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Regulations for Procedures for dealing with Questions of Fitness to Practise amongst Medical Students


Council Regulations 7 of 2006

Made by Council on 18 May 2006

Introduction

1.  The consideration of whether or not a student is fit to practise medicine must take place strictly in accordance with the following procedures.

First stages

2.  Any allegation that a medical student may not be fit to practise medicine should be made in writing, signed and passed to the Secretary of the Medical Sciences Division (‘the Secretary’). Anonymous allegations will not normally be considered.

3.  The Secretary should inform the Head of the Division of Medical Sciences (‘the Head of Division’) of the receipt of any written and signed allegation. The Head of Division will determine whether the matter can and should be resolved informally but if after appropriate consultation he or she judges that there is a case that a medical student’s conduct has been such that the student may not be fit to practise Medicine, the Head of Division shall so advise the Secretary, who will in turn inform the Proctors. If the Proctors should choose to investigate the matter separately under Statute XI of the University’s Statutes, the subsequent proctorial judgement may be considered as evidence within the procedures set out below, which will not be invoked until the Proctors have concluded their investigation. The Proctors will not themselves make judgements about fitness to practise.

4.  The Secretary shall write to the student concerned stating that an investigation of the student’s fitness to practise is going to take place and advising the student of the grounds for launching the investigation.

5.  The student’s college shall be advised that an investigation will take place.

The investigation

6.  The Head of the Division will refer the case to a suitably trained senior member of staff, who has had no previous involvement, for investigation and report. The investigator should interview the student concerned and the maker of the allegation and notes of these interviews should be taken. The interviewee(s) will be entitled to receive a typed copy of these notes. The investigator should be accompanied by another member of staff when interviewing the student and the student, or other person being interviewed, is entitled to be accompanied by another member of the University.

7.  If the investigator concludes that there is a serious issue of fitness to practise to be determined, this should be reported in writing to the Secretary and the student informed of the next steps in the process.

The Status of the Student during the Investigation

8.  The Head of the Division shall decide whether a student under investigation may, during the investigation:

(1) continue his/her studies without limitation;

(2) continue his/her studies but with specified limitations and conditions;

(3) be suspended from the Register of Medical Students or the Register of Clinical Students and therefore from the medical course;

(4) following consultation with the relevant Medical Directors, be prohibited from entering specified NHS Trust premises as a student.

9.  The Head of Division may, in the light of a student’s conduct when under investigation, review and change a decision regarding the student’s status during the investigation.

10.  A student may appeal to the Proctors against the decision of the Head of Division to suspend him or her. During the consideration of any such appeal to the Proctors, the student shall remain suspended.

The Adjudication

11.  The Medical Sciences Board (‘the board’) shall appoint a committee of three to consider the investigator’s report and adjudicate the case. The committee shall include one medically qualified person nominated by the board; one person nominated by the student, this person to be a medically qualified member of the Faculty of Clinical Medicine; and, in the chair, one senior member of staff from another faculty agreed between the board and the student or, if no agreement is reached, decided by the Proctors. No member of the committee shall have had any involvement or interest in the case or be a current teacher of the student.

12.  The student will be required to attend the meeting of the committee in person and will be given not less than four working days’ notice of the date and time of the meeting. If the student fails to attend without reasonable explanation, the committee will consider the case in the student’s absence. The chairman shall have discretion as to what constitutes a ‘reasonable explanation’. Members of the University who may have information relevant to the case may be required by the chairman to attend the meeting to give evidence. At the discretion of the chairman, the committee may also call upon other persons (whether or not a current member of the University) to provide advice on specific aspects of the case in writing or in person. The student may choose to be accompanied by a friend, relative, student representative or, where suspension or termination of the student’s medical studies is being considered, including termination on completion of their Honour School examinations, by a lawyer (‘the friend’). The meeting will be held in public unless the student wishes it to be held in private or the chairman considers that this is in the best interests of the student or a patient. All evidence or material submitted as part of the investigation will be regarded as strictly confidential, unless, following consideration of submissions, the committee decides otherwise.

13.  The following points shall serve as a guide to the conduct of the meeting. They may be varied at the discretion of the chairman, for example if he or she considers that the matter may most effectively be resolved informally.

(1) Prior to the meeting the Secretary to the committee will ensure that the student has copies of all documents circulated to members of the committee and is aware of the proceedings to be followed.

