Can I refuse to treat a racist patient?

Generally, no, if it is an emergency. In Cultural Awareness and Equality MSRA scenarios, you must provide life-saving care regardless of the patient's views. However, you can set boundaries, explain that abuse is unacceptable, and hand over care if safe to do so.

Should I shake hands with a patient?

It depends. In Cultural Awareness and Equality MSRA questions, offering a hand is polite, but if a patient declines due to religious or cultural reasons (e.g., cross-gender touch), you must respect this without taking offence. Being 'culturally sensitive' scores highly.

Cultural Awareness & Equality – Introduction (MSRA SJT)

Cultural Awareness & Equality

Cultural Awareness and Equality MSRA

This guide introduces the vital domain of Cultural Awareness and Equality MSRA scenarios. In the Professional Dilemmas paper, you must demonstrate the ability to provide care that is not just “equal” (the same for everyone) but “equitable” (adapted to individual needs).

🎥 Video Lesson (YouTube)

🎧 Podcast Lesson (Spotify / Apple / Amazon)

Introduction

Cultural Awareness & Equality is a core theme in the MSRA SJT and a major part of Good Medical Practice. The exam tests whether you can provide fair, respectful, equitable care — especially when faced with differences in culture, beliefs, communication needs, or health inequalities.

You are expected to act in a way that is non-judgemental, culturally sensitive, and free from bias, while prioritising patient safety and dignity. Many SJT pitfalls arise when candidates make assumptions or treat patients differently based on background, beliefs, language, disability, or social factors.

This section provides a clear, high-yield foundation to help you answer SJT scenarios safely and consistently.

What this section covers

Subtopics in this module:

Respecting Cultural & Religious Beliefs
Understanding patient values, traditions, dietary needs, modesty requirements, and how these affect care decisions.
Avoiding Discrimination
Recognising unconscious bias, challenging inappropriate behaviour, and ensuring fairness across all protected characteristics.
Providing Equitable Care to All Patients
Removing barriers to healthcare access, ensuring adjustments, and tailoring communication respectfully.
Addressing Health Inequalities
Identifying structural disadvantages, social vulnerability, and safeguarding concerns that may require advocacy or escalation.

Why this matters in the MSRA SJT

The exam uses cultural scenarios to assess:

your fairness
your respect for patient autonomy
your ability to avoid assumptions
your professional communication
your ability to challenge discriminatory behaviour
your understanding of equality law and GMC guidance
whether you offer equitable care, not identical care
how well you work with diverse patient groups

Expect questions involving:

religious objections
cultural dietary needs
language barriers
modesty concerns
caring for marginalised communities
handling discriminatory remarks from patients or colleagues
advocacy for vulnerable groups
unconscious bias in clinical decisions

High-yield MSRA principles

1) Treat all patients fairly and without discrimination

Protected characteristics must never influence clinical decisions.
When equality conflicts with safety, safety comes first, but always with respectful communication.

2) Avoid assumptions — ask, check, clarify

The SJT rewards behaviours like:

“Ask the patient about their preferences”
“Check what the patient means by…”
“Explore concerns sensitively”

3) Use professional interpreters when needed

Never rely on family/friends for complex or sensitive discussions.

4) Make reasonable adjustments

E.g.,

same-sex chaperone on request
quiet room
time for prayer
large-print documents
privacy for modesty reasons

5) Challenge discrimination appropriately

If a colleague behaves unfairly → act.
If a patient makes discriminatory remarks → remain professional, set boundaries, and continue safe care.

6) Understand health inequalities

The exam rewards awareness of social determinants:

homelessness
refugee status
low socioeconomic background
safeguarding risks
learning disability
lack of health literacy

What you will learn in this module

How to navigate cultural differences respectfully
How to provide equitable care in real-world clinical settings
How to avoid unconscious biases
How to respond when a patient declines care based on cultural or religious beliefs
How to handle discriminatory behaviour from colleagues or the public
How to ensure communication remains safe and effective
How to incorporate GMC, Equality Act, and dignity principles into SJT answers

MSRA SJT mindset for this topic

Prioritise dignity + fairness
Default to non-judgemental communication
Use interpreters and avoid assumptions
Respect beliefs unless unsafe
Challenge discrimination calmly and professionally
Offer choices, not pressure
Always consider vulnerability + inequalities

MSRA SJT FAQs – Cultural Awareness & Equality

What does cultural awareness mean in the MSRA SJT?
It means recognising and respecting patient beliefs, values, traditions, and needs while providing safe, fair, non-judgemental care.

How do I handle a patient with strong religious or cultural preferences?
Explore their concerns, clarify their preferences, offer safe alternatives, and respect their choices unless unsafe.

What if a colleague behaves in a discriminatory way?
Address it appropriately and escalate to senior staff if patient safety, fairness, or dignity is compromised.

What if a patient makes discriminatory remarks?
Remain professional, set boundaries, protect patient safety, and continue delivering equitable care.

How do I score highly on cultural SJT scenarios?
Avoid assumptions, use interpreters, respect dignity, challenge unfairness, and demonstrate sensitivity to health inequalities.