1. The following regulations shall govern the procedures in the University to ensure that pre-clinical and clinical medical students are fit to practise medicine.
2. There shall be a Medical Students Register which shall be maintained by the Faculty Boards of Biology and Clinical Medicine through a Fitness for Medical Practice Committee constituted in accordance with Regulation 5.
3. Where there is a question concerning the fitness for practice, through serious ill health or inappropriate conduct, of a medical student, the Committee shall appoint a Fitness for Medical Practice Adjudication Board constituted in accordance with Regulation 12 to consider whether to remove the student's name from the Medical Students Register. The Adjudication Board shall make its recommendations to the Committee.
4. A medical student shall be entitled to appeal to a Fitness for Medical Practice Appeal Tribunal constituted in accordance with Regulation 15 against a decision of the Committee to remove her or him from the Medical Students Register.
5. The Fitness for Medical Practice Committee shall consist of:
6. Members in classes (f)–(h) shall be appointed in the Michaelmas Term to serve for three years from 1 January following their appointment.
7. The Chairman of the Committee shall be appointed from among the members of the Committee in classes (f), (g), or (h) by the Faculty Board of Clinical Medicine.
8. The duties of the Committee shall be
9. The Committee shall meet at least once a year in the Michaelmas Term and whenever there is any business to consider. Five members shall constitute a quorum. The Committee shall submit the minutes of any meeting to the Faculty Boards of Biology and of Clinical Medicine and to the Medical Education Committee.
10. The Committee shall appoint at least ten members of the Regent House to the Fitness for Medical Practice Panel, which shall include but not be limited to members of the Faculties of Biology and Clinical Medicine and persons who are medically qualified, and shall publish annually in the Reporter a list of members of the Panel.
11. Members of the Committee shall not be eligible to serve on the Panel.
12. A Fitness for Medical Practice Adjudication Board shall comprise three members appointed by the Fitness for Medical Practice Committee to consider individual cases for removal from the Medical Students Register and to recommend to the Committee whether a medical student should remain on the Register. The three members shall be chosen from the Fitness for Medical Practice Panel and shall include:
13. No member of an Adjudication Board shall have had any involvement or interest in the case or be a current teacher of the medical student.
14. The Secretary of the medical student's Faculty Board,26 or a nominated deputy, shall serve as Secretary to the Adjudication Board.
15. The Council shall maintain two panels, panel (a) and panel (b) from which members of a Fitness for Medical Practice Appeal Tribunal shall be appointed as follows:
panel (a): |
persons who are legally qualified or who have had experience of acting in a judicial capacity, not being members of the Council; |
panel (b): |
members of the Regent House not being members of the Fitness for Medical Practice Panel or of the Faculties of Biology or Clinical Medicine. |
The Council shall appoint in the Michaelmas Term each year such number of persons as they shall see fit to serve as members of each panel for one year from 1 January following their appointment.
16. A Fitness for Medical Practice Appeal Tribunal shall be appointed to consider any appeal by a medical student against a decision of the Fitness for Medical Practice Committee, and shall confirm, quash, amend, or refer back to the Committee the decision made. An Appeal Tribunal shall consist of three members:
17. No member of a Tribunal shall have had any involvement or interest in the case or be a current teacher of the medical student.
18. The Registrary or a person nominated by the Registrary shall act as Clerk of the Tribunal.
1. The consideration of whether or not a medical student is fit to practise medicine must take place strictly in accordance with the following process which shall consist of three stages, preliminary, investigation, and adjudication.
2. If, at any stage:
3. On receipt of an expression of concern made under Regulation 7 below, and during the proceedings, the Chairman of the Fitness for Medical Practice Committee, following consultation with the relevant NHS Hospital Trust officer or lead general practitioner if appropriate, shall have the authority to decide whether a medical student, who is the subject of an expression of concern, shall:
4. The Chairman may, during the proceedings, review and change a decision regarding a medical student's status.
5. If the medical student is dissatisfied with the decision of the Chairman, the student may request an adjudication by the full Committee. Pending any such adjudication the Chairman's decision shall remain in force.
6. In the event that the Chairman has any involvement or interest in the case arising other than by way of these rules of procedure, the Chairman shall stand down from the Committee while the case is being considered and shall appoint another member of the Committee as Chairman in her or his place; references to the Chairman in these rules of procedure shall be deemed to be a reference to that other member of the Committee.
7. Any expression of concern that a medical student may not be fit to practise medicine shall be made in writing to the Secretary of the Committee; it shall show clearly the author's name and address, and be signed. Anonymous allegations shall not be considered.
8. The Secretary shall inform the Chairman of the Committee of the receipt of any written and signed expression of concern and shall ascertain whether the student has any disability which would affect the procedures to be followed and which would require appropriate steps to be taken to ensure the student is not disadvantaged.
9. Not more than three months after the expression of concern was first made under Regulation 7 above, the Chairman shall determine whether the matter can and should be dealt with informally or whether investigation as set out in Regulations 13–17 below should proceed, and whether any action under Regulation 3 above should be taken. Before the expiry of the three-month period, the Chairman may, having initially determined that the matter should be dealt with informally, subsequently determine that investigation as set out in Regulations 13–17 below should proceed and that action under Regulation 3 above should be taken.
10. If, after appropriate consultation, the Chairman judges that there is a prima facie case of an offence against the discipline of the University, action shall be taken as under Regulation 2(b) above.
11. The Chairman shall determine whether a report should be submitted to the Police.
12. If the University Advocate institutes proceedings against the medical student under Statute B, VI, any subsequent judgement of the University Courts may be considered as evidence within the procedures set out in Regulations 13–36 below. If the University Courts find that a charge is proven against the student then that finding shall be conclusive evidence within the procedures set out in Regulations 13–36 below that the student in question has committed the offence against the discipline of the University with which he or she was charged.
