The Council have considered the remarks made at the Discussion on 9 November 2004 of the Joint Report of the Council and the General Board on procedures of dealing with questions of fitness to practise medicine of medical students (Reporter, p. 203).
The Director of Medical Education in the Faculty of Clinical Medicine and the Director of Medical and Veterinary Education in the Faculty of Biology have been consulted, and this reply draws on their advice.
The Council now make the following comments:
1. It is important to realize that the circumstances dealt with are, in principle, matters which are not covered by the University's general disciplinary regulations. That is why there is a need for a special procedure.
2. The Council recognize that there could be circumstances in which it would be appropriate for the Proctors to be involved, especially if a matter appears prima facie to be a breach of the general disciplinary regulations. However, the circumstances which may arise in relation to fitness to practise medicine are very much wider than those and there is certainly no need for the Proctors always to be involved. The same applies in relation to the University Advocate. However, the regulations need to deal specifically with the University Advocate (the independent prosecuting authority in respect of possible prosecution of University disciplinary offences), in order to ensure the primacy of the University's disciplinary regulations over the issue of fitness to practise, and to protect the statutory duty of the University Advocate (under Statute A, VI, 28) to consider every complaint against a person who comes within the jurisdiction of the University Tribunal or the Court of Discipline. On receipt of a complaint of an alleged disciplinary offence, the Advocate may need to call on the Proctors for the purpose of investigation, and no change is proposed to that arrangement.
3. Professor G. R. Evans suggested that standing to take academic examinations might be affected by decisions taken under the fitness to practise procedures. Candidature for Tripos examinations is not affected by removal from the register for medical students. While it is true that standing for M.B., B.Chir. Degrees would be affected by an adverse decision as to registration, it is possible for a student to apply for re-registration, and indeed admission to another medical school.
4. Decisions arrived at under the fitness to practise procedures are, indeed, highly significant for the individual and that is why the two Faculty Boards have proposed that they should be spelled out in detail, with the safeguards set out in the detailed procedure, including an appeal stage. It should be pointed out that in principle a decision reached at appeal may be reviewable by the Commissary under Statute D, and probably also by the national Independent Adjudicator for Student Complaints when that jurisdiction is brought into effect.
5. Professor Evans suggested that the present Report suggests that student complaints and general disciplinary procedures are in some way defective. This does not seem to the Council to be the case. The new procedures are needed because the practice of medicine imposes additional requirements on medical students. The Council do, however, expect to review the existing procedures for student complaints generally with a view to simplification, when the jurisdiction of the national Independent Adjudicator comes into effect.
The Council have therefore submitted a Grace for the approval of the recommendations of this Report (Grace 1, p. 294).