I am Kate Thomas, the Vice Dean and medicine programme director at the University of Birmingham Medical School. I have been involved with medical students at Birmingham for nearly 27 years, for 24 of them I was responsible for student support, initially for final years and then for the whole welfare system. For the last three years I have been leading the programme team. I have been closely involved in student fitness to practise since it was introduced.

Achieving good medical practice

The new guidance for students on fitness to practise (FTP) Achieving good medical practice is, in my view, a huge leap forward in making it clear to students what the ground rules are. It is written in a way that makes it easy to read and is full of relevant, helpful examples. I am not sure that I have convinced our students that it’s a delight to read, but it is clear to me that many have read it, which is more than could be said for the old document!

Achieving good medical practice is, in my view, a huge leap forward in making it clear to students what the ground rules are.

It places much more emphasis on the areas that students can easily get wrong, such as use of social media, managing their health or raising concerns than the previous guidance, which had child pornography first in its list of “don’ts”. This alone makes it more relevant and useful to students.


Quote on social media from Achieving good medical practice

Professional behaviour and fitness to practise

The accompanying guidance for medical schools, universities and placement providers is not quite such an easy read, but again I feel it’s a huge improvement as the guidance is clearer and more helpful. Certainly we have found the firmer nature of the guidance has meant that changes we have needed to make to our processes, across all the FTP programmes at the University, have been accepted without the difficulties that we, and many other medical schools, encountered with the original guidance.

It is clear from the guidance that the consultation made a difference to the final version.

It is clear from the guidance that the consultation made a difference to the final version. “Cheating or Plagiarising: sharing with fellow students or others, details of questions or tasks from exams you have taken” must have come from an assessment lead somewhere. I am sure our students will be astonished to learn that we are not the only people in the known universe to see this as cheating.

Emphasis on professional behaviour

The new documents have caused me to look back to the introduction of FTP for medical students and see how much we have learned and how much better we handle things now.

Placing it the context of learning how to be a professional has gone towards making the concept of FTP seem more like something that helps students navigate the tricky transition from adolescent to professional.

Placing FTP in the context of learning how to be a professional, explaining how the Duty of Candour includes coming forward when a student has made a mistake, and putting an emphasis on how openness improves the situation for the student, have all gone towards making the concept of FTP seem less a stick medical schools like to beat students with and more like something that helps students navigate the tricky transition from adolescent to professional.

Quote on honesty from Achieving good medical practice

Staff attitudes

My next challenge is to explain the new guidance to colleagues in the medical school and placement providers whose experience of fitness to practise is of necessity much less than mine. The phrase ‘fitness to practise’ has somehow been taken up by some members of staff to describe any behaviour they don’t particularly like, for example students forgetting their swipe card to gain access to the building, which understandably annoys the students.

I am going to mandate the staff to read Achieving good medical practice too! Low level concerns make up the vast majority of the problems we deal with, true fitness to practise problems are very few and usually are the end of a long road of support and attempted remediation.

The new guidance contains the messages we want students to understand about professional behaviour in a way that they can see applies to them.

Cause for optimism

Within two weeks of introducing the new guidance to our fourth and fifth years, a student contacted me to say that he had accessed his own medical records and had realised this was wrong and wanted to let us know. He had not been found out for having done this, but said that having read the guidance he knew that he should be open about it. This gives me optimism that the new guidance contains the messages we want students to understand about professional behaviour in a way that they can see applies to them.

Professor Kate Thomas

Professor Kate Thomas has worked as a GP in Birmingham since 1989. She is also Vice Dean and Programme Director of the MBChB at the University of Birmingham’s School of Medicine.   

Kate has been involved in undergraduate medical education since 1989.  She was one of the team that set up the Community Based Medicine programme at Birmingham and was involved in student welfare for 24 years developing and implementing a comprehensive, well-regarded student support system for medical students.

Related posts

Faisel Alam blogs about being a medical student and the professional responsibility this brings both in and out of the workplace

Medical student Amy Edwards reflects on what professionalism really means for medical students

Swansea University Medical School’s Dr Clive Weston blogs about the GMC’s medical education standards launched in 2016