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Medical & veterinary progress panel

Medical and Veterinary Student Progress Panel

The Medical and Veterinary courses at Cambridge, as at other UK Universities, are covered by Fitness to Practise procedures. These are a mechanism to protect the public against the entry into these professions of individuals who might, in a variety of ways, be a danger to their patients.
These procedures set out a formal process and can have serious and long-term
consequences for a student who becomes officially subject to a Fitness to Practise investigation.
It has become clear to the Faculty Boards of Biology, Clinical Medicine and
Veterinary Medicine that there also needs to be a less formal mechanism for
monitoring the progress of medical and veterinary students.
To this end, a Medical and Veterinary Student Progress Panel has been established which will consist of members closely involved with medical and veterinary student affairs of an academic and pastoral nature. These individuals are not part of the Fitness to Practise procedures but have a clear understanding of their implications.
The broad remit of the Panel is to support and advise students, and staff dealing with medical and veterinary students, regarding issues that might potentially have fitness to practice implications if not addressed promptly, openly and supportively. The Progress Panel is not a disciplinary body. Its aim is to seek solutions to problems in their early stages, in order to help students successfully to negotiate a long, often difficult, and stressful course, which makes demands on students over and above those encountered by other University students.

The remit of the Progress Panel will include the following:
1. To keep under review the academic progress throughout the course of all
medical and veterinary students. This will include a review of all failures and
resit attempts at Second M.B. and Second Vet MB examinations, in order to
offer advice and support to students and Colleges as necessary and to ensure
that all students receive equitable treatment when a request for special
permission for a further attempt at an examination is made to either of the
Faculty Boards.
2. To provide a source of advice to students and their pastoral advisers,
particularly in the Colleges, when health, behavioural or disability issues
appear to impinge on the student's ability to successfully complete the course,
or to bring them within the ambit of the Fitness to Practise regulations.
3. To keep an accurate record of all students on the Medical and Veterinary
courses and the stage they have reached in the course, in order to be able to
provide accurate statistical returns to the General Medical Council and the
Royal College of Veterinary Surgeons.

First Remit:

Review and Monitor Student Academic Progress
In terms of academic progression and examination performance, the situation in Medicine and Veterinary Medicine is different to that in Tripos examinations for other subjects. For the M.B or Vet. M.B. examinations, which are the professional examinations essential for progression to medical or veterinary registration, one automatic resit is permitted following a failure to attain the requisite standard at the first sitting of the examination. The Regulations permit every student to make one resit attempt at Second M.B, Second Vet MB and Final M.B examinations. In the Final Vet MB, two automatic resit attempts at each examination are currently permitted by the Regulations.
The Progress Panel will routinely review all Second MB, Second Vet MB and Final MB and Final Vet MB examination results and may consult the College about any students showing multiple or repeated failures which may give concern about the student's ability to progress through the course. A single or isolated failure is unlikely to give cause for concern.
Additional resit attempts above those permitted by the regulations are only granted by means of a request for special permission to the Faculty Board of Medicine or Faculty Board of Veterinary Medicine. In recent years, students and the OIA have raised concerns that there may not always be consistency between the two Faculty Boards in how these decisions are made. This is clearly unacceptable within a single institution. For this reason it is felt that there is merit in the Progress Panel considering all cases for special permission to make further attempts at examination, and providing advice to students, Colleges and the Faculty Boards on the following issues:

a. Information which should be provided to Faculty Boards
b. the criteria that might be used in making decisions on allowing or refusing resit requests
c. the timing of resit attempts so as to give the student the best chance of success.
The decision to permit an additional resit attempt will continue to rest with the
relevant Faculty Board.
Appeal Panel
There will be a right of appeal following the decision of the Faculty Board. An
appeal panel will be set up for this purpose and will have membership from outside
the University as set out below.
The OIA has recommended that an appeal panel be instituted, and the proposal below is consistent with procedures in other Universities.

Procedure for special permission for additional attempts at examinations for Second MB, Second Vet MB, Final MB and Final Vet MB

This section deals with the submission of applications for special permission to make additional attempts at Second or Final MB or Second and Final Vet MB examinations over and above the automatic resit attempts permitted in the Regulations for both degrees.
The Progress Panel is concerned that there should be equitable and fair treatment of all students and that advice and assistance given to Colleges and students should be consistent for both medical and veterinary students.
Increasingly applications for special permission for additional attempts at examination are accompanied by complex medical or pastoral considerations, and experience with appeals against decisions of the Faculty Boards that have been referred to the OIA, reinforces the view that procedures need to be in place to ensure consistency of approach across the University.
The following procedure should be adopted for applications for second or subsequent
resit examinations.
1. The resit application form (available from the Faculty Board of Biology
website) together with supporting letters from Senior Tutor and Director of
Studies should be sent to the Secretary of the appropriate Faculty Board.
2. The applications is then passed to the Progress Panel at its meeting early in the Michaelmas Term. The panel will review the case, and if necessary will
communicate with the Senior Tutor of the College, if it seems that further
information or discussion might help the submission to the Faculty Board.
3. The Progress Panel will then pass the applications to the Faculty Board for
decision. The Progress Panel may also send advice or recommendation to the
Faculty Board. This is only likely to be generic in nature with the intention of
trying to produce consistency across the Faculty Boards but will not pre-empt
the final decision of the Faculty Board in individual cases.
4. It is hoped that the process will encourage the development of a two-way
exchange of views and information between the Progress Panel and Faculty
Board and between the Panel and Colleges.
A basis of case law will be built up over time to ensure consistency of
5. The Faculty Board will report its decision to the College and the Panel. The
College will report the decision to the student through the Senior Tutor.
6. In cases where an additional attempt at examination is granted, the Panel will be available to support the College with any advice necessary about the
progress and support of the student in the future
7. In cases when an additional attempt at examination is refused, the student will have a right of appeal to an Academic Appeal Panel. This will have a
membership drawn from individuals on an Academic Appeal Panel and would
include a veterinary member, a medical member and a legally qualified
member. The members of the Academic Appeal Panel will consider both
medical and veterinary cases. The Academic Appeal Panel should contain
membership from a University other than Cambridge.
8. Following the decision of the Academic Appeal Panel a letter of completion
will be issued which will conclude the internal University process.

