Introduction
1. The following regulations shall govern the procedures in the University to ensure that preclinical and clinical medical students are fit to practise medicine as defined in guidance issued by the Medical Schools Council and General Medical Council.
2. There shall be a Medical Students Register which shall be maintained by the Faculty Boards of Biology and Clinical Medicine through a Fitness for Medical Practice Committee (FMP Committee) constituted in accordance with Regulation 5.
3. Where there is a question concerning the fitness for practice, through serious ill health or serious or persistent cause for concern about the conduct, of a medical student, the FMP Committee shall appoint a Fitness for Medical Practice Adjudication Sub-committee (Adjudication Sub-committee) constituted in accordance with Regulation 11 to consider whether to remove the medical student’s name from the Medical Students Register or whether to formally warn, suspend or impose sanctions on the medical student.
4. A medical student shall be entitled to appeal to a Fitness for Medical Practice Appeal Tribunal (Appeal Tribunal) constituted in accordance with Regulation 15 against a decision of the Adjudication Sub-committee to warn or sanction the medical student, or suspend or remove the medical student from the Medical Students Register.
5. The FMP Committee shall consist of:
6. In respect of each individual case before the FMP Committee, all members of the FMP Committee shall be required to make a declaration of interest in the case.
7. Members in classes (d)–(f) shall be appointed in the Michaelmas Term to serve for three years from 1 January following their appointment.
8. The Chairman of the FMP Committee shall be appointed from among the members of the FMP Committee in classes (d), (e), or (f) by the Faculty Board of Clinical Medicine.
9. The duties of the FMP Committee shall be:
10. The FMP Committee shall meet at least once a year in the Michaelmas Term and whenever there is any business to consider. Five members shall constitute a quorum. The FMP Committee shall submit the minutes of any meeting to the Faculty Boards of Biology and of Clinical Medicine and to the Medical Education Committee.
11. An Adjudication Sub-committee shall comprise five members. Four members of the Adjudication Sub-committee shall be chosen by the FMP Committee, three from within its membership (one of whom shall be designated as Chairman by the Committee), and shall include two people who are members of the Regent House, being practising GMC-registered medical practitioners, and one person being a member of the Regent House, not being medically qualified. The fourth person appointed by the FMP Committee shall be an external member of the academic staff of a UK Medical School, being a practising GMC-registered medical practitioner who is not a member of the Regent House. One member of the Adjudication Sub-committee shall be chosen by the medical student from the FMP Committee and that person shall be a member of the Regent House. The Adjudication Sub-committee shall consider individual cases in accordance with the Fitness for Medical Practice Procedures and shall decide whether a medical student should remain on the Medical Students Register or should be sanctioned.
12. No member of an Adjudication Sub-committee shall have had any involvement or interest in the case or be a current teacher of the medical student. All members of the Sub-committee shall be required to make a declaration of interest in respect of the case.
13. The Secretary of the medical student’s Faculty Board, or a nominated deputy, shall serve as Secretary to the Adjudication Sub-committee. For the purpose of these regulations, preclinical students are assigned to the Faculty of Biology and clinical students to the Faculty of Clinical Medicine.
14. The Council of the University shall maintain three panels, panel (a), panel (b), and panel (c), from which members of an Appeal Tribunal shall be appointed as follows:
panel (a): |
persons who are legally qualified or who have had experience of acting in a judicial capacity, not being members of the Council; |
panel (b): |
members of the Regent House not being members of the Fitness for Medical Practice Panel or of the Faculties of Biology or Clinical Medicine. |
panel (c): |
members of the academic staff of a UK Medical School, being practising GMC-registered medical practitioners, who are not members of the Regent House. |
The Council shall appoint in the Michaelmas Term each year such number of persons as they shall see fit to serve as members of each panel for one year from 1 January following their appointment.
15. An Appeal Tribunal shall be appointed to consider any appeal by a medical student against a decision of an Adjudication Sub-committee, and shall confirm, quash, amend, or refer back to the Adjudication Sub-committee the decision made. An Appeal Tribunal shall consist of three members:
16. No member of an Appeal Tribunal shall have had any involvement or interest in the case or be a current teacher of the medical student. All members of the Appeal Tribunal shall be required to make a declaration of interest in respect of the case.
17. The Registrary or a person nominated by the Registrary shall act as Clerk of the Appeal Tribunal.
1. The consideration of whether or not a medical student is fit to practise medicine shall take place in accordance with the following process which shall consist of at least three stages, preliminary, investigation, and adjudication, and may be followed by a final appeal stage.
2. If, at any stage:
3. On receipt of an expression of concern from the Secretary of the FMP Committee made under Regulation 7 below, and during the proceedings, the Chairman of the FMP Committee, following consultation with the relevant NHS Hospital Trust officer or lead general practitioner if appropriate, shall have the authority to decide whether a medical student, who is the subject of an expression of concern, shall:
4. The Chairman of the FMP Committee may, during the proceedings, review and change a decision regarding a medical student’s status.
