and least sexist university in the country—and, elsewhere, one major university hospital was found to have given only 2 out of 32 internship spots to applicants with some form of immigrant background (ie. either 1st or 2nd gen), with strong circumstantial evidence of discrimination, leading to the launch of an inquiry.

It's been interesting to follow these developments, but the most intriguing aspect has been a little drama I've been following for a few months. In short, a med-student with a very obviously Middle-Eastern name has, in a collegial support forum for doctors and med-students, described his struggles with getting to an interview for any of the jobs he's applied to after graduation. By all accounts, he's not a bad student or a bad person, he doesn't stand out wrt personality problems, he's reasonably well-liked by his classmates and teachers, has positive references from previous jobs, and can communicate very well in Swedish, but nobody will give him a shot at an interview—not even for the least qualified junior doc/house officer jobs on offer. Understandably, this has been a pretty crushing experience—and, to top it off, his posts have often been met with condescending responses from white Swedish physicians disputing the existence of pervasive ethnic discrimination in the job application process; one of them even went so far as to say that he was being delusional.

Anyway, he seems to have become so frustrated that he decided to send in a new application for a job he'd already applied to—with the same resumé and the same letter, but using the name of his Swedish (non-HCW) partner instead of his own. Lo and behold, they called her immediately, conducted a brief telephone interview—which he guided her through in real-time—and gave her a job offer (conditional on references checking out). They're expecting her to come by to sign a contract tomorrow, and none of the people involved seem to have any presence on this honestly quite massive forum, so they appear to have no idea what's about to happen. In all the time that he's been waiting for some sort of feedback from this employer, they haven't called, and they haven't been willing to give him any info on the status of his application. So he's contacted the Swedish Medical Association and their lawyers appear to believe he has a very strong case for a discrimination suit, which will be both interesting and important (although I'm mostly curious about the upcoming interview). I think this will be a big story in Swedish healthcare.

Anyway, this has gotten me thinking, again, about the possibility of using CV/job application field experiments as a policy tool—whether by governments or by official trade unions/professional associations—eg. as a part of a quality assurance toolkit for labour policy. At present, this method is primarily used by researchers, whose work has consistently showed eg. that a male Arabic/Muslim name is associated with a severe penalty when looking for jobs, but this research isn't conducted in a way that allows for/encourages effective policy responses. Discrimination in the labour market is a massive problem, both for individuals as well as for society as a whole, and using field experiments of this sort as a policy QA tool would not only give us a clearer picture of the extent and nature of the problem, but also—perhaps—spur employers to address issues of bias in recruitment, eg. if investigations were coupled with the threat of fines or inspections or whatever. I've been encouraging the residents' & junior doctors' association to consider this sort of investigation as a tool in their recently revived and ongoing work against discrimination, and I think my chances might not be too bad—esp. after this story breaks.