FMHS Fitness to Practise Procedures

Application

Health professional students and staff members of the Faculty of Medical and Health Sciences at the University.

Note - The fitness to practise regime applies to health professional students whether they are on campus, on placement or elsewhere.

Purpose

To detail the procedures to be used when dealing with issues concerning a health professional student's fitness to practise.

Procedures

Scope

1. The FTP Policy and the FTP Procedures encompass fitness to practise concerns in three areas:

Health or personal issues

Health or personal issues that may affect a student’s future ability to practise as a health professional, include issues such as (but not limited to):

  • mental health issues
  • physical impairment
  • transmissible blood-borne viral infections
  • drug and alcohol issues

Note 1 - Such issues are likely to affect a student’s studies, progression or career pathways; expose the student, patients or staff members to potential risk, and/or expose the faculty or partner organisation to potential risk.

Note 2 – The issues may have different impacts depending on the discipline.

Professional attitudes and behaviours

Issues of concern relating to professional attitudes and behaviours during the programme include issues such as:

  • plagiarism
  • poor attendance
  • inappropriate behaviour
  • contravention of significant aspects of policy or protocol e.g. sensitive examinations

Note - Such issues may involve a single serious incident or involve a series of minor concerns which may or may not be related.

Issues external to the programme

Issues of concern regarding the actions of students occurring outside the programme, include a student committing a criminal offence. Where a student is convicted, is granted a discharge without conviction or is granted diversion by the police with regard to such an offence, the student must disclose this information to the head of programme.

Note - Such offences include drink driving and drug offences. A discharge without conviction usually requires a plea of guilty to be entered prior to being granted to indicate acceptance of responsibility for the commission of the offence. Diversion will usually require an acceptance of responsibility before being granted by the police.

Classification of issues

2. Fitness to practise issues are to be classified into one of three groups, according to the features applicable to each category:

Non-critical

Non-critical issues are those that raise concerns about future fitness to practise that would best be dealt with through support and counselling.

Note - Examples would include poor attendance, some lesser types of inappropriate behaviour.

Critical

Critical issues are those that raise more significant concerns regarding a student's future fitness to practise.

Note - Examples would include dishonesty, serious health issues (persistent or serious), significant contravention of a policy, drug and alcohol abuse.

Three repeated non-critical concerns will usually escalate to ’critical’.

Extraordinarily critical

An extraordinarily critical issue is an event giving rise to the need for immediate action because of the likelihood of significant harm, either involving a student, or resulting from the action of a student.

Referral process and disposal of issues relating to fitness to practise

General

3. Any concern about a student's fitness to practise that comes to the attention of a staff member must be reported in writing and dealt with in accordance with these procedures.

4. The fitness to practise process is to be commenced by referral through different pathways depending on the nature of the concern, the classification of the issue and its criticality.

Note - Guidance as to the classification of fitness to practise issues is provided in the FTP Guidelines.

It is anticipated that most referrals of a health professional student will come from a programme year co-ordinator, director of student affairs or head of department, but any academic staff member of FMHS may refer a health professional student to the fitness to practise process.

  • A student may make referrals, but only to the director of student affairs or programme year co-ordinator.

Note - Programme year co-ordinator includes a phase director in the medical programme.

  • Health professional students are encouraged to self-refer to the fitness to practise process
  • Anonymous referrals of a student for fitness to practise consideration will not be considered
  • A fair process is to be followed when dealing with all fitness to practise issues

Note - Guidance as to what constitutes a 'fair process' is provided in the FTP Guidelines.

5. Where a fitness to practise issue involves a MAPAS student, the head of TKHM is to be consulted with throughout the fitness to practise process, as appropriate in the circumstances.

Health and personal issues

Referral

6. The matter is to be referred to the director of student affairs, who will assess, in the first instance, whether the concern about a student's health or personal issue is potentially non-critical, critical or extraordinarily critical. In carrying out this assessment, the director of student affairs may take advice, including from the chair of the FTP Committee.

