Risk, in regulatory terms, is usually considered in terms of risk to patients, but students and practitioners may, themselves be at risk of harm or self-harm in environments where they are unsupported or subject to unreasonable demands.
Students and doctors are at risk of poor performance because of:
- lack of knowledge and skill (training and CPD)
- inability to apply knowledge and skill (personal and external factors)
- impairment (mental or physical illness, substance abuse, age related conditions)
- lack of professionalism (personality and circumstantial factors)
When a student or doctor demonstrates features of both impairment and poor performance, it is essential to deal with their health as the priority. They are unlikely to be responsive to remedial interventions if they are unwell or cognitively impaired.
It is a consistent findings across jurisdictions that poor performance is particularly associated with older age, male gender, previous complaints/poor prescribing, isolated practice, international graduates, high volume practice. Recognising these risk factors enables limited resources to be targeted where they are most effective. Clearly, it is desirable to identify potential performance issues early, when intervention (remediation or risk-modification) is easier and before harm, either to patients or the student/practitioner occurs. This often requires a partnership between the workplace and the regulator; the latter offering a range of graded interventions that reserve disciplinary action for a minority of cases.
This paper will explore:
- the identification of medical students and doctors at risk
- work-place interventions
- ‘right-touch’ regulatory interventions
Co-location with:
