Registration of medical students by medical boards

Medical Boards throughout Australia are considering amending their respective Medical Acts so that all students in each State or Territory are required to be registered with their Medical Board as a prerequisite for studying medicine. Such amendments have arisen from the increasingly litigious environment, the growing role of clinical education in traditionally preclinical years, and the recognition that medical students enjoy many of the doctor–patient privileges of fully qualified medical practitioners and must therefore assume appropriate responsibilities.

• New South Wales was the first State to introduce this requirement, having done so in 1992 after broad consultation. The Board's sole concern is with impairment, not misconduct or improper behaviour. In NSW this requirement has been well accepted and is perceived as an additional support mechanism for students.

• Victoria passed legislation in 2000 for registration to start in 2002, but precise details are not available (at the time of the Conference). This followed extensive consultation with students over the preceding years. The model is not dissimilar to the NSW model. Again, the Board's role relates solely to impairment.

• In South Australia, at the time of the Conference, legislation is before the upper house of parliament. There is a perceived lack of recent student consultation on the proposal. The proposed model possesses somewhat stronger teeth than the NSW or Victorian models in that it applies to medical students the same conditions of registration as currently exist for doctors. [This Act has lapsed. There was a change of government in South Australia before the Act was passed.]

• In Western Australia, there is strong student opposition to universal registration. The current proposal is that the Medical Board would have jurisdiction only over students referred by the University of Western Australia Faculty of Medicine, but negotiations are continuing.

• The concept has been mooted in most other States and Territories. Specific time frames are unknown.

The aim of registration is to facilitate early detection of impairment that would compromise patient welfare; to encourage impaired students to seek support; to facilitate alternative arrangements for medical students to enable disabled or impaired students to complete their degree; and to minimise risk to the public.

The Australian Medical Students' Association (AMSA) recognises the potential value of registration of students. It should be viewed as an additional support mechanism, as a way of supporting impaired medical students through their course, or assisting them in finding another career path should medicine prove to be unsuitable. If it is perceived as punitive or adversarial, it will not be accepted by students.

AMSA believes that the precise purpose of medical student registration needs to be very clearly defined given the significant additional powers that such an initiative would bestow upon State medical boards. Recognising the scope for its misuse, it is vital that the registration of medical students only be used for the initially intended purpose:

• to minimise risk to patients;

• to develop an impartial mechanism of notification and investigation of complaints against students, independent of the university; and

• to allow recognition of medical students by any public hospital, teaching or non-teaching, in that State.

The medical boards should only initiate investigations if they believe that the ability of a registered medical student to have direct patient contact may be affected by the student's physical or mental health; if the student has an impairment; or if the student has exhibited unethical conduct. Complaints made on other grounds, such as academic performance, should not be investigated by the Board, but should instead be referred to the university.