7. Where the student's health or personal issue appears to be extraordinarily critical, the director of student affairs must refer the matter directly and immediately to the deputy dean and to the relevant head of school/head of medical programme.

Note – As the medical programme is provided by three schools (School of Medicine, School of Medical Science and School of Population Health) where any fitness to practise matter involves a student in the medical programme, the head of the medical programme and the head of school will be involved.

Action

8. Where the student's health or personal issue is assessed by the director of student affairs to be either non-critical or critical, the student will devise an action plan addressing the concerns, to be agreed with the director of student affairs and the programme year co-ordinator and/or the head of school/head of medical programme, as appropriate in the circumstances.

9. Where the deputy dean considers that the student's health or personal issue is extraordinarily critical, the deputy dean may suspend the student from lectures, classes and any clinical attachment. In such case the head of school/head of medical programme is to ensure that the relevant course co-ordinators are informed that the student will not be attending the components of the programme specified.

Note - Suspension from the programme will lead automatically to withdrawal from any clinical attachment.

Anticipated outcomes

10. Where the student's health or personal issue of concern is non-critical, it is anticipated that the agreed plan of action will deal with the concerns relating to the student's fitness to practise, and that the student will be able to continue with their study in the programme. Such an outcome is also anticipated where the student's health or personal issue of concern is critical, however, in some such cases, it may be agreed by the director of student affairs and the head of school/head of the medical programme that the student may take a period of leave from study. Such leave requires approval under the applicable programme regulations.

11. For critical health and personal concerns, the head of school/head of medical programme may form the view at any point prior to the agreement of an action plan or during the period of an action plan that a student has persistent or serious health or personal issues that are likely to affect adversely the student's fitness to practise. Where the head of school/head of the medical programme forms this view, the head of school/head of the medical programme may interview the student with a view to encouraging the student to withdraw from the programme and advise the student to notify the relevant health profession authority. Where the student elects to withdraw from the programme, the head of school/head of the medical programme may also recommend that the dean notify such authority. In the event that the student does not withdraw from the programme voluntarily, the head of school/head of the medical programme must refer the matter to the chair of the FTP Committee.

12. Where the student's health or personal issue is considered to be extraordinarily critical, the head of school/head of medical programme must refer the matter immediately to the chair of the FTP Committee.

13. The full process for dealing with fitness to practise concerns relating to health or personal issues is shown in matrix form at Table 1 below.

Note - the requirements for record keeping and reporting of fitness to practise matters are dealt with in the table.

14. Guidance for dealing with fitness to practise matters relating to a student's health and personal issues is provided in the FTP Guidelines.

Table 1: Health or personal issues

Extraordinarily critical

For extraordinarily critical health or personal issues

Refer to: Deputy Dean and head of school/head of medical programme
Action: Suspension from the programme, including withdrawal from clinical attachment, or refer matter to chair of FTP Committee
Anticipated outcomes: Resolution by FTP Committee panel
Record keeping and reporting: FTP Committee panel decision/recommendation to dean and dean's decision recorded in student file

  Non-critical Critical
Refer to Director of student affairs Director of student affairs
Action Student to devise an action plan to be agreed with director of student affairs and the relevant programme year co-ordinator and/or head of school/head of the medical programme Student to devise an action plan to be agreed with director of student affairs and the relevant programme year co-ordinator and/or head of school/ head of the medical programme(unless issue is persistent or serious)
Anticipated outcomes Student may continue with their study Student may continue with their study or defer. If persistent or serious:interview regarding withdrawal  with head of school / head of the medical programme OR refer to chair of FTP Committee
Record keeping and reporting Report and notes kept on student file(Report held confidentially by director of student affairs in case of illness) Report and notes kept on student file(Report held confidentially by director of student affairs in case of illness)

Professional attitudes and behaviours

Referral

15. Any concerns about a student's professional attitudes or behaviours are to be referred to the programme year co-ordinator who will assess, in the first instance, whether such concerns are potentially non-critical, critical or extraordinarily critical. In carrying out this assessment, the programme year co-ordinator may take advice, including from the head of school/head of the medical programme.