(2) The student, the friend (if attending) and any members of staff required to attend under regulation 12 will then join the meeting.

(3) The chairman will introduce by name and explain the functions of the members of the committee, the staff and any others present. The chairman will explain the powers of the committee and will invite the Head of Division (or his or her nominee) to make an opening statement and then invite the committee to ask questions. Other staff attending will be offered the same opportunity to make a statement and may be asked questions. The chairman will invite the student or the friend to make a statement. The chairman will explain that the committee will wish to hear directly from the student in his or her own words. Members of the committee will be invited to question the student. The chairman will invite any other persons called upon by the chairman to attend the meeting to make a brief statement and will then invite the committee to ask questions. At each stage the chairman has discretion to allow reciprocal questioning by the various parties.

(4) Once the chairman is satisfied that the committee has completed its questioning and the student and staff have had a full opportunity to convey information to the committee, both the student and the members of staff will withdraw. The committee will then discuss the case. If for any reason the committee requires further clarification of any aspect of the case from either student or staff members they must all be invited back into the meeting while the questioning takes place. When the chairman so determines, they will leave the meeting again.

(5) The Chairman shall have discretion to adjourn the proceedings.

(6) The committee will make its decision. The decision and any findings of fact will be communicated to the student and the other parties (including the student’s college, the Director of Postgraduate Medical and Dental Education and the Director of Clinical Studies) as soon as possible. The outcome of the hearing will be published but the reasons for it will be regarded as confidential between the University, the student and the relevant regulatory bodies.

14.  If at any stage in the proceedings it should become apparent that the student’s alleged problems are caused by ill health, the fitness to practise procedures shall be stopped and the procedures set out in Part B of Statute XIII shall be invoked.

15.  Any investigation into, or disciplinary proceedings relating to the conduct of the student cannot commence, or must be adjourned, pending the finding of the procedures under 14. Until the Proctors shall have had the time to consider any case of medical student ill health referred to them, the Director of Clinical Studies shall have the power to suspend the student from the Register of Clinical Students and hence from the clinical course. A student may appeal to the Proctors against such suspension.

16.  Where the student is not found to be suffering from ill health, the matter may be referred back to the Proctors or the Head of Division, as the case may be, who may commence, or re-instate, the investigatory or disciplinary proceedings relating to the conduct of the student as referred to above.

17.  Whilst the determination of the student’s fitness to practise is a matter for the committee appointed under regulation 11, it will take into account any findings under regulation 14.

The Outcome of the Adjudication

18.  The committee appointed under regulation 11 may, following consideration of the case:

(1) permit the student to continue with the course;

(2) permit the student to continue with the course under close supervision;

(3) suspend the studies of the student for a specified time;

(4) require the student to re-sit a specified part or parts of the course;

(5) recommend, if the student has not yet completed the BA course, that he or she be allowed to complete that course but not be admitted to the Second BM course in Oxford (or the equivalent elsewhere);

(6) recommend, if the student has completed the BA course but not yet been admitted to the Second BM course in Oxford (or the equivalent elsewhere), that he or she not be admitted to the Second BM course in Oxford (or the equivalent elsewhere);

(7) require any other action considered appropriate by the committee to enable the student’s successful completion of the remainder of the course;

(8) recommend that the student be removed from the Register of Clinical Students but be allowed to pursue an alternative academic qualification.

19.  A student shall have the right of appeal to the University’s Appeal Court against any of the following recommendations: that the student be suspended from the Register of Medical Students; that the student be suspended or removed from the Register of Clinical Students; that the student not be admitted to the Second BM course in Oxford (or the equivalent elsewhere).

20.  During the consideration of any such appeal, the student shall remain suspended.

Confidentiality

21.  Any information provided by a student to a medical adviser is confidential. The medical adviser cannot use that information for any purpose other than that for which it was provided, without the student’s express consent. Anyone who receives medical information about the student from the medical adviser is similarly under a duty of confidence. Exceptions to this duty of confidentiality may apply where the student appears to be at risk of self harm or poses a risk to the health and/or safety of others.

22.  It is a criminal offence to disclose any information revealed by an enhanced CRB disclosure report. It is however permissible for the authorised counter-signatory to the application, in the course of his or her duties, to share the information with other members of the Department or University, if those other persons need the information for the purpose of carrying out their duties. The information can also be passed on to a Government department.