'Your CV looks amazing but I am sorry, you didn't get the job': analysing experiences of global majority physiotherapists aspiring to and working at consultant level practice in the UK

Introduction Effective leadership shapes organisational culture to deliver world class healthcare. Racially minoritised individuals rarely access opportunities leading to leadership positions. This paper expands on themes from qualitative research which explored experiences of qualified physiotherapists from racially minoritised backgrounds aspiring to (or working at) consultant level and codesigned recommendations that challenge inequitable practices which perpetuate unearned privilege. Methods The study used critical discourse analysis to understand the experiences of aspirants. Participants were recruited purposively using snowball sampling via professional diversity networks and social media. Semistructured interviews were conducted remotely. Externally facilitated focus groups supported cocreating research outcomes and strategies for action. Secondary analysis extends our initial analysis to focus on two themes, critically considering these in the context of the role of leadership. Results Data drawn from 17 participants from self-identified racialised groups who were either in consultant level positions, or aspiring to be, were included in secondary analysis. Analysis identified structural racism as an enduring social wrong, existing within different levels of organisations. Managerial 'gatekeepers' created barriers to career progression by not recognising skills, knowledge and experience. Pathways to career progression were hidden and unwieldy, operated by managers in ways that restricted leadership opportunities disproportionately to white peers. These challenges created a sense of 'un-belonging' resulting in negative health impacts. Conclusion Gatekeepers maintaining racist cultural practices and policies were key in upholding the hegemonic status quo. Collective strategies enabled a sense of ontological belonging and empowerment for participants and may be helpful for those experiencing similar concerns in their workplaces.