Professional behaviour and fitness to practise

When should students be given pastoral care and student support?

  1. Giving support to students is pivotal in helping to prevent issues of behaviour or health becoming more serious and a greater cause for concern*. Students may be affected by many issues during their time at medical school, including health, financial and family or other social issues. Medical schools should be aware that overseas medical students may have particular support needs due to their unfamiliarity with their new home and work environment. When concerns arise, medical schools should give their students access to appropriate support and adjustments to help manage these issues**.
  2. It’s important that support is made available to students who are going through formal fitness to practise procedures. Written procedures should also include the requirement to give support to students from the outset of the process.
  3. Medical schools should give their students clear information about the range and type of support services available. Staff should be aware of the details of what support is available and direct students to an appropriate service if necessary.
  4. Support services may include:
    • student health services (including mental health)
    • disability support services
    • occupational health services
    • confidential counselling services
    • support services through the student union – this may include peer support, and financial, housing and legal help or advocacy
    • personal tutors.

    Medical schools may also wish to signpost students to medical defence organisations who can support students through fitness to practise processes.

Working together and sharing information

  1. Medical schools should foster an open, transparent and supportive environment and encourage students to discuss problems openly with appropriate staff. There should be named or dedicated staff in the faculty so that students know whom they can go to for advice and support, in addition to their own personal tutor. Staff and students should work together to address any issues, wherever possible.
  2. There may be circumstances where information will need to be shared with relevant staff so they can provide support – but this should be done with the student’s consent. Staff should make clear to students that information may be shared without their consent in limited circumstances – if there is a potential risk to colleagues, patients or the student themselves.
  3. In such circumstances, disclosure of information should be limited to that which is relevant to the issue and should only be shared with those who have a legitimate need to know. This duty to share information in limited circumstances applies to medical school and university staff, and to independent practitioners who provide support services.
  4. Medical schools should make sure they regularly review the support a student is getting. They should monitor whether the support is helping to address the issues the student has, and find out what else, if anything, needs to be done.
  5. It is very important for the wellbeing of students that pastoral care and academic progress are kept separate where possible. Staff involved in making decisions on a student’s academic progression should not provide pastoral care.
  6. The GMC and the MSC have jointly produced guidance for medical schools and medical students on Supporting medical students with mental health conditions.The guidance also sets out some general principles medical schools can use to support students with physical health issues.

*See Promoting excellence Standard S3.1.

**See Welcomed and valued for guidance on how to support disabled learners.