Bachelor of Medicine - JMP Student Welfare and Fitness to Practise Procedure

Document Number001015
Date Approved25 March 2013
     

Date of Commencement:          25 March 2013

1.      Application of Procedure

1.1.     This procedure applies to all students enrolled in  MEDI Course/Units offered by the Schools of Medicine and Public Health (University of Newcastle (UoN)) and  Rural Medicine (University of New England (UNE)) in the delivery of the Bachelor of Medicine – Joint Medical Program (BMed – JMP).

1.2.     This procedure is to be read in conjunction with the following:

  i.       at UoN

Bachelor of Medicine - JMP Student Welfare and Fitness to Practise Guideline (001014)

Bachelor of Medicine - JMP Schedule (000874)

Bachelor of Medicine - JMP Student Placement Policy (000878)

Bachelor of Medicine - JMP Review of Progress Rules (000879)

Bachelor of Medicine - JMP School Assessment Responsibilities Guidelines (000881)

Bachelor of Medicine - JMP Student Academic Misconduct Rule (001008)

Student Academic Integrity Policy (000608)

Students with a Disability Policy (000344)

Student Misconduct Rule (000935)

 ii.       at UNE

Bachelor of Medicine - JMP Student Welfare and Fitness to Practise Guideline (001014)

Bachelor of Medicine - JMP Schedule (000874)

Bachelor of Medicine - JMP Student Placement Policy (000878)

Bachelor of Medicine - JMP Review of Progress Rules (000879)

Bachelor of Medicine - JMP School Assessment Responsibilities Guidelines (000881)

Bachelor of Medicine - JMP Student Academic Misconduct Rule (001008)

Student plagiarism and academic misconduct: coursework policy (SED07/948)

Student Behavioural Misconduct Rules (SED07/989)

2.      Definitions

In the context of this document:

BMed – JMP program means the Bachelor of Medicine – Joint Medical Program offered in partnership;

Case Manager means the academic member of staff nominated to lead a Case Management Team of the SWFTP;

Clinical Dean means the clinician academic officer in charge of the clinical sites for the delivery of the JMP, i.e., Central Coast Clinical School, Hunter Clinical School, Manning Clinical School, Peel Clinical School, Tablelands Clinical School;

Clinical School site means any of the sites used for clinical teaching and learning in delivery of the BMed-JMP including GP practices, public and private hospitals and/or community health and mental health facilities;

Course/Unit Coordinator means the officers responsible for the delivery of a Course/Unit and for ensuring its appropriate content and assessment as approved by the JMP Committee. The Coordinators assigned to a Course/Unit at UoN and UNE will consult with the Program Convenor and the Heads of School as appropriate. Final responsibility for delivery of the Course/Unit rests with the Dean of Medicine - JMP;

Dean means the Dean of Medicine – Joint Medical Program;

ERG means the Executive Review Group of the SWFTP Committee

Faculty means the Faculty of Health at the University of Newcastle and/or the Faculty of The Professions at the University of New England;

Head of School means the Head of the School of Medicine and Public Health (UoN) and/or the Head of the School of Rural Medicine (UNE), or their respective nominee;

JMP means the Bachelor of Medicine Joint Medical Program, offered jointly by The University of Newcastle and the University of New England in partnership;

Mandatory notification means notification to the Medical Board of Australia as required in the Board’s guidelines;

Medical Board’s Impaired Practitioner Program means the program detailed in information of the Medical Board’s website www.medicalboard.gov.au 

National professional code means the suite of codes, guidelines and policies of the Medical Board of Australia, as detailed on their website, http://www.medicalboard.gov.au/Codes-Guidelines-Policies.aspx

PBL Tutor means tutors delivering tutorial sessions for the Problem Based Learning component of the BMed-JMP;

School/s means the School of Medicine and Public Health at The University of Newcastle, and the School of Rural Medicine at the University of New England;

SWFTP Committee means the JMP Student Welfare and Fitness to Practise Committee;

University means The University of Newcastle and/or the University of New England;

Universities means The University of Newcastle and the University of New England;

Year Assessment Decision Committees - means the five committees (one for each year of the BMed)   responsible for recommending final grades to the Heads of School and for reviewing the assessment of courses / units in accordance with the Universities’ quality assurance principles

Year Chair means the Academic staff members responsible for the overview of the Years 1-5.

3.      JMP SWFTP Principles and Procedure

3.1.     Aim

The  SWFTP Procedure aims to ensure that the Universities:

  • identify and provide early support to students who may be experiencing major personal difficulties in their progress through the JMP.  Relevant matters are distinct from academic progression issues or behavioural misconduct which are dealt with by the relevant school and policy.
  • identify students who are not progressing as expected and required in their training to become fit to practise as medical practitioners, whether or not the student demonstrates behaviours which require mandatory notification.
  • fulfil statutory obligations with respect to reporting students where they display notifiable behaviour.

