Med student travel rort 'much wider' than first thought

More than 50 University of Otago medical students have had their qualifications withheld after the tertiary institution found an overseas placement rort was "much wider" than first thought.

In a statement today the university said that, after information about medical trainee interns failing to meet elective placement attendance expectations came to light in recent months, it had identified the problem was much wider than first thought.

Following a requirement that all students provide an attendance declaration as part of an ongoing investigation, the university ascertained that one in 5 (21.5%) of its final-year medical students in 2019  failed - to a lesser or greater degree - to meet acceptable attendance requirements.

Dean of the Otago Medical School, Professor Barry Taylor said the Medical School was "extremely disappointed" by the extent of the issue.

“While the majority of trainee interns have completed their placements in hospitals and medical centres where they said they would be - a significant number are involved in a major breach of our trust.”

On the basis of the information gathered, 53 students (21.5%) have had their qualifications withheld.

The university was working on a package of consequences for students.

These would include automatic referral to the Fitness to Practice Committee; they would need to pay back the grant funding for each week of holiday they took instead of attending their placements; write a self-reflective essay and agree to a package of community service or research that would ensure time lost from the elective is made up.

They would be unable to graduate with the rest of their class in December.

The rest of the sixth-year students - 194, who met attendance requirements - have been granted terms and would graduate next month.

Working with the Medical Council, the university has identified a restorative pathway which may allow students involved to begin contributing to the health system without undue delay.

Prof Taylor highlighted that elective placements were aimed at broadening a student’s overall experience rather than teaching essential clinical skills and students involved were already well qualified to commence clinical work. 

This allowed for consideration to be given to the remedial work the university would require, and other consequences, not overly delaying the entry of a significant numbers of new doctors into the hospital workforce.

"The failure to complete an elective does not mean that a person lacks the skills to function fully as a first year doctor, and we will be taking this into account in our subsequent decision making on these students," he said.

"We will however be requiring completion of work that we are satisfied is at least equivalent to that which has been missed and there are significant other consequences for those involved."

Students had been told they had the opportunity to have their cases reconsidered at the end of this week and at that point may be able to seek registration for the Medical Council. 

Before that, students would be required to make a binding commitment to carry out additional community and/or academic work at least equivalent to the time they missed on placement. 

Such work would be monitored by the Medical School and non-compliance reported to the New Zealand Medical Council. 

Additional educational actions would also be required, along with the requirement to make proportionate repayment of their training grant for the period when they were not in attendance at their placement.

All students in the group will also be considered under Medical School Fitness to Practice processes.  This is likely to see cases referred to the New Zealand Medical Council, which has the option of imposing monitoring of individuals once they commence work as doctors.

The university’s withholding of qualifications at this point also means that students involved will not be able to graduate in December alongside the rest of their class.

Prof Taylor reiterated that he and the university as a whole were profoundly disappointed in the actions of these students, who let themselves, the school and their colleagues down.

"The university is disappointed in the actions of these young people, whose behaviour has fallen well short of what was expected of them as students and future health professionals. As a consequence of their decisions, they are now facing serious consequences. 

"We hope this experience will ultimately make them better, more accountable doctors.  It is our sincere hope that, in time, the students will become fully contributing members of the medical profession.

“Electives are a valuable part of a medical education which are part of the curriculum at most medical schools. These students have missed out on gaining important experiences but have also let themselves, the University, the public and other medical professionals down.”

Prof Taylor underlined that the students were in a position of privilege and trust.

"One important lesson for us is that we have to look again at relying on a system significantly based on trust.  We are reviewing what we have done that has contributed to this occurring in such a wide-spread way and have already begun taking actions to limit the chances of this happening again."

Inquiry launched

As a result of these findings, the university’s Vice-Chancellor Prof Harlene Hayne has announced a broad and detailed university inquiry that will investigate how this level of misconduct occurred and how it may be prevented in future.

While the terms of the inquiry are yet to be formally agreed, the university expected to also look into prior years to investigate whether this had happened in the past, and would report on this in due course.

The results of this inquiry are not likely to be known until next year.

Prof Taylor supported the intent and scope of the inquiry.

"This is a wide-spread situation and not likely to be isolated to this year’s students, or just this Medical School. The University acknowledges that its systems relating to the elective placements have allowed for the dishonesty to occur. It is reviewing the programme and will ensure that it contains far greater checks and balances to reduce as far as possible the opportunity for any case like this to recur," he said.

"Some immediate measures have already been put in place to decrease chances of this occurring again, such as blacklisting some locations, increased reporting requirements, and mid-placement checks with student supervisors."