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Students who study on medical and healthcare programmes are required to demonstrate high standards of conduct and behaviour and must be physically and mentally fit to undertake the demands of their profession. This is because your studies will bring you into contact with patients and members of the public who may often be vulnerable. As you are working towards joining a registered profession, your behaviour at all times, both in the clinical environment and in your personal life, must justify the trust that patients and the public place in you as a future medical or healthcare professional. You must use your judgement in applying the principles set down by your professional regulator and be prepared to justify your decisions and actions.

From the outset of your course, you will start to learn the laws, regulations and guidance relevant to your practise as well as the skills and knowledge you will need to treat patients. The university will support you in your journey from student to practitioner. Occasionally, however, concerns may arise which cannot be remedied through support or remediation and universities must have processes in place to identify and handle students whose conduct or health raises concern about their fitness to study or practise.

The Procedure for Consideration of Fitness to Study or Practise (PDF) sets out the process by which St George’s will consider such matters.

What you need to know

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Initial (informal) stage (paragraph 2)

If concerns are raised about a student’s conduct, health, professionalism (including attendance and communication) or failure to progress academically, the student may be referred by their course director to the Student Progress Monitoring Committee (SPMC).

What is the SPMC?

The SPMC meets on a termly basis (November, February and May) to monitor the progress and status of students on all programmes of study with academic progress, conduct or health concerns. The Committee is made up of a number of internal and external members, including Course Directors, and acts in an advisory capacity to manage concerns about individual students which Course Teams have not been able to be contain within the course systems for monitoring low-level concerns (eg meeting with senior staff, progress meetings) or through routine access to health or support services.

These meetings may also discuss any drug or alcohol-related concerns. See the Drug and Alcohol Policy.

What do the SPMC do?

The Committee represents the informal stage of considering a student’s fitness to study or practise. The Committee discusses whether any further support is available to help manage concerns relating to health and personal circumstances or whether any intervention is necessary to highlight the need for an immediate improvement in professional behaviour.

After each meeting, the Dean for Students and/or the Student Conduct and Compliance Team will write to individual students, setting out the concerns that were discussed and the proposed informal resolution the Committee would like to agree with the student. The student will be asked to confirm in writing whether they agree to the proposed action(s) – known as making an undertaking ‘formal promise’ - within 10 days of receiving the letter. Where an agreement is not received, it will be deemed that the matter has been unable to be resolved informally and a referral will be made to the secondary (formal) stage of the Procedure for consideration of Fitness to Study or Practise.

Students who do not receive a letter from the Dean for Students and/or the Student Conduct and Compliance Team have been reported by their Course Director or Occupational Health to a) be making satisfactory progress or b) to be adhering to previous undertakings.

Occasionally, the SPMC may decide that concerns are too serious to be dealt with at an informal level, concerns are escalating or that earlier interventions have not been successful (a pattern of behaviour is emerging). In these instances, the SPMC will make a recommendation to the Course Director that matters are escalated for investigation under the secondary (formal) stage of the Procedure for Consideration of Fitness to Study or Practise.

Secondary (formal) stage (paragraph 3)
3.1 - Appointment of Investigating Officer

The secondary (formal) stage begins with the appointment of an independent Investigating Officer. Students will be informed in writing that the formal stage of the procedure has been invoked and the specific nature of concerns/allegations that have led to the investigation.

The Investigating Officer will collect and consider the evidence, allow the student the opportunity to respond to the allegations and produce a report of their findings with a recommendation for further action. The student will receive a copy of the report.

At each stage of the process, information, options and action points will be clearly communicated to the student in writing and reference will be made to procedural timescales.

3.2 – Referral to Hearing Committee

Not every investigation will result in a student being referred to a Hearing Committee. Where a student is referred to a Hearing Committee by the Investigating Officer, the date will be notified well in advance to allow ample time to prepare for the hearing and seek support and advice. St George’s will send written notice to the student and the student will be asked to provide a written response to the St George’s case.

The Hearing Committee will be made up of internal and external academic and clinical staff and a student representative. These individuals will have not been involved in the consideration of the case at an earlier stage. On the day of the Hearing Committee, the student can be accompanied by a person of their choice. During the hearing, both parties will be able to present their case to the Committee and the Committee will be invited to ask questions in accordance with the Running Order.

