Fitness to Practise concerns arising during Admissions process

 

Fitness to practise and offer conditions for admission to the MBBS programme

All medical students joining Brunel Medical School (BMS) are expected to uphold the standards of professionalism and ‘Fitness to Practise’ (FtP) in accordance with the requirements of the UK General Medical Council (GMC).  Further information about FtP for medical students can be found here.

Students are also expected to uphold standards of professionalism and FtP prior to registration on the MBBS programme and during the admissions process. These standards are reflected in the conditions of acceptance for a place to study on the MBBS programme, documented in your offer letter. These conditions include the following:

(1)   You declare any criminal convictions or cautions that appear in the Criminal Conviction Form produced by police authorities in your country of residence and you pass the enhanced Disclosure and Barring Service (DBS) check in the UK. For further details please refer to the Professional Course Requirements webpage here.

(2)   You meet all occupational health requirements. These include completion of a medical questionnaire, immunisations and blood tests. Other tests may be required on a case-by-case basis. For further details please refer to the Professional Course Requirements webpage here.

(3)   You disclose any prior formal FtP procedures undertaken whilst you were registered on another professional programme of study.

(4)   You understand that prior to registration on the MBBS programme, your information will be shared with the Excluded Students Database (ESD) in order to verify your FtP. Further information about the ESD can be found here.

(5)   You understand that, once registered on the MBBS programme, if you are withdrawn from the programme as a result of a FtP outcome, this information and a copy of the decision against you will be stored on the ESD.

A student who accepts an offer of a place to study on the MBBS programme but who does not meet conditions (1), (2) or (3) above may have their offer of a place on the MBBS programme withdrawn on FtP grounds, subject to the decision of a formal Health and Conduct  Panel (HACP) to which the student will be referred. The decision will be taken on a case-by-case basis, taking into consideration the potential risk to the public (including patients and carers) if the student were to register as a medical student and subsequently practise as a doctor.

The Health and Conduct Panel

Reasons for referral

The Health and Conduct Panel will be convened in the event of professionalism or FtP concerns arising during the Admissions process for entry to the MBBS programme on order to determine whether the student will be permitted to continue their application, or whether their offer of a place on the MBBS programme will be withdrawn. This can happen due to the following reasons:

(1)   A student declares a relevant criminal conviction or caution on their criminal conviction disclaimer.

(2)   A relevant criminal conviction or caution is revealed by the enhanced UK Disclosure and Barring Service (DBS) check or by the Criminal Conviction Form produced in the student’s country of residence, despite the student not having declared the relevant offence(s).

(3)   A student does not meet all occupational health (OH) requirements, most commonly due to a failure to comply with the necessary blood test or immunisation requirement, leading to concerns about their FtP. Further information can be found here.

(4)   A student has a health condition, or disability, that may raise concerns about their ability to meet Outcomes for Graduates, even with the provision of reasonable adjustments

(5) A student discloses prior formal FtP procedures undertaken whilst registered on another professional programme of study.

(6)   A student’s details are matched against the list of students on the Excluded Student Database (ESD), without having disclosed any prior formal FtP procedures.

(7)   A student’s conduct during the admissions process raises concerns about their professionalism and FtP.

(8)   The University becomes aware that a student has:

  1. Not declared a prior criminal conviction or caution
  2. Not declared prior FtP procedures undertaken whilst registered on another professional programme of study
  3. Given incorrect or misleading information in relation to meeting occupational health requirements

 

Most health conditions and disabilities do not affect a medical student’s FtP, as long as the student

  1. Demonstrates appropriate insight
  2. Seeks appropriate medical advice
  3. Complies with treatment

Process

(1)   The student will be informed about the nature of the concern, which would normally relate to (1) to (8) above. They will be informed that a referral to the Panel has been made.

(2)   The student will be given the opportunity to make a written submission explaining the circumstances. If the concern is about a criminal conviction or caution, or ESD finding, which was not declared by the student, they will be asked to explain why they did not declare. The student will be asked to submit any evidence they wish to be considered by the Panel. The student will have 10 working days to do this, with extensions possible if there are extenuating circumstances.

(3)   The Panel will meet to consider the concern and any written documents provided by the student. The names and contact details of the student will be redacted from the documents presented to the Panel at this stage. The Panel will have the following options:

  1. Withdraw the offer of a place to study on the MBBS programme,  on the basis that the concern is not compatible with the professional standards and FtP expected of medical students.
  2. Permit the student’s application to proceed on the basis that the issue raised does not call into question the applicant’s current fitness to practise on the MBBS programme
  3. Request the student attends a meeting to discuss the matter. The purpose of this meeting will be to establish further information and/or assess their insight into the issues involved.