16. Where the student's professional attitudes or behaviours are considered to be extraordinarily critical, the programme year co-ordinator must refer the matter immediately to the deputy dean and head of school/head of the medical programme.

Action

17. Where the student's professional attitudes or behaviours are determined by the programme year co-ordinator to be non-critical, the student will be given remediation advice and guidance.

18. Where the student's professional attitudes or behaviours are considered to be critical, the head of school or head/head of the medical programme will ensure that the matter is investigated as soon as is reasonably practicable and a written report submitted to him/her before deciding what further action to take.

19. Where the student's professional attitudes or behaviours are considered to be extraordinarily critical, the deputy dean may suspend the student from lectures, classes and any clinical attachment. In such case the head of school/head of the medical programme is to ensure that the relevant course co-ordinators are informed that the student will not be attending the components of the programme specified.

Note - Suspension from the programme will lead automatically to withdrawal from any clinical attachment.

Anticipated outcomes

20. Where the student's professional attitudes or behaviours are determined as being non-critical, it is anticipated that the student may continue to study in the programme.

21. Where, after investigation, the student's professional attitudes or behaviours are considered to be critical, the head of school/head of the medical programme will refer the matter to the chair of the FTP Committee

22. Where the student's professional attitudes or behaviours are considered to be extraordinarily critical, the head of school/head of medical programme will refer the matter to the chair of the FTP Committee

23. The full process for dealing with fitness to practise concerns relating to professional attitudes or behaviours is shown in the matrix at Table 2 below.

Note - the requirements for record keeping and reporting of fitness to practise matters are dealt with in the table.

24. Guidance for dealing with fitness to practise matters involving a student's professional attitudes or behaviours is provided in the FTP Guidelines.

Table 2: Professional attitudes and behaviours

Extraordinarily critical

For extraordinarily critical professional attitudes and behaviours

Refer to: Deputy Dean and head of school/head of the medical programme
Action: Suspension from programme or withdrawal from clinical attachment
Anticipated outcomes: Refer to chair of FTP Committee
Record keeping and reporting: FTP Committee panel decision/recommendation to Dean and Dean's decision recorded in student file

  Non-critical Critical
Refer to The programme year co-ordinator The programme year co-ordinator
Action Remediation advice and guidance Investigation of incident. Written report provided to the head of school/head of the medical programme
Anticipated outcomes Student may continue their study Refer to chair of FTP Committee
Record keeping and reporting Report held on student file Report held on student file. If referred to FTP Committee, decision/recommendation to Dean recorded in student file

Issues external to the programme

Referral

25. Students must bring to the attention of the director of student affairs any issue that may affect their future ability to register as a health professional with the relevant registration body.

Note - Issues in this category will often involve a criminal conviction.

26. The director of student affairs will assess, in the first instance, whether the issue is potentially non-critical, critical or extraordinarily critical.

Action

27. Where the director of student affairs assesses the matter to be non-critical, the director of student affairs will provide, or refer the student for, remediation advice and guidance.

28. Where the director of student affairs assesses the matter to be critical or extraordinarily critical the director of student affairs will refer the matter to the head of school/head of the medical programme with a recommendation that it be referred to the chair of the FTP Committee.

29. Where the issue external to the programme is considered to be extraordinarily critical, the deputy dean may suspend the student from lectures, classes and any clinical attachment. In such case the head of school/head of the medical programme is to ensure that the relevant course co-ordinators are informed that the student will not be attending the components of the programme specified.

Note - Suspension from the programme will lead automatically to withdrawal from any clinical attachment.

Anticipated outcomes

30. Where the matter is determined to be non-critical, it is anticipated that the student may continue with their study in the programme.

