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Table 2: Outcomes of an investigation or fitness to practise committee or panel

This list is not exhaustive, but highlights factors to consider. Sanctions (conditions, suspension or expulsion) may be appropriate when most or all of the factors listed are apparent. To keep the terminology simple, references to panel in this table mean a fitness to practise panel or committee.

< Expulsion from medical course                  Reviewing a student’s fitness to practise following a sanction >  

No action

Possible outcome of investigation or panel:

  • The student’s fitness to practise is not impaired.
  • There is no risk to patients or to public confidence.
  • The student has insight into any medical condition.
  • In cases of health, the student is seeking appropriate treatment, following the advice of the people treating them, and adjusting their studies appropriately.
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Warning

Possible outcome of investigation or panel:

  • The student’s fitness to practise is not impaired.
  • Their behaviour does not present a risk to patients or to public confidence.
  • The student’s behaviour raises concern and is a significant deviation from expected standards.
  • The concerns are serious enough that if there were a repetition, it would be likely to result in a finding of impaired fitness to practise.
  • The concern warrants a formal recording to help identify repeat behaviour.
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Referral to fitness to practise panel

Possible outcome of investigation only:

  • The student’s fitness to practise may be impaired.
  • The breach of professional values is serious and may present a risk to patients or to public confidence.
  • The student does not show insight into the situation.
  • The student is likely to repeat the behaviour.
  • There is evidence that the student is inherently incapable of following good practice and professional values. For example, they have received previous warnings or are in breach of agreed conditions or undertakings.
  • A decision maker decides that the evidence is sufficient to put before a fitness to practise panel.
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Undertaking

Possible outcome of investigation or panel:

  • The student’s fitness to practise is impaired.
  • The proposed undertakings offer sufficient safeguards to protect patients and the public.
  • The student has shown genuine insight into their problems and wants to resolve them.
  • The student is already seeking help and support that would comply with any conditions the medical school may wish to impose.
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Condition

Possible outcome of panel only:

  • The student’s fitness to practise is impaired.
  • The conditions will protect patients during the time they are in force.
  • The student has shown sufficient insight, and is willing to respond positively to support and conditions.
  • There are identifiable areas of the student’s studies in need of further assessment or remedial action.
  • The student has genuine insight into their health problem, is aware of compliance with the guidance on health and has agreed to abide by conditions relating to their medical condition, treatment and supervision.
  • Patients will not be put in danger either directly or indirectly as a result of the conditions.
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Suspension

Possible outcome of panel only:

  • The student’s fitness to practise is impaired.
  • The breach of professional values is serious, but not fundamentally incompatible with the student continuing on a medical course – expulsion not justified to protect patients and the public. But, given the seriousness, any sanction less than suspension would not be in the public interest.
  • The student’s judgement may be impaired, in cases that relate to the student’s health, and there is a risk to patient safety if the student were allowed to continue on the course even under conditions.
  • There is no evidence that the student is inherently incapable of following good practice and professional values. For example, they have not received previous warnings, nor are they in breach of agreed conditions or undertakings.
  • The panel is satisfied the student has insight and is not likely to repeat the behaviour.
  • There will be appropriate support for the student when they return to the course.
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Expulsion

Possible outcome of panel only:

  • The student’s fitness to practise is impaired.
  • The student has done serious harm to others, patients or otherwise, either deliberately or through incompetence, particularly when there is a continuing risk to patients.
  • The student has shown a reckless disregard for patient safety.
  • The student has seriously departed from the principles set out in Outcomes for graduates (Tomorrow’s Doctors) and Achieving good medical practice: guidance for medical students.
  • The student has behaved in a way that is fundamentally incompatible with being a doctor.
  • The student has committed offences of a sexual nature, including involvement in child pornography.
  • The student has violated a patient’s rights or exploited a vulnerable person.
  • The student has abused their position of trust.
  • The student has committed offences involving violence.
  • The student has been dishonest, including covering up their actions, especially when the dishonesty has been persistent.
  • The student has put their own interests before those of patients.
  • The student has persistently shown a lack of insight into the seriousness of their actions or the consequences.
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