Dr Christine Bradford
You've been going through a tough period and have had concerns raised about you, leading to a university investigation. How can you prove you're taking the right steps to get back on track? Dr Christine Bradford looks at the process of remediation.
When medical students graduate, they should be 'fit to practise medicine'.
This sounds obvious, but there are high expectations for the standards of behaviour that medical students should meet. You are studying to become a member of a regulated profession, and it is essential that public trust and confidence in that profession should not be undermined.
MDU medical student members often call or make contact with us when concerns have been raised about them by their university. If these issues are not easily resolved by lower level university investigative procedures, students may become the subject of a university fitness to practise (FTP) investigation – which of course can be a very stressful experience.
There is no prescribed list of what concerns may progress to a formal FTP investigation. These can be related to health, for example, but are often related to the professionalism and probity of the student, particularly if the issues of concern are of a certain severity or persistent in nature.
What can I do?
Should you receive notification that you are subject to an investigation of this nature, you should make prompt contact with us to see what support and guidance we can offer.
To avoid a serious sanction in the context of an FTP investigation – or indeed, in any other medical school investigative setting – you will need to be able to exhibit to your university that you have satisfactorily addressed the recognised concerns, which will have been particularised after a review, assessment or investigation.
This process is called remediation, which is really an umbrella term for any activity that is undertaken to correct a perceived concern. These might include advice, mentoring, directed learning or even repeating a part of the clinical course, depending on the nature of the concerns about behaviour or competence.
Where health issues have been the cause for concern, then advice and management from independent health professionals is likely to be needed.
Remediation plans will be agreed between you and the university and there will be reviews at agreed intervals. You are responsible for driving the remediation process and demonstrating that concerns have been resolved. The plans and undertakings will vary depending on the nature of the concerns.
It is generally much more difficult to demonstrate that probity and attitudinal issues have been remediated. Reflective study and statements can help in such circumstances, and so can references and testimonials to try to demonstrate that a particular behaviour was an aberration or has now been corrected.
Exhibiting a thorough knowledge and understanding of the GMC's student guidance on professionalism is essential. You can request MDU advice and support when preparing evidence.
While you may be able to demonstrate to your university that you have remediated satisfactorily in the context of a university investigation, there is still the hurdle of applying for GMC provisional registration, when a 'fitness to practise declaration' needs to be made.
As part of this, any disciplinary or fitness to practise action or investigation that you have been subject to during the course of your studies has to be declared, regardless of the outcome of any investigation. The GMC then reviews your declaration, and makes a decision. In 2015, of the 7522 applications for provisional registration by UK graduates, six were refused.
This underpins that the process of remediation must not be seen as a 'quick fix', but must include ongoing reflection and learning – so that you can clearly demonstrate that the actions you've taken and changes you've made are genuine and permanent, and any issues of concern are unlikely to recur.
Dr Christine Bradford
MDU medico-legal adviser
Christine originally trained at the University of Glasgow. She was a GP principal in the west of Scotland for eight years. Before joining the MDU she was a GP locum and a senior medical adviser to life insurance companies. As well as working as a medico-legal adviser she is a course tutor in Medical Ethics to undergraduate medical students at the University of Edinburgh. Christine is based in Glasgow.
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