Gateways guidance: 8. Confidentiality and disclosure

Although there is no legal duty on applicants to disclose their impairment, they should be encouraged to do so in order that reasonable adjustments can be made.

When completing the application forms, applicants should be invited to disclose their impairments, and be told why they are being asked. It should be made clear that it will have no effect on the decision of interview panels, but is simply to inform the school of their requirements for the interview and for assessment of the need for reasonable adjustments to be made if a place is offered. Some students already have confidence in declaring their impairment:

1. ‘I have a relatively hidden disability (brittle bone disease). I have always declared my condition on any forms I have filled in which required me to do so.’
2. Medical student

Medical schools should therefore be proactive in encouraging applicants to disclose an impairment. This might involve:

• asking applicants to declare their disabilities on application and enrolment forms
• publicising the provisions made for disabled students, or providing opportunities for students to tell tutors or disability officers in confidence
• defining competence standards against which all applicants can measure themselves
• asking students once they are on the course whether they need any specific arrangements because of a disability
• explaining to students the benefit of disclosure and how this information will be kept confidential.

It is also important to ensure that the atmosphere and culture are open and welcoming so that disabled people feel safe to disclose an impairment or health condition. This might include the assurance that support is available for students who experience discrimination from hospital or primary care staff, patients or carers.

Encouraging applicants to disclose an impairment or health condition requires a confidentiality policy to ensure that the information will not be misused, and to give applicants confidence in the system.

1. ‘Many people with a mental illness do not regard themselves as disabled...If these students are to disclose their disability, the inclusion of mental illness needs to be spelt out. It needs to be made clear that disclosure is necessary so that support can be provided, and that they will not be penalised. Disclosure is much more difficult for mental health disabilities than for physical disabilities due to the stigma which unfortunately is still very prevalent.’
2. Member of Doctors' Support Network

Where information on disabled students may come through different channels, there must be a suitably confidential means to bring the information together.

A disabled student has the right to ask that the existence or nature of their impairment or health condition is treated as confidential. In determining whether it is reasonable to make an adjustment, the medical school must consider how far making the adjustment is consistent with a disabled person’s request for confidentiality. It is possible to share information with staff, with a disabled student's permission, that identifies the reasonable adjustment and not the impairment.

The school’s confidentiality policy should be stated and circulated to all applicants and staff. It should be made clear how the information will be used and treated, and what are the consequences of contravening the policy.