31. Where the matter is determined to be critical or extraordinarily critical the FTP Committee panel will determine the matter or make a recommendation to the dean.

Note - The outcome will necessarily be dependent on the nature of the fitness to practise concern arising.

32. The full process for dealing with fitness to practise concerns relating to issues external to the programme is shown in the matrix at Table 3 below

Note - the requirements for record keeping and reporting of fitness to practise matters are dealt with in the table.

33. Guidance for dealing with fitness to practise matters concerning issues external to the programme is provided in the FTP Guidelines.

Table 3: Issues external to the programme

Extraordinarily critical

For extraordinarily critical issues external to the programme

Refer to: Deputy Dean and director of student affairs
Action: Suspension from programme or withdrawal from clinical attachment
Anticipated outcomes: FTP Committee panel to decide matter or make recommendation to Dean
Record keeping and reporting: FTP Committee panel decision/recommendation to Dean and Dean's decision recorded in student file

  Non-critical Critical
Refer to Director of student affairs Director of student affairs
Action Provide student advice and guidance Refer to head of school/head of the medical programme for referral to chair of the FTP Committee
Anticipated outcomes Student may continue their study FTP Committee panel to decide matter or make recommendation to Dean
Record keeping and reporting Report held on student file FTP Committee panel decision/recommendation to Dean and Dean's decision recorded in student file

Fitness to practise committee

Referral procedure

34. A referral to the FTP Committee must be sent to the chair of the FTP Committee who will decide, after such consultation as the chair considers appropriate, whether the matter should be dealt with by a FTP Committee panel or referred back to the relevant unit for disposal.

Constitution of the FTP Committee panel

35. Where the chair determines that the matter is to be dealt with by an FTP Committee panel, the chair will appoint members to the panel to hear the matter.

36. The chair of the FTP Committee is ex officio a member and chair of the FTP Committee panel. The chair must ensure that at least two senior member of the school that delivers the programme being studied by the student are appointed as members of the FTP Committee panel.

37. A specialist member may be appointed if the chair considers this appropriate having regard to the fitness to practise matter being considered.

Note - Membership of the panel (which must be no fewer than five members, including the chair) should be decided according to the needs of the particular case being referred. For example, membership may differ in composition according to whether the case involves conduct or is health-related.

38. The chair of the FTP Committee must not appoint any person to the panel who has had prior involvement in the fitness to practise matter under consideration.

Note –The chair of the FTP Committee is ex officio a member of the panel. The chair is therefore automatically a member of the panel and is not required to be specifically appointed to the panel.

39. After deciding the membership of the panel, the chair will direct that the FTP Committee panel convene on a specified date and time to hear the matter.

Pre-meeting procedures

40. The head of school/head of the medical programme will notify the student, in writing, when the student’s case will be heard by the FTP Committee panel, inform the student of the reasons behind the referral, and provide to the student the material that will be considered by the panel and other relevant documents. The head of school/head of the medical programme will also notify the student as to who will be present at the meeting.

41. The student will be advised of the right to make a written submission to the panel and to appear before the panel in person. Where the student’s state of health makes it impossible or inadvisable to attend the meeting in person within a reasonable period of time, the panel may consider and determine the matter on the papers.

42. The student will be given at least one week’s notice in writing of the date of the panel meeting and will be advised of the right to be accompanied by up to two support persons.

Note - Such persons include a fellow student, a member of academic staff, a member of the Student Counselling Service or legal representative.

43. If the student wishes any other person to attend the meeting to provide evidence to the panel, the student must advise the head of school/head of the medical programme as soon as practicable.

FTP Committee panel meeting

44. The FTP Committee panel meeting is a closed meeting and will be held in private.

45. Other persons, such as the relevant director of student affairs and programme year co-ordinator, may be invited to be present during the meeting to provide information if required by the panel.