5. If the medical student is dissatisfied with the decision of the Chairman of the FMP Committee, the student may request an adjudication by the full FMP Committee. Pending any such adjudication the decision of the Chairman of the FMP Committee shall remain in force.
6. In the event that the Chairman has any involvement or interest in the case arising other than by way of these rules of procedure, the Chairman shall stand down from the Committee while the case is being considered and shall appoint another member of the Committee as Chairman in her or his place; references to the Chairman in these rules of procedure shall be deemed to be a reference to that other member of the Committee.
7. Any expression of concern that a medical student may not be fit to practise medicine shall be made in writing to the Secretary of the Committee; it shall show clearly the author’s name and address, and be signed. Anonymous allegations shall not be considered.
8. The Secretary of the FMP Committee shall inform the Chairman of the FMP Committee of the receipt of any formal expression of concern received in accordance with Regulation 7 and the Chairman of the FMP Committee shall ascertain whether the student has any serious illness or disability which would affect the procedures to be followed and which would require appropriate steps to be taken to ensure the student is not disadvantaged. At this stage the Secretary of the FMP Committee shall inform the medical student of the details of the cause for concern and that this matter is being considered by the Chairman of the FMP Committee under this stage of the procedure.
9. The Chairman of the FMP Committee shall determine whether the matter can and should be dealt with informally or whether investigation as set out in Regulations 13–17 below should proceed and whether any action under Regulation 3 above should be taken. The Chairman of the FMP Committee shall normally take this initial decision within one month from the date of her or his receipt of the expression of concern. Before the expiry of the one-month period, the Chairman may, having initially determined that the matter should be dealt with informally, subsequently determine that investigation as set out in Regulations 13–17 below should proceed and that action under Regulation 3 above should be taken.
10. If, after appropriate consultation, the Chairman considers that there is a prima facie case of an offence against the discipline of the University, action shall be taken as under Regulation 2(b) above.
11. The Chairman of the FMP Committee shall determine whether a report should be submitted to the Police.
12. If the University Advocate institutes proceedings against the medical student under Statute B, VI, any subsequent judgement of a University Court may be considered as evidence within the procedures set out in Regulations 13–38 below. If a University Court finds that a charge is proven against the student then that finding shall be conclusive evidence within the procedures set out in Regulations 13–38 below that the medical student in question has committed the offence against the discipline of the University with which he or she was charged.
13. If the Chairman of the FMP Committee decides to instigate an investigation following receipt of an expression of concern, the Secretary of the FMP Committee shall write to the medical student concerned, to the Senior Tutor of the student’s College, and to her or his Tutor, stating that an investigation of the medical student’s fitness for practice is going to take place. The letter to the medical student shall state the nature of the expression of concern made under Regulation 7 above and the grounds for launching the investigation.
14. The Chairman of the FMP Committee shall refer the case to an Investigator, chosen from amongst the members of the FMP Committee, who is also a member of the Regent House and who has had no previous involvement or interest in this case and who is not a current or former teacher of the medical student. The Investigator shall interview the medical student concerned, the maker of the allegation, and any other relevant persons. Notes of these interviews shall be taken and a written report prepared and submitted by the Investigator to the Chairman of the FMP Committee.
15. During any interview with the Investigator, the medical student may be accompanied by a member of the University or other representative chosen by the medical student who shall notify the Investigator two days in advance of any meeting if he/she will be accompanied and by whom.
16. On receipt of the Investigator’s report, the Chairman of the FMP Committee shall make a determination, in consultation with members of the FMP Committee (not including the Investigator) if the Chairman so desires, to take one of the following decisions:
17. The Secretary of the FMP Committee shall inform the medical student, the student’s Senior Tutor, and the student’s Tutor in writing of the decision within five working days of being notified by the Chairman of the FMP Committee of her or his decision, and in the case of a category (b) decision, shall also state the agreed conditions on which the student may continue on the course. The letter from the Secretary informing the student shall be submitted to the next full meeting of the FMP Committee.
18. An Adjudication Sub-committee of five members, appointed in accordance with Regulations 11–13 of the regulations setting out the roles, duties, and composition of the Fitness for Medical Practice Committee, Fitness for Medical Practice Adjudication Sub-committee, and Fitness for Medical Practice Appeal Tribunal, shall consider the Investigator’s report and shall consider and determine the case, where it is required to do so following the decision of the Chairman of the FMP Committee under Regulation 16(b) or (c).
19. The medical student shall be required to attend the meeting of the Adjudication Sub-committee in person, unless prevented by grave cause. The medical student and her or his Tutor shall be informed by letter of the details of the hearing in writing, no fewer than fourteen days in advance. The letter to the student shall be sent to the student’s College and Cambridge residential addresses.
20. If the medical student has good cause to object to the membership of the Adjudication Sub-committee, he or she shall inform the Chairman of the FMP Committee in writing of the details in advance of the meeting of the Sub-committee. The Chairman of the FMP Committee shall decide whether to replace that member of the Adjudication Sub-committee and shall inform the medical student accordingly. The Chairman’s decision shall be final.
