What to expect from a student fitness to practise investigation

What is a fitness to practise investigation?

Universities have an obligation to investigate any concerns raised about a medical student's fitness to practise by lecturers, clinicians, fellow students or members of the public.

Depending on the nature of the concern, this could then lead to a fitness to practise (FTP) investigation or a disciplinary process.

Final-year students going through an FTP process will not be able to graduate until the investigation is finished, as medical schools have a duty to ensure that all students are fit to practise.

While GMC guidance offers a framework for managing concerns about students, it has no remit to intervene in the medical school's investigation process. All universities have their own regulations and procedures concerning student discipline and FTP. As such, FTP processes can vary in structure, timings and procedures.

Across one year, 67% of student files supported by the MDU were related to FTP investigations. This is just a snapshot, and will not encompass all the FTP investigations that were carried out.

Could I be suspended?

Some concerns are serious enough to trigger a student being suspended from the course during a FTP process. Keep in mind that a suspension is not a finding of any facts of the case. While it may seem like a punitive measure, it isn't - instead, this is a risk assessment usually built into a local policy.

Suspension is usually a decision the medical school makes based on insufficient information to secure the safety of you and potential patients while an investigation is initiated.

While it may be frustrating and seem personal, challenging this during an ongoing investigation may show a lack of understanding and insight into a medical school's obligations.

Get support

As an MDU student member, you can reach out to us for support and advice if you're called to a FTP investigation or hearing. This can be a difficult process to face especially if you haven't had to deal with any concerns before. You can also contact student support or your student union.

How it works

Interview

This is a fact-finding interview and a student's opportunity to provide their account. Usually minutes will be taken for the meeting. It is important to be open and honest; concerns about probity are almost always more serious than the original allegations.

While it can be difficult to face criticism or challenges, medical students are expected to view concerns as learning opportunities. Even if you deny any allegations, you should consider and reflect if you could have acted in a different or better way.

The ideal outcome from an FTP interview is for a student's case to be closed at this stage and not proceed to an FTP hearing. We'd advise getting in touch with us before any FTP interview for support and advice.

Hearing

If your case is escalated to an FTP hearing, you should be informed of the reasoning for this decision and given a specified amount of time to provide supporting documents. Read our article for more information on what you should provide and receive before facing an FTP hearing.

We'd always advise having someone with you at an FTP hearing, and we can often provide a supporter to be present.

A typical structure of an FTP hearing is:

• the chairperson will introduce committee members
• a case presenter will make a statement (this is usually the background to the case)
• the student will then be invited to make an opening statement
• the chair will invite the case presenter and the student to ask any questions of each other
• the chair will invite any questions from the panel to the student (the panel and chair can usually ask questions at any time during the hearing)
• any witnesses will be called
• the chair will invite the case presenter to make a closing statement
• the chair will invite the student to make a closing statement.

After the hearing, you and your supporter may be asked to wait outside the room while the FTP committee deliberates the outcome. Or you may be informed of the outcome within a certain number of days - usually no longer than two weeks, but again, it will depend on the local policy.

Declaring fitness to practise with the GMC

When applying for provisional registration with the GMC, any student who has been subject to FTP proceedings may need to declare this. Your medical school may be asked to share relevant details with the GMC, so bear in mind there is potential for your future professional regulator to see your response to the concerns. You can always contact us for advice and support with GMC declarations.

After the FTP process

Possible outcomes

Possible outcomes from an FTP hearing include no further action, a warning, conditions, or expulsion from the course. In our experience, a medical student stands a considerably higher chance of achieving a favourable outcome if they can show they have reflected on a concern, gained insight into the issue, and taken proactive steps to remediate - compared to a student who does not show insight.

Reflection and insight

While going through an FTP process can initially seem devastating, most students tend to reflect on the experience and find it was a helpful learning journey, often providing them with personal insight about themselves and their strengths and weaknesses, and helping them to become a better doctor.

MDU members are welcome to contact us for advice at any time.

This page was correct at publication on 29/02/2024. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.