Professor TJ David explains what information you should provide – and what you should receive – before facing a fitness to practise hearing.

Having to attend a medical school or university fitness to practise (FTP) committee is arguably one of the worst things that can happen to a medical student.

As a student member of the MDU, your first step should be to contact the MDU without delay and get advice on preparing for your hearing. The MDU has helped more than 100 students in the last two years with FTP investigations, and can help with writing statements and offer support and representation if needed and allowed by local procedures. Getting in touch with the MDU only a day or two before the meeting will make it much more challenging for them to help.

Here are a few other things to bear in mind when facing an FTP hearing.

What you need to know before

Point of contact with the medical school

The most likely person to contact you is the FTP committee secretary. You should be provided with their email address and telephone number.

Time, date and location of the meeting

You must be given adequate warning of the time, date and location of the meeting, and your university’s FTP rules should stipulate the minimum permissible warning period. You cannot be expected to prepare if you’re only told about the meeting the night before.

Names of the FTP committee members

You’re entitled to know the names and the professional roles of the committee members in advance. If you’ve previously interacted with a member (eg, been taught or supervised by) you should explain this to the committee secretary. 

If you’ve had significant interaction with certain individuals (or if they’ve made significant decisions about you before) they should not be members of the committee. 

If you object to any committee members, you need to explain your reasons.

Legal representative

Some universities will not permit students to be accompanied by a legal representative. However, they cannot prevent you seeking and obtaining medico-legal advice from your defence organisation, which might include helping you to prepare for the meeting and helping you put together a written submission and gather testimonials.

Sufficiently detailed allegations well in advance

You must be provided with written reasons for your referral to an FTP committee. 

Allegations against you must be provided in sufficient detail to help you understand the concerns. Vague allegations (such as ‘poor attendance’, ‘not complying with sickness reporting regulations’ or ‘bad language’) are unfair. The allegations must be precise so you can put your side of the story forward. 

Allegations must be provided well in advance so you can provide your own explanations.

Anonymous complaints are fundamentally unfair

You should not have to face allegations that are based on an anonymous complaint. If you don’t know who has made a complaint, it’s likely to be difficult or impossible for you to provide a response and defend yourself. 

Fellow students, or staff, have a professional duty to assist an FTP process, and they should never be told that they can make a complaint but not back it up by signing a statement and giving evidence at a hearing.

Rules, regulations and procedures

It’s essential that you’re supplied with FTP rules and regulations in advance of an FTP hearing (sometimes described as the terms of reference). 

You need to know the medical school or university regulations, including the powers of the committee and possible outcomes. It would be unfair to apply a penalty if the possible outcomes hadn’t been fully spelled out to you in advance.

If you don’t feel well enough to attend

Inform the committee secretary without delay if you don’t feel well enough to attend the meeting. This should be put in writing, if possible, accompanied by a letter from a doctor confirming the problem.

The final decision about whether or not you are well enough to attend (if there is any doubt about this) is a medical decision, made by a doctor in occupational health – not by a member of the committee.

It’s essential that you’re supplied with FTP rules and regulations in advance of an FTP hearing (sometimes described as the terms of reference).

Inform the committee secretary about a disability

The committee cannot provide the necessary support if they don’t know about a disability. There are many things the committee can do to help a student with disabilities including hearing impairment, dyslexia, colour blindness, or a mental health problem (such as anxiety, depression, panic attacks etc). If possible, supply relevant medical evidence.

Cooperate with a health assessment

In some cases, a student facing an FTP hearing may need to be assessed by occupational health and/or an independent specialist (eg psychologist or psychiatrist), which may be accompanied by random testing for drugs and/or alcohol. 

It’s really important to fully cooperate with such assessments – not doing so is likely to be seen as a sign that your FTP is impaired. 

Same papers as the committee members

It’s a fundamental principle that you’re provided with the identical set of papers to those supplied to the committee members well in advance of the meeting. It would be wrong for you to be taken by surprise by being questioned about a document you hadn’t seen in advance (sometimes described as an ambush).

court gavel documents

Photo credit: SuperStock

Your written submission is important

The secretary should invite you to prepare a written submission, which must be received well before the meeting (so it can be circulated to, and read by, the committee and the school representative). 

Use this opportunity to set out your full response to any allegations. Take note of deadlines and ensure you adhere to them. Late submissions are unlikely to be accepted without a very good reason.

The MDU can help you write a statement ahead of your FTP hearing, so make sure you contact them as soon as possible.

What to include

The committee needs to know in particular:

  • whether or not you accept any allegations, criticisms or concerns
  • what explanations you have for your actions
  • how you plan to change your behaviour in the future (if you accept that change is needed)
  • information about mitigating circumstances (events beyond your control, like a health problem, or financial or accommodation difficulties, or personal difficulties)
  • favourable information such as previous good behaviour or evidence that your behaviour has improved
  • in cases of ill health, how you plan to manage your health problems in the future.

The committee cannot consider information it has not received; if you’re unsure whether or not something is relevant, it’s better to mention it. This is your opportunity to ensure that your case is properly investigated, and it would be unwise to leave out information that could result in the committee forming an impression that was not based on the whole truth.


Testimonials can be helpful, but with two provisos – one being that the testimonial writer should be a professional who knows your work as a student, and the other being that the testimonial should set out what the writer knows about your predicament. Relatives, friends or school teachers are unlikely to be suitable.

During the FTP hearing

Make sure you tell the truth

It is vital that anything you say to the committee or include in a written statement is accurate and truthful. Dishonesty is likely to come to light, and harm the chances of favourable outcome. 

Insight into errors

Lack of insight is regarded as a grave sign. It’s virtually impossible to correct and prevent errors without recognising mistakes. 

Insight has three components: the willingness and ability to recognise and accept that what you’ve done is wrong, exploring and understanding why the error occurred, and understanding why there is a need to avoid repeating errors.

Examples of lack of insight

  • Not taking responsibility for your own actions and not accepting that they were wrong. An individual who readily accepts they’re at fault is taking a constructive first step in response to a problem behaviour. The opposite can be called distancing, which means placing the blame on anyone or anything other than yourself, which in turn is likely to be regarded as evidence of lacking insight.
  • Minimising the seriousness of an adverse behaviour suggests a lack of insight. An example would be to describe repeated signature forgery or other serious dishonesty as no more than a simple error.
  • Timely steps to apologise at an early stage could help to provide evidence of insight. However, delayed, half-hearted or seemingly insincere apologies may make matters worse.
  • Show that you recognise the potential implications and consequences of your actions. So, a student who has shown a bad attitude to communication, repeatedly failing to respond to emails and ignoring necessary administrative tasks, needs to be able to explain the potential for harm (for example, to patients, the public, running services) if this problem is not fully overcome.

After the hearing 

Appeals against the outcome

The regulations, and any outcome letter, should explain that you have the right to appeal against the outcome and provide an outline of how an appeal can be made. 

If an appeal is unsuccessful, you should be provided with a ‘completion of procedures’ letter. Without this, you cannot proceed to the final possible step of complaining to the Office of the Independent Adjudicator (OIA). 

You have up to 12 months to complain to the OIA, which will look closely at whether the university has followed its own procedures, and it can easily take between six to 12 months to receive a decision.

This page was correct at publication on 02/09/2022. 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.