The boards are referring to students who exhibit unprofessional conduct, thereby endangering the safety of patients. Research has shown that ‘such students often find themselves facing disciplinary action later in their career’,the eight examination boards write in the Dutch Journal of Medicine.
Since 2010, faculties at higher education institutions have been able to refuse or expel a student they consider to be unsuited to the profession ‘because of their conduct or public statements’.
This power was introduced by the then Education Minister Ronald Plasterk in direct response to a case in which a paedophile applied to study Educational Sciences in 2007. The man was the secretary of the Party for Neighbourly Love, Freedom and Diversity, a political organisation commonly known as the ‘paedo party’. By investing the necessary time and effort in legal action, three universities were able to refuse him admission. Plasterk wanted to create a more robust basis for refusing students on grounds like these.
The Faculties of Medicine subsequently came up with their own ‘right to expel’ regulation. This was used for the first time in 2015, after a medical student sent messages of a sexual nature to a 15-year-old patient and her mother.
Nevertheless, the examination boards argue that the ‘right to expel’ regulation does not always work in practice because the legal requirements are too strict. For instance, the faculty has to demonstrate that the student concerned is putting others at risk. “But if there are indications that a student could be a danger, you cannot leave them alone with a patient”, explains Fred Petrij, clinical geneticist and chair of the examination board at Erasmus MC.
He adds that the complex procedure involved ‘demands so much time and energy of the examination boards that they generally don’t even attempt it’. In over ten years, the ‘right to expel’ regulation has been used successfully on three occasions, while it is estimated that each medical faculty has at least two unsuitable students at any given time. “It is more or less a matter of waiting until they trigger an incident that is serious enough to invoke the regulation”, the examination boards write.
Unprofessional conduct during internships cannot always be substantiated either. The boards say students often get away with an undeserved pass because the doctor ‘is too busy’ to assess them properly or ‘has no time for the considerable red tape associated with a fail’.
The examination boards now want to expand the ‘right to expel’ regulation. They feel that if, in the eyes of supervisors, a student should not be left alone with a patient, this ought to be given the same weight as a situation in which patient safety has actually been compromised. They also advocate a Professional Conduct portfolio – a sort of certificate of conduct – as part of a student’s file, which should be readily accessible even if the student switches university.