A medical student discovers someone she knows is set to be a patient at her clinical placement – raising ethical questions about conflict of interest and impartiality.

The scene

A medical student called the MDU advisory helpline. She explained that she was due to start a clinical attachment in paediatrics the following week in a district general hospital close to her home.

At weekends, she volunteered as a tutor in a local secondary school.

She had learned that one of her students had been admitted to a paediatric ward at the hospital that she was to be attached to. It seemed likely that the child would be an inpatient for a prolonged period – probably for most of the student's clinical attachment – and the student wondered how to proceed.

MDU advice

It's not unusual for doctors and medical students to come into contact in a clinical setting with patients they know from a non-clinical context. In these cases, it's important that the doctor or student remains professional and doesn't let any prior knowledge influence their interaction with the patient.

The GMC's publication Achieving good medical practice: guidance for medical students (2016) provides advice which is helpful in the situation described above.

Patients, the GMC and medical schools expect medical students to behave in a professional manner befitting the trust that will be placed in them after graduation.

The medical student was advised to review the relevant sections of the GMC guidance. This included the section on establishing and maintaining partnerships with patients (paras 54-55), which emphasises the importance of treating patients fairly and with respect, and being clear with patients about the role a student will take in their care.

In addition, the MDU adviser suggested that the student review the sections on maintaining patient confidentiality (paras 56-59) as well as the information on social media use.

It was also advised that the student may wish to review any university or medical school policies which may be relevant in this context.

It's important that the doctor or student remains professional and doesn't let any prior knowledge influence their interaction with the patient.

The MDU adviser recommended that the medical student make initial contact with the doctor responsible for coordinating her attachment in order to explain the situation. It was also suggested that she discuss the situation with the consultant responsible for the child's care. Finally, it was suggested that the consultant speak to the child, or the parent with the child's consent – subject to the child being willing to have such a discussion, to make sure that they had no objections to the student being involved in their care.

If any party – doctor, student or patient – felt that the medical student should not have contact with the child in the context of her clinical placement, then this should be respected. Even if it was felt to be appropriate initially, this position could be reviewed as required during the course of the student's attachment.

If all parties were happy for the student to be involved in the usual way as with any patient, any clinical or sensitive information the student learned about the child should remain confidential, and particular care would need to be taken after the attachment ended and the child was discharged, when their previous tutor/pupil relationship would be re-established.

The MDU also advised the student that if the pupil approached her after the placement was over seeking advice about her medical care, the student should explain that she was still a student, not a doctor, and avoid giving medical advice.

This page was correct at publication on 02/07/2018. 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.