3.2.     Governance

There are four governance elements to the Student Welfare and Fitness to Practise procedure:

  • Dean of Medicine-JMP 
  • The SWFTP Committee
  • The Executive Review Group
  •  Case Management Team

3.2.1.   Dean of Medicine- JMP

   i)          The Dean of Medicine-JMP has ultimate responsibility for all matters considered as part of the SWFTP procedure

   ii)          Any correspondence with external agencies is  over the signature of the Dean of Medicine-JMP

  iii)          Any action taken by the Dean of Medicine-JMP will be in consultation with the Pro Vice-Chancellor of the relevant Faculty.

3.2.2.   The SWFTP Committee

     i)         The Joint Medical Program Student Welfare Fitness to Practise Committee (SWFTP Committee) is an advisory committee providing advice and information to the Dean of Medicine -JMP on student welfare matters of significant concern.

    ii)         SWFTP Committee has oversight of the student welfare process, including the application of principles and the procedure, development of best practice responses and application of these in a consistent way across both schools.

    iii)         Membership includes experts internal and external to the JMP, and student and community representation.

    iv)         At no time are details of individual students in the process to be disclosed or discussed in the SWFTP Committee in a way that identifies the student.

    v)         Experts who are members of the SWFTP Committee can be consulted on particular matters as required, maintaining confidentiality at all times.

3.2.3.   The SWFTP Executive Review Group

    i)         The Executive Review Group comprises the Heads of Schools, a representative or representatives of the Clinical Deans and the BMed-JMP Program Convenor. The Office of the Dean provides secretariat functions to the Executive Review Group and the SWFTP process.

   ii)         The Chair of the Executive Review Group is appointed by the Dean of Medicine-JMP.

   iii)         Any matter considered by the Executive Review Group remains strictly confidential between the Executive Review Group and the Case Management Team managing that matter.

   iv)         Members of the Executive Review Group can refer a matter for investigation at any time to a trained member of academic staff [part of a Case Management Team] to investigate the concern and to determine if the matter requires to be referred to another specific university process.

   v)         The Executive Review Group member who has referred a matter for investigation to the Case Management Team remains responsible for oversight of the processes of the Case Management Team, and must be familiar enough with the progress of the matter to report its status at Executive Review Group meetings as required.

  vi)         The Executive Review Group considers recommendations of the Case Management Team and provides recommendations to the Dean of Medicine-JMP about conclusion of or further management of the matter.

 vii)         The Executive Review Group monitors and maintains a record of referred students, their progress through the process, and their ongoing welfare including the management and monitoring for any conditions which might be imposed upon that student's registration by the Medical Council of NSW, or the Australian Health Practitioners’ Regulation Authority, until they conclude their studies in the JMP or leave the JMP through graduation or some other route.

3.2.4.   Case Management Team

  The SWFTP Case Management Team:

     i)         comprises at least two investigators, with at least one being an academic staff member (drawn from a panel of academic case managers trained in the Student Welfare and Fitness to Practise support process),  and the other being an appropriately trained academic or professional staff member (who may be a member of the Office of the Dean)

    ii)         is convened on a needs basis according to the nature of the concern

   iii)         is convened as soon as needed by the Dean of Medicine-JMP, a Head of School, a Clinical Dean, or other member of the Executive Review Group

   iv)         is able to interview stakeholders to the matter and seek other relevant information about the matter or triggering event, ensuring all aspects of confidentiality and, where necessary, consent, are met

    v)         evaluates concerns, and makes recommendations to the Executive Review Group (and in this way to the Dean of Medicine-JMP) regarding management or interventions required

   vi)         concludes its role once the management plan has been enacted by others designated responsible for the ongoing support of the student (monitored by the Executive Review Group).

4.     Scope of the Procedure

4.1.     Areas covered

A student’s fitness to practise will be considered in any or all of the following domains as determined by the Case Management Team (as each has the potential to impact on the quality of the service delivered to patients).

i)        Area 1: Health or Personal issues

Issues that may affect the student’s future ability to practise medicine and are likely to affect a student’s studies, progression and/or career pathways; expose the student, patients or staff members to potential risk; and/or expose the BMed- JMP and thereby the Universities to potential risk.

ii)       Area 2: Professional Attitudes

Whether a student’s actions indicate the required level of respect and sensitivity towards patients and colleagues, in keeping with professional standards.

iii)      Area 3: Issues External to the Program

Issues regarding the actions of the student occurring outside the program, such as any offence which is potentially punishable by three or more months in gaol (e.g., drug/alcohol related convictions, pornography convictions).