21. Any written evidence submitted by the medical student shall be sent to the Secretary of the Adjudication Sub-committee no fewer than seven working days in advance of the meeting. If the medical student wishes to call any persons to give oral evidence, it shall be the medical student’s responsibility to secure their attendance and the medical student shall inform the Secretary to the Adjudication Sub-committee of the identity of the persons no fewer than seven working days in advance of the meeting.
22. If the medical student fails to attend the meeting without reasonable explanation, the Adjudication Sub-committee may consider the case in the medical student’s absence. The Adjudication Sub-committee shall have discretion to decide what constitutes a ‘reasonable explanation’.
23. The Adjudication Sub-committee and/or the medical student may call upon persons who may have information relevant to the case to give evidence (whether they are members of the University or not) either orally at the meeting or in writing in accordance with Regulation 21 above.
24. The medical student may choose to be accompanied by any of the following, limited to one in each category: a ‘friend’ nominated by the student (for example, a relative or student representative); a College representative nominated by the student; a legal representative (at the student’s own expense). If the student decides to be so accompanied, he/she must inform the Secretary to the Adjudication Sub-committee of the identity of the individual and the capacity in which they are attending seven working days in advance of the meeting.
25. The medical student’s Tutor (or a deputy appointed by the Tutor), if not nominated by the student under Regulation 24, shall be entitled, with the student’s consent, to be present.
26. The meeting shall be held in private.
27. The Sub-committee shall determine its own procedure for the conduct of the meeting. The procedure shall normally include the following:
28. The Adjudication Sub-committee, following consideration of the case, may:
29. The Secretary of the Adjudication Sub-committee shall communicate in writing the decision of the Adjudication Sub-committee and the reasons for the decision, specifying any time period or sanction that may apply, to the FMP Committee and the medical student, to the Senior Tutor of the student’s College and her or his Tutor, and to the relevant Faculty Board.
30. A medical student shall have the right of appeal to an Appeal Tribunal against a decision of the Adjudication Sub-committee implementing a category (ii) recommendation or a category (iii) recommendation.
31. A medical student may appeal a decision of an Adjudication Sub-committee on only one or more of the following grounds:
32. A medical student may give notice of appeal in writing within twenty-eight days of the date of notification of the Adjudication Sub-committee’s decision to the Chairman of the FMP Committee stating the grounds on which the appeal is made. On receipt of the appeal letter, and if the Chairman of the FMP Committee considers that there are grounds for an appeal in accordance with Regulation 31, the Chairman of the FMP Committee shall inform the Registrary who shall appoint an Appeal Tribunal to hear the appeal. The medical student shall not be entitled to rely during the appeal hearing, without the permission of the Appeal Tribunal, on any grounds other than those set out in the appeal letter.
33. During the consideration of the appeal, the decision of the Adjudication Sub-committee shall remain in force.
34. An Appeal Tribunal hearing shall be arranged as soon as possible, and normally within three months of the date of the medical student’s request for an appeal, in accordance with the following procedures:
35. The Appeal Tribunal shall consider its decision in private. The Clerk of the Appeal Tribunal shall be present throughout the hearing and throughout consideration by the Tribunal of its decision.
36. The Appeal Tribunal may confirm, quash, amend, or refer back the decision to the Adjudication Sub-committee.
37. The Appeal Tribunal shall not confirm a decision implementing a category (iii) recommendation unless the members are unanimously satisfied on the balance of probabilities that the case is proved.
38. As soon as possible, normally within seven working days, the Clerk of the Appeal Tribunal shall send a Completion of Procedures letter to the medical student informing her or him of the decision and the reasons for the decision. The Secretary to the Appeal Tribunal shall also inform the Chairman of the Adjudication Sub-committee, the FMP Committee; the Director of Medical Education and, as appropriate, the Director of Medical and Veterinary Education; the Senior Tutor of the student’s College, and her or his Tutor.
39. When a medical student has received a formal warning, suspension, or permanent removal from the Medical Students Register this information shall be entered on the student’s record. The FMP Committee shall determine whether the information is to be permanently kept on the medical student’s record, until a further review or until one year after the student has obtained full registration with the General Medical Council. The student shall be required to declare any such information to the General Medical Council when applying for provisional registration.
40. A medical student who has received a category (ii) recommendation which requires the student to undertake remedial work or work under supervision shall be required to sign a declaration that he or she will undertake such remedial work or work under supervision.
1. Medical students have a responsibility to report any illness or disability likely to affect their fitness to practise medicine to their Tutor or Director of Studies and, as appropriate, to the Director of Medical Education or Director of Medical and Veterinary Education.
2. The following procedures shall be followed for medical students whose health is considered to make them unfit for medical practice:
3. A medical student who has undertaken to comply with arrangements for the management and supervision of her or his condition shall be required to sign a declaration that he or she will comply with the arrangements and will inform the General Medical Council of her or his condition and the arrangements for the management and supervision of the condition.