Medical Student Fitness to Practise Defence Barristers
Healthcare regulators set the learning outcomes and standards that must be covered by qualifications leading to registration. They also approve and monitor these training programmes. The standards expected of registered healthcare professionals are set by healthcare regulators and the standards expected of students are based on these principles.
Medical Student Fitness to Practise
In relation to a doctor’s fitness to practise, therefore also medical students, the GMC states:
To practise safely, doctors must be competent in what they do. They must establish and maintain effective relationships with patients, respect patients’ autonomy and act responsibly and appropriately if they or a colleague fall ill and their performance suffers.
But these attributes, while essential, are not enough. Doctors have a respected position in society and their work gives them privileged access to patients, some of whom may be very vulnerable. A doctor whose conduct has shown that they cannot justify the trust placed in them should not continue in unrestricted practice while that remains the case.
A medical student’s fitness to practise may be impaired by reason of:
- deficient professional performance
- a conviction or caution in the British Isles (or a conviction elsewhere for an offence which would be a criminal offence if committed in England or Wales)
- adverse physical or mental health
- not having the necessary knowledge of English
- a determination (decision) by a regulatory body responsible for regulation of a health or social care profession, either in the UK or overseas, to the effect that their fitness to practise as a member of the profession is impaired
Risk to patients, public or bringing the profession into disrepute
If a medical student’s behaviour suggests they may be a risk to patients or the public, or may bring the profession into disrepute, the school or university will launch a formal investigation.
If there is sufficient evidence to call into question a medical student’s fitness to practise, the school or university can deal with the issue without the need for a fitness to practise committee. For example, a warning, educational remediation, educational agreement or offer an undertaking might be more appropriate.
The outcomes of an investigation could also refer the case to a fitness to practise panel or committee.
How does student fitness to practise work?
- If a concern is raised there will be an initial investigation. If no evidence is found then you will carry on in your training as before. If there are some issues that need addressing they may be relatively minor and resolved by you agreeing to additional support and supervision for a period of time.
- If the issues continue, or are more serious, they may be referred to a fitness to practise panel or committee through formal student fitness to practise procedures. You should be informed of this in writing and be offered an opportunity to present written evidence. There may be a formal hearing where you have to appear at a meeting with the panel/committee and answer questions about the issues and present evidence on how you are addressing them. The panel will make a decision on the appropriate course of action to help you become fit to practise, or whether it is best for you to leave the course. These are called sanctions. Alternatively, they may provide you with a warning or find there is no issue and allow you to continue training.
There are four types of sanctions:
- Undertakings – an agreement between you and the training provider where it is found that your fitness to practise is impaired and you acknowledge this. This agreement is usually taken forward before and instead of a formal hearing.
- Conditions – Conditions such as remedial tuition and increased supervision may be applied where there is a significant concern about your fitness to practise, you have shown insight in to your problems and there is a good chance this will help you get back on track.
- Suspension from the course – This would occur to prevent you continuing with the course for a period of time. Suspensions occur when the concerns about your fitness to practise are serious but not so serious as to justify immediate expulsion from the course. You would be expected to comply with any further conditions when returning to the course.
- Expulsion from the course – The most severe sanction is the panel’s decision that expelling you is the only way to protect patients and the public. Your behaviour would be judged to be completely incompatible with that of continuing on the course or eventually practising.
The GMC will require you to disclose conditions, suspensions and expulsions when applying for registration.
Representation & Appeals
Should you have to attend a student fitness to practise hearing your training provider will allow you to be represented. You are advised to seek legal advice to help you through the process and have legal representation should you have to attend a hearing.
Your training provider will have a clear appeals procedure for student fitness to practise decisions setting out what the process is and what can be considered. A finding of impaired fitness to practise could have lasting and significant implications for students and trainees. You are advised to seek legal advice to help you with appeal proceedings.
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