4.2.    Unprofessional conduct and professional misconduct

As identified in the national professional code, matters which fall under Unprofessional and Professional Misconduct and may require referral by the Case Management Team include these areas:

4.2.1.    Unprofessional Conduct - includes:

     i)         breach of the National Law 

    ii)         breach of a registration condition or undertaking

   iii)         conviction for an offence that may affect suitability to continue practice

   iv)         influencing, or attempting to influence, the conduct of another registered health practitioner that may compromise patient care

    v)         accepting a benefit as inducement, consideration or reward, for referrals or recommendations to use a health service provider

   vi)         offering or giving a person a benefit, consideration or reward, in return for providing referrals or recommendations to use a health service provider

  vii)         referring a person to, or recommending, another health service provider, health service or health product, if there is a financial interest, unless the interest is disclosed.

4.2.2.   Professional misconduct - includes:

     i)         conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience

    ii)         more than one instance of unprofessional conduct

   iii)         conduct that is not consistent with being a fit and proper person to hold registration in the profession.

4.3.      Matters outside the scope of SWFTP (in the first instance)

     i)         Issues of plagiarism and academic probity

    ii)         Issues that require referral to the university disciplinary process

   iii)         Academic failure with no identified student welfare issues

   iv)         Issues which can be dealt with via the other processes of the University.

Note: where an issue is dealt with through a University investigation or disciplinary process, the outcome of that process may have implications concerning an individual’s fitness to practise

5.      Advice to Students of SWFTP Procedure

Students will receive advice of the SWFTP procedure that applies to their enrolment in the JMP:

i)        Prior to entry:

At time of application students will be informed that the SWFTP guideline prevails in the JMP to assist students to deal with  stresses and strains on physical and mental well-being which students can experience while studying medicine.

ii)       On enrolment:

At the time of enrolment in the BMed-JMP, students will:

 a)       be informed of the existence of the JMP obligations in relation to ‘Student Welfare and Fitness to Practise’ procedures and the Medical Board’s Impaired Practitioners Program;

 b)       be provided with a copy of the procedure document and asked to declare their acceptance to study within the framework at the commencement of their studies in the program.  The role of the Year Chair and Clinical Deans in assisting with issues and the importance in terms of registration with the Medical Board will also be explained.

iii)      At the start of each year:

At the commencement of each year, students will be:

 a)       reminded of their duties and responsibilities; and

 b)       encouraged to self-identify for assistance as required.

6.      Identification and Referral of Students of Concern

6.1.     Identification

Students of concern in need of support can be identified through a number of processes:

The processes within each course /unit of the JMP which assess professional skills and behaviour of students at the conclusion of a clinical attachment may identify acute concerns about a student.

Other indications for referral to the SWFTP process can include (but are not limited to):

     i)         Persistent ‘below expected level’ of performance that has previously been addressed through the school

    ii)         Repeated notifications of concerns about FTP on supervisor’s report forms

   iii)         Significant concerns about an aspect of FTP on a supervisor’s report

   iv)         Persistent poor academic performance where an issue of student welfare is identified as a contributory cause

    v)         Concerns  about student behaviour reported  that have not been resolved by a Clinical Dean or Head of School

   vi)         Concerns  about health that have not been resolved by a Clinical Dean or Head of School

   vii)         As an outcome of  University disciplinary process

  viii)         Recurrent (e.g., in consecutive semesters) applications for special consideration

   ix)         At the request of the Dean of Medicine- JMP to provide advice on an issue of Fitness to Practise

    x)         Self-identifying by individual students who may identify a need for structured assistance.

6.2.     Referral

Students in need of support can be entered into the case management/ support process by members of the Executive Review Group (ERG) only.

Participation in case management is designed to assist the student to achieve their individual potential. Participation in the case management process is voluntary on the part of the student. In the absence of participation the concern or complaint will be investigated and the student informed of the Case Management Team’s recommendations.

Matters can be brought to the attention of members of the Executive Review Group by anyone, but would usually be brought to the ERG’s attention by:

     i)         The Dean of Medicine - JMP

     ii)         Heads of School

    iii)         Clinical Deans

    iv)         Program Convenor

    v)         Year Chairs

   vi)         Year Assessment Decision Committees

  vii)         University disciplinary Committees

 viii)         Course/unit co-ordinators

   ix)         Clinical or PBL tutors

    x)         Complaints received from members of the public or other health professionals 

A student’s peers can informally bring their concerns about the welfare or fitness to practise of a student to the attention of a Head of School or Clinical Dean or any other academic or other members of staff, who may then inform members of the ERG as necessary.