46. The chair will control the meeting procedure.

Note - Procedural guidance for the conduct of the meeting is provided in the FTP Guidelines.

Procedure following the FTP panel meeting

47. Where the panel decides the matter, the chair of the FTP Committee will advise the student in writing of the panel's decision(s).

48. Where the panel makes a recommendation to the Dean, the Dean will advise the student in writing of the decision.

49. Where applicable, the student must be advised of the right to appeal the decision.

50. Where the Dean decides to terminate the enrolment of the student in the programme, the relevant head of school/head of the medical programme must ensure that the student is given advice about other study options that may be available to the student.

Processing of FTP reports and record keeping

51. All reports (including notes of discussions) of issues that may affect a student's fitness to practise are to be recorded and submitted to the director of student affairs and programme year coordinator on a fitness to practise report form.

52. Notes, reports and other details relating to fitness to practise issues and the outcomes of any fitness to practise process will be retained in the student's file, in confidentially sealed envelopes, for a minimum of 7 years from the date of the student's graduation. This information may be disclosed to the relevant health profession authority where necessary for the health profession authority to discharge its responsibility to ensure that health professionals granted registration are competent to practise and are fit for registration and to practise, or where necessary to enable the health profession authority to put in place any additional arrangements or support that may be required to ensure the safety of the student and the public following registration.

Note - Record keeping requirements are shown in row 4 of Tables 1, 2 and 3 respectively.

53. The director of student affairs will maintain for audit purposes a secure, password-protected register which will record all fitness to practise issues and outcomes. This record must be kept for a minimum period of 7 years.

Definitions

The following definitions apply to this document:

Academic staff member refers to a member of the academic staff of the University, and includes an honorary teaching staff member and a teaching staff member whose services are engaged under a contract for service.

Dean refers to the dean of FMHS.

Deputy Dean refers to the deputy dean of FMHS.

Director of student affairs refers to the director of student affairs in the medical programme or equivalent role in an FMHS school or TKHM.

Discipline includes the disciplines of medicine, nursing, optometry, audiology and pharmacy.

FMHS means Faculty of Medical and Health Sciences.

FTP Committee means the FMHS Fitness to Practise Committee.

FTP Committee panel means the FMHS Fitness to Practise Committee panel convened by the chair of the FTP Committee to sit on a case by case basis, to investigate, decide and/or make recommendations to the Dean on a fitness to practise matter.

FTP Policy means the FMHS Fitness to Practise Policy.

FTP Procedures means the FMHS Fitness to Practise Procedures.

Head of school means the head of a school within FMHS.

Health profession means the practice of a profession in respect of which an authority is appointed under the Health Practitioners Competence Assurance Act 2003, and includes the practice of dietetics, practice of medicine, practice of nursing, practice of optometry, practice of medical imaging and practice of pharmacy.

Health profession authority means the body that is responsible for the registration and oversight of practitioners of a particular health profession under the Health Practitioners Competence Assurance Act 2003.

Health professional student refers to a student on a programme of study delivered by FMHS leading to a new registration status in a health profession (i.e. pre-registration student), and to a student undertaking continuing professional development or advanced studies relating to their health profession which does not lead to a new registration status.

MAPAS refers to the Māori and Pacific Admissions Scheme.

Panel refers to the FTP Committee panel.

Programme Year Co-ordinator means the staff member responsible for co-ordinating the relevant health professional programme for the year in which the student is studying, and includes the phase director of the relevant phase of the medical programme.

Staff member refers to an individual employed within FMHS whether on a full or part time basis, and includes an independent contractor.

Student means a health professional student.

TKHM refers to Te Kupenga Hāuora Māori.

University means the University of Auckland and includes all subsidiaries.

Key relevant documents

Document management and control

Owner: Deputy Dean FMHS
Content manager: As appointed by the Deputy Dean of FMHS
Approved by: Dean of FMHS
Date approved: 26 June 2019
Review date: 26 June 2024