(4)   If a meeting is required the student will be invited to attend. The applicant will be given the opportunity to make a statement before the Panel asks questions. The meeting will conclude with an opportunity for a final comment by the student. The decision will normally be sent to the student within 10 working days.

(5)   Students will be given summarised reasons for any decision to withdraw the offer of a place to study on the MBBS programme at either stage of the process (before or after meeting the student). There is no right of appeal against the decision of the Panel at either stage.

(6)   In the event that the application proceeds and the student is registered on the MBBS programme, they will be offered a meeting with the medical school Academic Head of Student Support, or nominee, nearer to the start of their studies. 

The documents relating to the Panel’s decision will be confidentially held on the successful applicant’s files for as long as the student’s file is kept. This would not include actual DBS certificates.

Panel

The HACP will consider the concerns that have arisen on a case-by-case basis, taking into account the nature of the concern, whether the student has demonstrated dishonesty, and the potential for harm to patients if the student were to enter the MBBS programme and subsequently practise as a doctor.

The Panel will be appointed by the Dean of the Medical School (or nominee). The Panel will include:

  1. A member of Brunel Medical School academic staff.
  2. BMS Director of Clinical Affairs, or nominee.
  3. BMS Academic Lead for Fitness to Practise, or nominee.
  4. A member of staff from another programme within the College of Health, Medicine and Life Sciences with experience of FtP procedures.

At least one member of the Panel must be a medical practitioner registered with the General Medical Council. 

The Academic Head of Admissions will not be a member of the Panel or involved in the decision process.

The Excluded Student Database (ESD)

Brunel University London is one of a number of UK universities that has signed up to the Protocol for the Excluded Students Database for sharing information on students with the Medical Schools Council (MSC). The ESD is shared between universities offering courses leading to the registered professions, namely medical, veterinary, pharmacy and dental course.

The MSC has created an information sharing system known as the ESD to enable these universities to share securely information about students who have been excluded on fitness to practise grounds from courses leading to entry to one of the above registered professions.

The purpose of the ESD is to protect the public (including patients and carers) from risk and to prevent fraudulent applications to professional courses.

BMS will provide Information to the ESD about any registered BMS student who goes through formal FtP procedures and is withdrawn on FtP grounds. Further information about FtP procedures for medical students can be found here [insert link to paragraph below]. No information is provided to ESD until the University’s appeal process has been completed. If the decision to withdraw stands, the following information will be added to the ESD:

  1. Known names of the student, including any changes in name
  2. Current gender and gender at birth
  3. Date of birth
  4. Medical school that the student was excluded from
  5. UCAS ID
  6. Photograph
  7. Copy of the outcome letter at the end of the FtP proceedings (note – this would only be made available by the MSC once a match has been identified).

The details of any student who does not progress or graduate for any reason other than FtP (such as academic or visa reasons) will not be added to the ESD.   

Data Protection Act 2018

Data Protection legislation permits the university to check the Excluded Student Database (ESD) for all students who have accepted an offer of a place on the course. Student consent to make this check is not required as the University has a duty under public interest to ensure patient safety. The check of the database will be carried out by the BMS Academic Lead for Admissions or delegated representative once an offer of a place has been accepted by the candidate. Other candidates will not be checked against the database.

Fitness to practise procedures for medical students

Once registered as a student on the MBBS programme, if a student’s health or conduct becomes a cause for concern they will be offered appropriate support and guidance to continue their studies. Health and conduct concerns are overseen by the BMS Health and Conduct Panel. However, some concerns cannot be remedied with support. For this reason, the GMC requires all UK medical schools to have FtP procedures to investigate medical students whose health or conduct may cause risk to the public, including patients and carers. GMC guidance on professionalism and FtP can be found here.

FtP procedures are a formal process involving a Panel that is required to make an independent decision on a student’s FtP, based on the evidence presented to them. Decisions are made on the basis of balance of probabilities. The FtP Panel must take into account the balance between patient and public safety, the interests of the medical student and the need to maintain trust in the medical profession. Following FtP procedures, the student may be permitted to continue their studies or may be required to withdraw from the MBBS programme. Further details can be found in Senate Regulation 14.