Even as a trainee doctor, the safety of patients must be your paramount concern. This guidance sets out broad principles which are intended to clarify the legal position for student doctors in regard to work undertaken with patients. For these purposes, a student is one whose name is on the Medical Student Register and who has access to patients as part of an agreed attachment under the supervision of a specified medical practitioner.
- Always wear a badge identifying you as a student doctor, and introduce yourself as such
- Always obtain a patient’s permission to see/examine him/her.
You may not: –
- initiate X-ray or other diagnostic investigations; request blood for
- make a formal diagnosis of death;
- perform any practical procedure nor give any medication (intravenous or oral) without authorisation and supervision by a medical practitioner
- sign statutory certificates (e.g. death) or prescription sheets;
- obtain patient consent;
- witness a patient’s signature on any official hospital document;
- sign hospital accident forms;
- ‘identify’ patients before operation;
- check blood bags for transfusion;
- authorise any patient to be discharged from hospital (particularly A&E)
In regard to patient care, students report to junior doctors as part of the clinical team which reports to the consultant. When the trainee doctor is absent he/she is required to designate another qualified doctor to cover him/her and a student may be an assistant to the official deputy. Whenever doubt exists as to patient management, seek assistance from a qualified doctor or, in obstetrics, from a certified midwife. The degree of supervision is determined by the practitioner and so will vary from firm to firm; consequently students may find that in some firms they are allowed to carry out duties which are forbidden in others.
If you undertake a task which you know – or ought to know – that you are not qualified or sufficiently experienced to perform, you may be guilty of negligence. If a patient were to suffer harm as a result of your exercising less than reasonable care, you might be held personally liable/legally responsible. You could in theory be sued, but in practice the patient would sue the supervising practitioner or the Hospital Trust and it is unlikely that the hospital authority would refuse to assist a student with any defence that might be necessary, or to meet damages if awarded. The level of responsibility which had been delegated to the student by the supervisor must be held to be reasonable in regard to the student’s experience and level of attainment. If you had been given a task to perform for which you were not sufficiently skilled, a court would probably conclude that you were not to blame for having performed it badly.
If a patient suffered injury as a result of a procedure carried out by a student, a Medical Defence Organisation would be expected to support the member responsible for the student at the time, provided that the student had been authorised to undertake the procedure in question.
Medical students must take advantage of the free cover provided by Medical Defence Organisations before they meet any patients (i.e.at the start of Year 1).
Carry out only those tasks authorised by a consultant or named deputy and perform the task on the basis of a standard procedure and you will not incur legal liability.