Deciding when students are not fit to practise

Medical students are privileged in that they benefit from the generosity of patients who are willing to be questioned and examined when it may not be of direct benefit to them. This is because patients recognise the need to train a future generation and because they trust and respect them by virtue of their status. The more elevated a status, the easier it is for it to be undermined.

So just as a robust disciplinary process is necessary to maintain public confidence in doctors, it is also necessary to justify the trust and respect enjoyed by medical students. Any disciplinary process a medical undergraduate may go through should therefore consider impairment to fitness to practise and be robust enough for its findings to be accepted by the profession's regulatory body. Thus, standard university or college disciplinary processes are no longer sufficient.

The question of medical student fitness to practise has been the subject of careful consideration by a number of jurisdictions. Most Australian states, for example, require medical students to register with their state's medical board.1 Until recently, legislation was being considered which would have enabled the Irish Medical Council to establish a register of medical students.

The Medical Council of New Zealand does not have jurisdiction over its medical students but can register an applicant only if it is sure that, among other things, an applicant has not been convicted of an offence, does not suffer a physical or mental condition which may affect a doctor's ability to practise, or is not under investigation or the subject of an order of a professional disciplinary tribunal.2 Its medical school disciplinary procedures are correspondingly robust. In the United …