Fitness to practise
Becoming a doctor means more than acquiring knowledge and skills. Medical students cannot complete the undergraduate curriculum without coming into close, and sometimes intimate, contact with members of the public who may be vulnerable or distressed. It is essential that you do nothing to diminish the trust which sick people and their relatives place in you.
The award of a medical degree automatically entitles the graduate to be provisionally registered by the General Medical Council and to practise under supervision as a doctor. By awarding a medical degree a university is therefore confirming that the graduate is fit to practise to the high standards laid down by the GMC in its guidance to the medical profession, Good Medical Practice [http://www.gmc-uk.org/].
Universities have a duty to ensure that no member of the public is harmed as a consequence of participating in the training of their medical students. If your conduct as a medical student falls below the high standards of honesty or behaviour that the public has a right to expect from the medical profession, you will be required to appear before a Fitness to Practice Committee and your course may be terminated.
Responsibilities of Southampton medical students
A medical student is studying not only for a university degree but also a professional qualification. Upon successful completion of the training he/she will not only have the BMBS degree but also be able to practise as a doctor. The training, therefore, is conducted in an environment that requires medical students to behave throughout their training in ways that are consistent with the principles of medical professional practice.
Failure to disclose information which directly relates to your fitness to practise may result in the termination of your programme of study. This could be because of the failure to disclose the information (dishonesty) rather than being related to the information itself.
These principles are clearly stated in the documents that form the basis of the medical student teaching programmes in Southampton:
- GMC Documents: 'Tomorrow's Doctors' and 'Medical students: professional behaviour and fitness to practise' available at http://www.gmc-uk.org/
- QAA Benchmarking Statement
These underlying principles have been translated into detailed aims and learning outcomes for the Southampton BM programmes.
It is essential that medical students are able to fulfil the requirements laid out in these documents to be an effective medical student and a capable practising doctor. Some relate to behaviour and conduct expected from medical students from the outset and others will be acquired during the course.
We select students whom we believe will demonstrate appropriate attitudes and behaviour from the start. Our curriculum also has specific aims of recognising and developing professional attitudes and behaviour, together with opportunities to facilitate their achievement.
Students who have difficulty in achieving these standards will be offered support and guidance to help overcome their difficulties. In the majority of such cases students will eventually be successful in completing the course.
However, in exceptional circumstances a medical student may not be able to fulfil these requirements and therefore will not be able to continue to study medicine at the University of Southampton.
Specific applications of some of these objectives
It is not possible to illustrate each of these objectives, however, the following are specific examples of how these objectives will be interpreted in practice:
General attitude and behaviour
You are expected to:
- Not allow your views about a person's lifestyle, culture, beliefs, race, colour, gender, sexuality, age, social status or perceived economic worth to prejudice your interaction with patients, teachers or colleagues.
Specific examples of this are: Being prepared to physically examine patients (which includes touching) in order to establish a clinical diagnosis irrespective of the gender, colour, culture, beliefs, disability, deformity or disease of the patient.
- You are expected to maintain appropriate standards of dress, appearance and personal hygiene so as not to cause offence to patients, teachers or colleagues, impair your performance or jeopardise safety.
This would include being prepared to expose your face fully to patients, teachers and colleagues.
- You should inform the Faculty of Medicine if you have any disability, sensory impairment or other condition whether or not that could affect your studies or pose a risk to patients or colleagues. This is so that we can meet our obligation to provide you with appropriate information and support services and also in order that (where necessary) an assessment of fitness to practice can be undertaken.
A disability, chronic medical condition or specific learning difficulty is not necessarily likely to prevent you from being offered a place, but it is appropriate for an assessment of its effects on your safe practice to be undertaken.
For example, dyslexia must be declared so that it can be assessed and appropriate help identified if necessary.
If you have a serious infectious condition (e.g. HIV or are a carrier of hepatitis B or C) that can be passed on to patients, or if your judgement or performance could sometimes be significantly affected by a condition or illness or its treatment, you must seek and follow advice from a suitably qualified doctor in the occupational health service about modifying clinical contact with patients.
- Read and agree to the University's rules on Academic Integrity
Attitudes and behaviour towards patients
You are expected to:
- demonstrate respect for patients that encompasses, without prejudice, diversity of background and opportunity, language, culture and way of life. This includes treating patients politely and considerately, respecting patients privacy and dignity and respecting their right to refuse to take part in teaching activities.
- always make clear to patients that you are a student and not a qualified doctor, and not recommend treatment or suggest patients take action that might be interpreted as medical advice.
- treat information about patients as confidential, taking all reasonable precautions to ensure that any personal data concerning patients will be kept safely. This principle of confidentiality includes not discussing patients with other students or professionals outside the clinical setting, except anonymously and for educational purposes.
