A warm mix of Dutch and Papiamento can be heard when some 30 students, doctors, pharmacists and other biomedical scientists meet at the Erasmus MC’s education centre on Saturday afternoon. Sheeney Magdalena (21) from Curaçao has just finished her Bachelor’s in Medicine at VU University Amsterdam and, following a minor in Business at Nyenrode University, she is now also pursuing the Master’s in Healthcare Management at EUR. This broad orientation has a clear purpose. “I want to help Curaçao. And if I ‘just’ become a doctor, I’ll fail on the island. You have to bring more knowledge and skills than that.”

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Just work hard

Camille Baker (21), a medical student at EUR, also sees the benefits of a broad orientation. “On Curaçao, you don’t have the luxurious facilities that are normal here in the Netherlands. That’s why I think subjects like tropical medicine and trauma surgery are so relevant.”

With good marks and outside-the-box thinking, Camille has managed to make it into the honours class and secure a student job at the Erasmus MC. Still, he sees many problems with racism and inequality of opportunity. “My father always says that you just have to work hard and you’ll make it. I do believe in that, but students in the Antilles definitely don’t have the same opportunities as students from the Netherlands.”

Unequal opportunities

Erasmus MC diversiteit artsen studenten nietwesterse achtergrond – Elzeline Kooy (2)
Image credit: Elzeline Kooy

His thoughts are confirmed by the presentations. “The admission rates for students with a Turkish, Moroccan, Surinamese or Dutch-Caribbean migration background have further declined since the introduction of decentralised selection”, explains Lianne Mulder, sociologist and PhD student at Amsterdam UMC. In fact, according to her research, only students whose parents are among the wealthiest 10 percent of the Dutch population have good chances of being admitted, while just about everyone else is turned down.

Subsequently, the students with a migration background who do manage to make it through the selection process systematically receive worse marks than their colleagues without a migration background, says Chantal van Andel, psychologist and project leader for diversity and inclusion at the Erasmus MC.

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The students who make it to the finish line and eventually become doctors must then face the next challenge. Internist-nephrologist Mahdi Salih and internist-educator Adrienne Zandbergen of the Erasmus MC conducted research on the application procedures for physicians in Internal Medicine. “Doctors with a non-Western migration background are significantly less likely to secure training positions for specialisation. Doctors with a PhD are even less likely to get a training position than white colleagues who do not have a doctorate.” In addition, when determining the need for specialists, neither the Antilles nor any of the three islands that belong to the Netherlands as ‘special municipalities’ are taken into account.

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Shortage of medical professionals

“So how can we access those training positions with this system?”, someone else asks. There are discussions about dubious assessments, uncomfortable interviews, educators who think that ‘Curaçaoans are too relaxed’ and educators who don’t want to hire doctors if they plan to return to the Antilles.

The urge to fight through these issues echoes through the room, and the reason is obvious. “There is simply a shortage of medical professionals in the Antilles”, says Syenon Baromeo (32), who moved from Curaçao to the Netherlands to study pharmaceutical science. He now hopes to contribute as a pharmaceutical specialist. “Because of these shortages, patients are unable to obtain adequate care. They deserve care providers who understand their culture, language and environment. And those are people who come from the islands themselves.”