The decision of the Hearing Committee and their reasoning for the decision will be communicated to the student within 10 working days of the hearing in the form of a formal report.

Appealing the outcome

Under the terms of the Procedure, students have the right to appeal an outcome under certain circumstances. The process for this is outlined in paragraph 4 of the Procedure.

Support and advice

The Vice President for Education and Welfare is able to meet with students to guide them through the operation of the student procedures and provide general advice and support.

All St George’s students can access an external online support service called Togetherall. This service is available 24/7 and is completely anonymous. They also offer a number of self-guided support courses. More information about Togetherall can be found on the University’s Togetherall webpage and in the following resources:

The different regulatory bodies have also issued guidance that students who find themselves under a Fitness to Study or Practise investigation can utilise:

General Medical Council (GMC)

The GMC set the standards and outcomes for medical education in the UK. Medical students are studying to join a trusted profession that will bring them into contact with patients and members of the public. Because of this, they must demonstrate a high standard of behaviour at all times, which justifies the trust placed in them as a future member of the medical profession. Medical schools and universities must have a process to identify and deal with students whose fitness to practise may be impaired.

The GMC and the Medical Schools Council (MSC) have released some myth busters on student fitness to practise. These are addressed to medical students and they dispel some common misconceptions about student fitness to practise. For example, the myth that students should not tell their schools about a health concern, or that students often get expelled through student fitness to practise procedures. Medical students were involved in the development of the content through the GMC’s Student Voice Group.

The myth busters add to the existing resources to support the guidance that was jointly produced by the GMC and the MSC in 2016, on student professionalism and fitness to practise. Other resources include case studies, FAQs, ‘thought pieces‘ and teaching resources developed by medical students.

Nursing and Midwifery Council

The Nursing and Midwifery Council are the regulator for all nurses and midwives in England, Wales, Scotland and Northern Ireland. They set standards for education, training, conduct and performance.

As future nurses and midwives, The Code details the professional standards that nurses and midwives are expected to uphold whilst practising and being registered in the UK.

Health and Care Professions Council (HCPC)

The HCPC keeps a register of health and social care professionals who meet the required standard for training, professional skills, behaviour and health. The HCPC currently regulate the following professions: arts therapists, biomedical scientists, chiropodists/ podiatrists, clinical scientists, dietitians, hearing aid dispensers, occupational therapists, operating department practitioners, orthoptists, paramedics, physiotherapists, practitioner psychologists, prosthetists / orthotists, radiographers, social workers in England and speech and language therapists.

The HCPC has produced Guidance on conduct and ethics for students (PDF) and Guidance on health and characterwhich provide information on standards of conduct, performance and ethics.

Royal College of Occupational Therapists (RCOT)

The RCOT have published their professional standards for occupational therapy practice, conduct and ethics and the second edition of the Career Development Framework.

These essential resources support occupational therapists at every stage of their career to help them provide the highest quality care.

They will also support occupational therapists in meeting the mandatory requirement to develop knowledge and skills by engaging in continuous professional development.

Fitness to practise and criminal matters
Declaring investigations by a third party, cautions, convictions and charges

Students are required, under the university’s general regulations, to self-disclose any change to their criminal record status without delay to the Registry via the Student Conduct and Compliance Team. The online enrolment process takes place around August/September each year. During re-enrolment, students agree to the following:

  • I undertake to notify the Registry should any incident occur that may reasonably be regarded as preventing me from working with children or vulnerable adults during the remainder of my training.

  • I undertake to notify the Registry should I be subject to any further criminal convictions (this includes spent convictions), bind overs, cautions, investigations or other findings or orders of a criminal nature.

  • I agree to St George’s requesting a further enhanced DBS check if it is considered necessary and that I will be liable for the cost of the check.

  • I understand that continued registration on the programme of study is dependent on fulfilling this requirement and that failure to comply with this requirement would be addressed as a disciplinary or fitness to practise issue in line with university policies and procedures.

If during your time at St George’s you are accused of, convicted or charged with an offence, you must declare this immediately to the university by contacting the Academic Registrar and Head of Student Conduct and Compliance via email. Do not wait until the point of re-enrolment to disclose that you are under police investigation or that there has been an alteration to your criminal record status.


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