A student can refer themselves if they feel their welfare is at risk and they are having difficulty getting the welfare help they need.

6.3.     Informing the student

6.3.1.      Required information

     Students are to be informed and kept informed about

     i)        being referred to the SWFTP process

    ii)         what to expect from the SWFTP Procedure

    iii)        the progress of any investigation about them

   iv)         who their contact person is during the investigation (this would usually be the Case Manager managing the matter)

    v)         what the referral to the SWFTP Procedure  might mean for them, and

   vi)         how to seek emotional support during the process.

6.3.2.      Timing for providing information

                The student is informed by the Case Manager once a Case Management Team has been convened. This should occur, in person if possible, as soon as practical once a concern is identified and determined to warrant management according to this SWFTP Procedure.

6.3.3.      Support persons

                In any meetings involving the student, the student may select a support person to be present and observe the proceedings. This support person would not act as a “representative” in terms of speaking for the student, as the student’s own responses would be needed for adequate assessment of the matter. 

7.      Outcomes

7.1.     For a student referred to the SWFTP procedure the possible outcomes are:

      i)        No problem identified – that is, after investigation the Case Management Team believes there is no issue and no further action is required

     ii)        Problem or potential problem identified.

7.1.1.      Where a problem is identified outcomes may include any or all of: 

      i)        Observation and monitoring of conduct with set time frames for review specified and clear advice for the student about what will happen if concerns remain or further concerns are raised;

    ii)         Remediation planned (with goals, timeline and mentor identified)
This could include (for example) specific sessions on interpersonal communication with a tutor experienced in this area, or online modules dealing with aspects of professional behaviour;

   iii)         Referral to other services
Services could include (for example) university counselling services or careers advisors;

  iv)          Referral to other University processes
This could involve (for example) disciplinary procedures;

   v)         Advice to the relevant School to ensure the case management plan is supported in its delivery

                Such support would require ensuring that all relevant parties at Clinical School sites had capacity or support to assess and manage the case.

7.1.2.      Where the problem identified is significant and may place the public at substantial risk of harm, the outcome may be:

     i)         Notification by senior officers of the University to pre-registration authorities or other agencies as per statutory obligations; and/ or

    ii)         A recommendation to the Dean of Medicine-JMP for suspension/exclusion from studies.

7.1.3.      To preserve confidentiality, the Executive Review Group of the SWFTP Committee will make a recommendation directly to the Dean of Medicine- JMP concerning the outcome for the student.

7.1.4.      The student is kept informed and notified of outcomes as soon as possible and practical.

7.2.     Further action

Where necessary a management plan is agreed between the student and the Dean’s representative responsible for the student’s ongoing welfare and fitness to practise (this may be the Year Chair); and milestones and outcomes of that plan are reported to the Executive Review Group (which then monitors the student’s welfare until the student concludes their studies in the JMP).

8.      Referral monitoring

  i)       Referral numbers, newly referred matters and status of each matter in progress will be reported monthly to the Executive Review Group.

 ii)       The progress of any referred student will be reported monthly at the Executive Review Group meeting until the Executive Review Group is satisfied that the student no longer has welfare concerns, or until the student has left the JMP through graduation or some other route.

iii)       The number of students in the process and their status and case outcomes are reported as de-identified data to the SWFTP Committee twice per year.

9.     Timeframe guidelines

Any student welfare matter should, where possible,  be finalised by the Case Management Team and recommendations made back to the Executive Review Group within 30 days of having been referred to the Executive Review Group or an ERG member. Particularly complex matters may take longer than 30 days to finalise and have recommendations formulated, but this should be noted to the ERG within the 30 day timeframe, with an estimated time of completion.

The need to report back to the Executive Review Group does not mean that a management plan cannot commence earlier, in consultation with the person who is going to be responsible for the student’s ongoing welfare.

10.    Appeal

A student will have access to avenues of appeal consistent with appeal policies and procedures specified by each university.

Any decision or action taken by the ERG will be communicated directly to the student, referencing the policy under which that action is authorised.

The appeal process for action taken will be according to the identified jurisdiction.

11.    Essential Supporting Documents

Bachelor of Medicine - JMP Student Welfare and Fitness to Practise Guideline 001014

 

 

Approval AuthorityJoint Medical Program Committee
Date Approved25 March 2013
Date for Review25 March 2016
Policy SponsorDean of Medicine - JMP
Policy OwnerDean of Medicine - JMP
Policy ContactJMP Coordinator
Amendment History

New procedure approved by Joint Medical Program Committee, 25 March 2013.