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How does health relate to student fitness to practise?

The key point is that a health condition alone is not a fitness to practise issue. As we say in the student fitness to practise guidance, in most cases, health conditions and disabilities do not affect a medical student’s fitness to practise, as long as the student:

  • demonstrates appropriate insight
  • seeks appropriate medical advice
  • complies with treatment.

The issue escalates into fitness to practise when a student doesn’t demonstrate insight into their condition, or compromises patient safety by not following medical advice.

Showing insight into health issues

Part of showing insight into their condition is the student being open and honest with their medical school, and seeking appropriate support / medical advice. This is also outlined in the guidance under the key areas of professionalism concern, showing reasons for impaired fitness to practise in medical students (under ‘Health concerns and insight or management of these’).

The main thing for students to do is to share information with their medical school and see what support they can access. We and medical schools understand that students may go through difficult periods with physical or mental health issues during their time at university. Everyone’s aim is for the students to excel in their studies, and the medical school / university has a lot of support systems in place to help students as much as possible, whatever the issue they are facing. These include personal tutors, student health services, occupational health, student advice centre, confidential counselling etc.

We hope the practical advice on Your health - dos and don’ts is helpful for medical students, and we have also developed a case study on personal health as an additional resource.

Fitness to study

On a separate note, when a student has a medical problem, it’s important for medical schools to consider their fitness to study – whether they are well enough to participate and engage in their programme. The Higher Education Occupational Physicians group publishes fitness to train standards for medical students on its website.

Removing a student from the course on health grounds

In exceptional circumstances, medical schools can remove students from the course if they if they consistently fail to manage their health condition, have a lack of insight into the impact their health has on others, or consistently fail to follow the advice of their treating physician. It is important to note that in this case it is not the health condition that leads to exclusion but rather the student’s behaviour in relation to their health condition that would lead to exclusion.

Medical schools can also remove students from the course if they have a health condition or disability that means they will not be able to meet the outcomes of undergraduate medical education. This is a different situation from the management of the condition, and the views of occupational health physicians and other specialists will be crucial in supporting medical schools to make this decision.

This is not the same as erasing someone from the register, as it does not prevent a student from being able to apply to re-join another medical course in the future. The guidance has a section dedicated to the exceptionally rare occasion where a student is expelled on health grounds.