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Table 1: Reasons for impaired fitness to practise in medical students

The reasons for impairment are set out at Section 35C (2) of the Medical Act 1983 (as amended). There are six reasons why the fitness to practise of a fully or provisionally registered doctor may be impaired. Two of these – deficient professional performance and not having the necessary knowledge of English – are not included in the table because they are unlikely to be addressed by the medical school or university student fitness to practise process (see paragraphs 13 and 15).

Note: this list of impairments is not exhaustive.


Misconduct - this includes issues that raise a question about a student’s honesty, trustworthiness or character

Key areas of concern Examples of behaviour
Cheating or plagiarism
  • Cheating in examinations
  • Signing peers into taught sessions from which they are absent
  • Passing off the work of others as your own
  • Sharing with fellow students or others details of tasks in questions from exams you have taken
  • Forging a supervisor’s signature or feedback on assessments, logbooks or portfolios
  • Falsifying feedback on assessments, logbooks or portfolios
Dishonesty or fraud, including dishonesty outside the professional role
  • Falsifying research
  • Committing financial fraud
  • Creating fraudulent CVs or falsifying other documents
  • Misrepresentation of qualifications
  • Failure to declare relevant misconduct issues to medical school or university
  • Wilful withholding or misrepresentation of health issues (eg blood-borne viruses)
Drug or alcohol misuse
  • Driving under the influence of alcohol or drugs
  • Abusing prescription medication
  • Alcohol consumption that affects clinical work, the work environment, or performance in the educational environment
  • Dealing, possessing, supplying or misusing drugs, even if there are no legal proceedings – this may include legal highs
  • A pattern of excessive misuse of alcohol
Aggressive, violent or threatening behaviour
  • Assault
  • Physical violence
  • Bullying
  • Harassment
  • Stalking
  • Online bullying or trolling
Failing to demonstrate good medical practice
  • Misuse of social media
  • Breach of confidentiality
  • Misleading patients about their care or treatment
  • Culpable involvement in a failure to obtain proper consent from a patient
  • Sexual, racial or other forms of harassment
  • Inappropriate examinations or failure to keep appropriate boundaries in behaviour
  • Unlawful discrimination
Persistent inappropriate behaviour
  • Uncommitted to work or a lack of engagement with training, programme of study or clinical placements
  • Neglect of administrative tasks
  • Poor time management
  • Non-attendance
  • Poor communication skills
  • Failure to accept and follow educational advice and unwillingness to learn from feedback given by others
  • Being rude to patients, colleagues or others
  • Unwillingness to learn from constructive feedback given by others
  • Being disruptive in teaching sessions or the training environment
  • Challenging behaviour towards clinical teachers or not accepting criticism
  • Failing to answer or respond to communications

Conviction or caution

A conviction or caution in the British Isles for a criminal offence (or a conviction elsewhere for an offence that would be a criminal offence if committed in England or Wales)*

* Note: Medical schools can still take action in the light of any misconduct, even if there is no criminal caution or conviction relating to any of these matters

Key areas of concern Examples of behaviour
Any conviction or caution
  • Possessing, dealing or supplying illegal drugs
  • Theft
  • Physical violence
  • Fare avoidance
  • Financial fraud
  • Child pornography
  • Child abuse or any other abuse
  • Sexual offences


Adverse physical or mental health

Key areas of concern Examples of behaviour
Health concerns and insight or management of these
  • Failure to seek appropriate treatment or advice from an independent and appropriately qualified healthcare professional
  • Failure to follow the requirement to tell your medical school or university if you have a serious health condition
  • Refusal to follow medical advice or care plans, or to comply with arrangements for monitoring and reviews
  • Failure to comply with reasonable adjustments to ensure patient safety
  • Failure to recognise limits and abilities or lack of insight into health concerns
  • Failure to be immunised against common serious communicable diseases (unless contraindicated)

Determination of impaired fitness to practise

A determination by a body in the United Kingdom responsible under any enactment for the regulation of a health or social care profession to the effect that the person’s fitness to practise as a member of that profession is impaired, or a determination by a regulatory body elsewhere to the same effect

Key areas of concern Examples of behaviour
A determination, regardless of whether or what sanction was imposed
  • A finding of impairment of fitness to practise by a health or social care regulatory body
  • A previous finding of impairment of fitness to practise by a university or medical school that was not disclosed on application for admission