Confidential Information
Some concern has rightly been expressed about how to deal with confidential medical information pertaining to appeals. At present medical evidence submitted to the Faculty Boards is seen by the Clinical Dean in the case of medical students, or by the Dean of the Veterinary School or in his absence the Director of Teaching in the Department of Veterinary Medicine.
This procedure will be maintained when cases are sent to the Progress Panel.
All discussion at the Progress Panel will be confidential but notes on generic issues and matters of principle from the meeting will be passed to the Faculty Boards. At present the Progress Panel has no statutory standing and these procedures are being suggested for adoption on a trial basis. It is envisaged that the support, advice and consistency of process, which this single body can offer, will be helpful to students, Colleges and Faculty Boards, and if this general approval is forthcoming the necessary statutory changes will be introduced so that this procedure is applied to all
requests for special permission for additional attempts at examination.

Second remit:
to advise on health, behavioural and disability issues relevant to progress or
fitness to practise. Health, behavioural and disability issues frequently play a part in difficulties of academic progression and application for special permission for additional attempts at examination. For this reason it is considered impractical to have a Progress Panel to deal with these issues and a separate progress Panel to deal solely with academic progress. Very rarely are applications for resits made with no pastoral components to the case. It is this very fact that has made decisions very difficult and consistency hard
to achieve.
|Academic and pastoral issues cannot be separated and in fairness must be considered together.

A cornerstone of the agreement that medical and veterinary students sign when they are admitted to the Medical or Veterinary Students Register at the beginning of the course is that as entrants to the medical and veterinary professions, they must recognise that on occasions they will encounter personal problems that may impinge on their professional capabilities. The responsible professional behaviour is to acknowledge this and to ask for help. This help is often sought through the student’s College.
The Progress Panel is being set up with the intention of providing advice, help and support to the College with the objective of getting the student back on track as soon as is feasible. There is no intention to usurp the College role, but rather to support it. This support and advice will be provided in the context of the requirements of the Regulations, and of what the experience of the Panel suggests is the most appropriate way forward.
The aim is again to provide consistency of advice and equal opportunity for all
students across both medical and veterinary courses.
Mechanism of Referral for pastoral reasons.

Students could be referred to the Progress Panel in a number of ways.
1. The Directors of Studies or pastoral advisers might contact a member of the
Progress Panel for advice. Where a decision to refer was made in the case of a
preclinical student the Director of Medical and Veterinary Education should then be informed. In the case of a clinical student where a referral might originate from a clinical superviser either the Clinical Dean (Clinical School) or the Director of Teaching, (Department of Veterinary Medicine) would be informed.
2. The Senior Tutor on behalf of the College might refer a student on the advice of the
student's Director of Studies or Tutor.
3. The Director of Medical and Veterinary Education in the Preclinical course may refer a student. The Clinical Dean or Director of Teaching at the Department of Veterinary Medicine may refer a student who has come to their attention in the clinical course. In all cases the Senior Tutor of the student's College would be informed and they should inform the student and decide on what documentation might be provided if necessary.
Cases would be considered in confidence and if necessary anonymously in the first instance. Feedback would be provided from the Progress Panel to the Senior Tutor and through them to the student and if necessary to others in the College, always with the student's consent.

The primary aim being to maintain the student's progress through the course if at all possible or to take remedial steps if it appeared that progression was likely to be impeded.
Third remit:
To keep an accurate record of all students on the medical and veterinary courses and the stage they have reached in order to be able to provide accurate statistical returns to the General Medical Council and the Royal College of Veterinary Surgeons.
The Progress Panel would keep a database of all medical and veterinary students and their progress in terms of progress requirements both in formal examinations and extra mural or other requirements. Students leave both medical and veterinary courses for all the usual reasons and some return after an absence. Because of the requirements for professional qualification, it is important to be able to track students, and which examinations they have passed.
Currently it is very difficult to access this information, which can result in the Clinical Schools being unclear as to which students are actually progressing from the third to fourth year of the course.
It can be difficult sometimes for Colleges to keep track of a student’s status and a database receiving prompt and accurate information of examination results could be of value in this regard.
It is hoped that these procedures will be seen as a constructive way forward, not set in stone, but as evolving mechanism for improving the way medical and veterinary students are administered at Cambridge.

A. R. Jefferies
3 June 2010
Panel Membership:
Clinical Dean / Director of Medical Education in the Clinical School - Chair
Director of Medical and Veterinary Education - preclinical course
Director of teaching in the Department of Veterinary Medicine
Associate Clinical Dean West Suffolk Hospital
Senior Tutors X 4 (including chair of Welfare and Finance Committee)
1 Preclinical and 1 Clinical College Director of Studies
Clinical School Assistant Registrary
Secretary of Faculty Board of Biology
Secretary of Faculty Board of Veterinary Medicine
Additional members co-opted as required