Professional behaviour and fitness to practise

About this guidance

The General Medical Council (GMC) and the Medical Schools Council (MSC) have published this document to give high-level guidance about managing processes for professionalism concerns and fitness to practise in medical schools and universities. You should read it together with Achieving good medical practice: guidance for medical students, which outlines the standards of professional behaviour expected of medical students.

You may also find it helpful to read Supporting medical students with mental health conditions and Welcomed and valued, which give guidance on how schools can support students with mental health conditions and disabilities, with additional resources to support the use of this guidance in practice.

What does this guidance cover?

The GMC and the MSC, referred to as ‘we’ and ‘us’ in this document, have produced this guidance. It is aimed at medical school and university staff, and at placement provider organisations, who identify, manage and support students whose professionalism or fitness to practise is a cause for concern. This guidance will also be useful for anyone involved in fitness to practise investigations and hearings, and for those involved in making decisions about student fitness to practise.

Medical students are working towards joining the medical profession. Their studies will put them in contact with patients and members of the public, who may often be vulnerable.

Because of this, we expect medical students to display standards of professional behaviour that are different from those expected of other students not training to join a regulated profession. Meeting these standards is a requirement for graduation with a primary medical qualification. This guidance only applies to medical students. Once a doctor is registered their fitness to practise is monitored by the GMC.

Medical schools are responsible for giving their students opportunities to learn, understand and practise the standards we expect of them. To support this, we have produced Achieving good medical practice: guidance for medical students – a guidance document for students that outlines the standards of professional behaviour expected of them. Medical schools are reminded that fitness to practise should be just part of how they make sure their students become excellent professionals. Education and training on professionalism are also important.

When a medical student’s conduct or health becomes a cause for concern, it is essential that they get the appropriate support and guidance to continue their studies. But some concerns can’t be remedied with support, so medical schools and universities must have a process in place to identify and deal with students whose conduct or health is such that their fitness to practise may be impaired.

Using this guidance

In this guidance, we use the terms ‘you must’ and ‘you should’ in the following ways.

  • ‘You must’ is used for an overriding principle.
  • ‘You should’ is used when we give an explanation of how you can meet an overriding principle.
  • ‘You should’ is also used where the principle will not apply in all situations or circumstances, or where there are factors outside your control that affect whether or how you can follow this guidance.

This guidance aims to give medical schools and universities a consistent framework for addressing health and behaviour concerns in medical students. Medical schools and universities will also have their own local procedures that are appropriate for their size and governance structure, and they must follow these procedures.

Local procedures and practices should reflect the information given in this guidance. Any deviation from the medical school or university’s own procedures or this guidance should be justifiable and the reasons for any deviation documented.

In relation to the GMC’s statutory role, this guidance is advisory rather than mandatory. However, GMC quality assurance reports on medical schools may recommend that they comply with this guidance or may commend an institution for good practice. Also, given that the GMC has to be satisfied that graduates applying for registration with a licence to practise are fit to practise, it would be surprising if a medical school thought it sensible to disregard this guidance.

How can medical students use this guidance?

Although this guidance is mainly aimed at medical schools and universities, medical students may also find it useful. It can help them to understand how medical schools and universities deal with professionalism concerns and fitness to practise issues. Students should also look at their own medical school or university processes for guidance on local procedures and practices.

Medical schools and other stakeholders – including medical students – were consulted as part of the development of this guidance, and medical schools gave valuable input to the pre-consultation development of this guidance.