Since the beginning of this century, Erasmus MC has sought to have more options to expel unsuitable medical students. Since 2010, this has been possible if a student poses a danger to fellow students, colleagues, or patients, but this remains difficult to prove. Therefore, the examination boards of all medical programmes want better guidelines to protect the safety of future patients, but so far these efforts have been in vain.
For this article, author Tessa Hofland spoke with doctors and supervisors from Erasmus MC and other university medical centres, eighteen in total. Some interviews were lengthy, while others were more brief.
Additionally, the author relied on written sources; including legal rulings from the Council of State and the Higher Education Appeals Tribunal regarding the iudicium abeundi, teaching and examination regulations from the Medical programme, the 2022 plea from the chairs of the examination boards, the iudicium abeundi protocol from the Dutch Federation of University Medical Centres, parliamentary questions and responses, and a memorandum explaining the introduction of the iudicium abeundi, as well as parliamentary questions following the plea from examination boards for an expansion of the iudicium abeundi, a PhD study on professional behaviour among medical students, and several articles. Documents can be checked at the editorial office upon request.
It is important to note that the idea for this investigative project emerged before the attack by Fouad L. at Erasmus MC. The issues had arisen before he was a medical student and continue to persist even after his sentencing to life imprisonment. However, this horrific event has intensified the urgency of this research.
The impetus for this investigation was an article about an expelled student that was rapidly read multiple times on the EM website, and which became a topic of ongoing discussion among medical students – as students informed us at the time. Following the attack, EM delayed the production of this story due to the sensitivity of the subject at Erasmus MC.
This investigative journalism project about the possibilities and impossibilities of expelling a medical student from the programme, concentrates particularly on the period when students are undertaking medical internships. The reason for this focus is that all publicly known examples of the application of the iudicium abeundi related to students who encountered problems during their medical internships. Therefore, the author focused on doctors who supervise these students.
Too many medical students about whom there are serious doubts regarding their suitability as doctors receive their diploma, examination committees and programme directors say. They have been calling on the government since the start of this century for more options to expel these students. The murder of a lecturer at Erasmus MC in 2023 raised the question: why is it not possible to expel clearly unsuitable students from medical programmes?
Medical interns wear a white coat and are therefore seen by patients as doctors. This brings a significant responsibility, not only for them but also for the doctors who supervise them. “It all boils down to one question: would you want this young doctor by your bedside?”
Examination boards and study programmes want it to become easier to expel unsuitable medical students, as they fear for future patient safety. Berk Uzunalioglu, chair of the advocacy group De Geneeskundestudent, calls for caution. “Patient safety and the right to education don’t have to be at odds.”
An assessment from a doctor who has never seen you, little in-depth feedback, a discriminatory nickname… Medical interns have a lot to deal with. Four (former) interns share their experiences – including the very positive ones.
The Council of State has rejected the appeal of a medical student who was expelled. The student was removed from the programme due to concerns regarding future patient safety should they become a doctor. According to the university, there was a ‘pattern of unprofessional behaviour’. The student was already presenting himself as a doctor on LinkedIn.