- be aware of the appropriate limits of confidentiality (e.g. where the patient may be putting self or others at risk)
- not abuse a patient's trust (e.g. by engaging in improper personal relationships with patients or their close relatives).
Attitudes and behaviour towards staff
You are expected to:
- demonstrate appropriate respect for academic, clinical and support staff, and treat them with consideration whether in a taught class, the Student Office, the Library, Skills Lab, IT facilities, departments, clinical or social settings.
- attend classes and clinical teaching sessions promptly and in appropriate dress; not leave early (except by arrangement with the staff concerned); observe safety rules; not behave disruptively. Notify the relevant teacher, in advance if possible, if you are unable to attend classes.
- report prolonged absence (>3 days) to the Student Office, with an explanation and medical evidence where appropriate.
- follow rules and instructions about examinations, in particular by arriving promptly at the start, bringing only permitted materials, and being silent on entering the exam room.
Maintain communication with staff by:
- attending scheduled appointments with personal tutors;
- completing appropriate forms to record extenuating circumstances which may have affected your academic work or absence from examinations;
- regularly reading your university e-mail, Blackboard and checking teaching notice boards as advised by academic staff;
- participating responsibly in student feedback sessions and processes.
- actively engage in remedial work after an academic failure (exam or attachment).
Attitudes and behaviour towards students
You are expected to:
- demonstrate respect for other students that encompasses, without prejudice, diversity of background and opportunity, language, culture and way of life.
- take responsibility in supporting other medical students in seminar, practical and clinical work.
Students with disabilities or health problems
You should read very carefully the following statements which describe our position - and that of all other medical schools in the UK - with regard to certain personal circumstances which could make it difficult or impossible for you to practise as a doctor.
Students with disabilities
The University of Southampton welcomes students with disabilities. However, we have a special responsibility to ensure that all candidates admitted to the course will be eligible for registration by the General Medical Council on graduation.
Accepting someone who is unlikely to fulfil the rigorous demands of professional fitness to practise would not be in the interests of the student, as it would raise inappropriate expectations and would be contrary to our overriding duty of care to the public.
Failure to disclose such a history would, however, be regarded as reason to reject the candidate because this is a form of dishonesty and as such, is inappropriate conduct.
All students with a disability are welcome to request a prospective visit to the University's Enabling Service. Students who indicate on their UCAS form that they have a disability will be referred to the University's Enabling Service on enrolment.
Students with dyslexia
The central question when considering an applicant who has dyslexia is whether the condition is of sufficient severity to prevent that person practising safely as a doctor.
In general, the requirements for admission to medical school are so high that we are dealing with a self-selected group of people who have largely learned to compensate for their dyslexia. The approach we take is to try to explore with the applicant the extent to which dyslexia interferes with his or her studies and their life in general. In addition, we try to judge the level of insight that the student has about difficulties that might be encountered with important matters such as accurate drug prescribing.
Students who indicate on their UCAS form that they are dyslexic will be referred to the University's Dyslexia Support Services on enrolment. However, all students with dyslexia are welcome to request a prospective visit to the University's Dyslexia Support Services. Students whose Pastoral Tutors consider may have a specific learning difficulty will also be referred to the University's Dyslexia Support Services for assessment.
The University has extensive learning support facilities. Medicine has a policy of allowing a limited amount of extra time in written examinations. However, usually no concessions will be made in the conduct of clinical examinations. The 1983 Medical Act states that when a University grants a medical degree it is not only confirming that someone has reached the requisite academic level but that they are also fit to practise medicine which, of course, is not simply a question of academic attainment.
Students with serious communicable diseases
Health screening and immunisation is carried out by our occupational health service. Students who know or believe they might have been at risk of serious viral infections such as Hepatitis B or C or HIV should inform the occupational health service.
If the student is found to be a carrier of Hepatitis C or B virus or other chronic virus infection such as HIV, arrangements may be made for them to continue the programme without having to undertake exposure-prone procedures depending on the nature of the infection. Additional checks are carried out on entry for tuberculosis, rubella and chicken pox, and offers are made subject to satisfactory screening.
Students with mental health or behavioural difficulties
We ask you to inform us if you have been or are being treated for mental illness, if you have been diagnosed as having a personality disorder or if you have deliberately harmed yourself. We also ask you to tell us if you are addicted to drugs, including alcohol. This is so that the appropriate evaluation of your current fitness to practise can be completed.
Criminal offences and other related matters
Section 5 of the UCAS form asks for declaration of criminal convictions. For Medicine, a positive answer should be given for this section if an applicant has a history of cautions, reprimands or police warnings. The fact that an individual has received one in the past would not necessarily preclude them from being made an offer. This would depend upon the nature of the offence and when it occurred.