OHSAS and Fitness to Practise

What is OHSAS?

Occupational Health & Safety Advisory Services (OHSAS) offers a range of services including assessment and advice on students and employees with health problems and disabilities, Health surveillance, assessment for fitness for tasks (according to HEOPS Guidelines), drug screening, General Health screening, Occupational and Physical therapy, Counselling and psychology, Stress surveys and risk assessments.

OHSAS also provides practical advice to help students and employees to perform their tasks and duties safely with a reduced risk of aggravating illness or injury. In addition, OHSAS provides advice on helping and supporting return to work or study quickly and safely. They also provide advice on work or study place adjustments, modifications and equipment with support to students and employees to develop effective coping strategies for work or study.

In what circumstances might a student be referred to OHSAS?

A student may be referred to OHSAS because of concerns on their fitness or ability to perform some tasks related to the medical course. The range of tasks expected in the medical course can be found in the HEOPS Guidelines. OHSAS will provide an Occupational Health report after the referral to the Medical School.

Can I see a referral form from the Medical School before it is sent to OHSAS?

A student can choose to see the terms of a referral before it is sent to OHSAS.

Can I see the OHSAS report before it is returned to the Medical School?

The student may also see the Occupational health report before it is sent to the Medical School. Whether a student chooses this option or not, the student will be sent a copy of the OHSAS report in keeping with good practice. In addition a copy will also be sent to a student’s GP and, when appropriate, any consultant the student is seeing for medical care of the condition.

Who can access my OHSAS records?

OHSAS may give a report which includes a report from the individual’s personal medical doctors to the Medical School when a student is seen.

Medical Records themselves held by Occupational Health can only be accessed by:

• Staff of the Service.

• The person to whom the record relates.

• Any party to whom the individual gives consent for release.

• The Courts on issuing an Order of Release (rare).

Will my information be shared with others?

Without the student’s permission the University cannot access the Occupational Health Medical Record. Explicit informed consent will be sought from the student if a request is made for specific medical information to be shared.

What will be included in the report?

In an Occupational Health report The Medical School will normally be informed of the nature of any relevant impairment, its effect on function, and adjustments necessary to allow the student to fulfil the required competencies for graduation and professional practice. Specific information about underlying causes will not be disclosed, except where this serves a specific purpose to protect patients or benefit the student, and only with the student’s explicit, informed consent.  OHSAS will not provide the Medical School with a student’s diagnosis or treatment. Medical and personal information disclosed during the assessment processes will not be disclosed by the occupational health service.

What happens after an OHSAS assessment?

After assessment, OHSAS may make one or more of the following recommendations which will be used to inform discussions between the student and the Medical School, for example on 

  • how the student may be supported in undertaking the tasks required under the HEOPS Guidance
  • what infrastructure arrangements may be put in place
  • how capability issues may be addressed through the various options in terms of the Fitness to Practice process

What recommendations can OHSAS make?

The recommendations in an OHSAS report may also indicate that the Medical School should consider whether

  • The student should continue with or return to the medical course.
  • The student should continue with or return to the medical course with minor support from the Medical School. It is the responsibility of the student to inform their supervisors of any adjustments made.
  • The student should continue with or return to the medical course with significant support from the Medical School. This may require some time to accomplish depending on the condition or disability. It is the responsibility of the student to inform their supervisors of any adjustments made.
  • The student should temporarily discontinue the medical course pending treatment of the condition or disability and be reassessed prior to return to the medical course.
  • The student should temporarily discontinue the medical course until the medical school has completed infra-structure arrangements to help and support the student’s return to the medical course. These arrangements may be assessed by OHSAS prior to the students return to the medical course.
  • The student should be referred to Fitness to Practice to consider permanent discontinuation from the medical course.


What is the need for Fitness to Practise?

Patients must be able to trust and respect their doctors. Society rightly expects doctors to behave in an appropriate manner. They are expected to have high moral values and to work within a code of practice determined by the profession itself and by the law.

The Medical School has a duty to ensure that its graduates are fit to enter the medical profession. It fulfils this duty by enabling students to acquire the knowledge and develop the skills and attitudes appropriate to their future role as doctors and the vast majority of students achieve this.

However, occasionally the Medical School must act when a student appears to have problems or exhibits behaviour which is not compatible with their future role. In common with other medical schools and in line with GMC guidance, the Medical School has set up a procedure which will be followed when a student’s health and /or behaviour is causing concern. Students should be aware that the outcome of Fitness to Practice procedures may not necessarily be punitive and that these procedures can be beneficial for students both in monitoring problems and in identifying the need for support.

In what circumstances will a student be referred to Fitness to Practise?

An assessment of professionalism and fitness to practice underlies all parts of the medical course and assessments. Mark schemes and progression criteria include provision for teachers and examiners to report concerns about fitness to practice if any aspect of a candidate’s performance during the course or assessments gives cause for concern about behaviour, attitude or fitness to practice. Fitness to Practice concerns are considered by the Student Support & Progress Committee and can lead to a student failing to progress or to qualify.

Further examples of areas of concern related to student fitness to practice may be found in Table 1 from the GMC’s guidance Medical students: professional values and fitness to practice.

Who can report a Fitness to Practise concern?

Fitness to practise concerns may be reported by:

  • Administrators
  • Nurses or Allied health Professionals (AHPs).
  • Convenors
  • Clinical attachment supervisors
  • Tutors and Examiners

What is the procedure for Fitness to Practise?

The full Fitness to Practise procedure is available on MBChB here in the Policies and Regulations Section. This flowchart also gives a summary of the procedure.