13. When an investigation is initiated, the Secretary of the Committee shall write to the medical student concerned and to the Senior Tutor of the student's College and her or his Tutor, stating that an investigation of the student's fitness for practice is going to take place. The letter to the student shall state the nature of the expression of concern made under Regulation 7 above and the grounds for launching the investigation.
14. The Chairman shall refer the case to an Investigator, chosen from a list of members of the Regent House appointed by the Committee, who has had no previous involvement in this case. The Investigator shall interview the medical student concerned, the maker of the allegation, and any other relevant persons. Notes of these interviews shall be taken and a written report prepared and submitted by the Investigator to the Chairman.
15. During any interview with the Investigator, the medical student may be accompanied by a member of the University or other representative chosen by the student.
16. If the Chairman concludes from the Investigator's written report that there may be a serious issue to be determined concerning the medical student's fitness for medical practice, the Chairman shall refer the matter for adjudication in accordance with Regulations 18–28 below. The Secretary of the Committee shall inform the student and the Student's Senior Tutor and Tutor of the Chairman's conclusion and of the adjudication process.
17. If the Chairman, after consultation with other Committee members if the Chairman so desires, concludes that there is no issue to be addressed, a determination that no further action be taken shall be submitted to the Secretary of the Committee in writing. The Secretary shall inform the student and the student's Senior Tutor and Tutor of the decision. The Chairman's letter to the Secretary shall be submitted to the next full meeting of the Committee.
18. An Adjudication Board of three members, appointed in accordance with Regulations 12–14 of the regulations for the Fitness for Medical Practice Committee, Fitness for Medical Practice Adjudication Board, and Fitness for Medical Practice Appeal Tribunal, shall consider the Investigator's report and shall adjudicate upon the case on behalf of the Committee.
19. The medical student shall be required to attend the meeting of the Board in person. The student and her or his Tutor shall be informed of the details of the meeting in writing, not less than seven days in advance. The letter to the student shall be sent to the student's College and Cambridge residential addresses.
20. If the medical student has good cause to object to the membership of the Board, he or she shall inform the Chairman of the Committee in writing of the details in advance of the meeting of the Board. The Chairman shall consider whether to advise the Committee that the member(s) should be replaced and shall inform the medical student accordingly.
21. If the medical student fails to attend the meeting without reasonable explanation, the Board may consider the case in the student's absence. The Board shall have discretion to decide what constitutes a ‘reasonable explanation’.
22. Members of the University who may have information relevant to the case may be invited by the Board or the medical student to attend the meeting to give evidence. The Board may also call upon other persons (whether or not current members of the University) to provide advice and give evidence on specific aspects of the case in writing or in person.
23. The medical student may choose to be accompanied by any of the following: a ‘friend’ nominated by the student (for example, a relative or student representative); a College representative nominated by the student; a legal representative (at the student's own expense).
24. The medical student's Tutor (or a deputy appointed by the Tutor), if not nominated by the student under Regulation 23, shall be entitled to be present.
25. The meeting shall be held in public unless the medical student requests that it be held in private (in which case the Chairman of the Board shall normally rule that the hearing shall be in private), or unless the Chairman considers that a private hearing would be in the best interests of any person involved, for the whole or a part of the meeting.
26. The Board shall determine its own procedure for the conduct of the meeting. The procedure shall normally include the following:
27. The Board, following consideration of the case, may:
28. The Committee shall make a decision based on the recommendations of the Board and the Secretary of the Committee shall communicate in writing the decision of the Committee to the medical student, to the Senior Tutor of the student's College and her or his Tutor, and to the relevant Faculty Board. No member of the Committee who has had any involvement or interest in the case shall be present when the Committee consider the Board's recommendations or make a decision.
29. A medical student shall have the right of appeal to a Fitness for Medical Practice Appeal Tribunal against a decision of the Committee implementing a category (ii) recommendation or a category (iii) recommendation.
30. A medical student may appeal in writing within twenty-eight days of the notification of the result of the decision to the Secretary to the Committee stating the grounds on which the appeal is made. On receipt of the appeal letter, the Secretary will inform the Registrary who shall appoint a Tribunal to hear the appeal. The medical student shall not be entitled to rely during the hearing, without the permission of the Tribunal, on any grounds other than those in the appeal letter.
31. During the consideration of the appeal, the decision of the Committee shall remain in force.
32. A Tribunal hearing shall be arranged as soon as possible in accordance with the following procedures:
33. The Tribunal shall consider their decision in private. The Clerk of the Tribunal shall be present throughout the hearing and throughout consideration by the Tribunal of its decision.
34. The Tribunal may confirm, quash, amend, or refer back to the Committee the decision of the Committee.
35. The Tribunal shall not confirm a decision implementing a category (iii) recommendation unless they are unanimously satisfied beyond reasonable doubt that the case is proved and that the circumstances of the case require this decision to be taken.
36. As soon as possible, normally within seven working days, the Clerk of the Tribunal shall write to inform the medical student of the decision and the reasons for the decision and inform other parties including: the Chairman of the Committee and the Secretary; the Director of Medical Education and, as appropriate, the Director of Medical and Veterinary Education; the Senior Tutor of the student's College and her or his Tutor.
1. Medical students have a responsibility to report any illness or disability likely to affect their fitness to practise medicine to their Tutor or Director of Studies and, as appropriate, to the Director of Medical Education or Director of Medical and Veterinary Education.
2. The following procedures shall be followed for medical students whose health is considered to make them unfit for medical practice.