Ensure the prospective pupil is mature and understands the need for confidentiality.
Define what is expected of the pupil.
Obtain patient consent before allowing work experience students to attend consultations.

Work experience placements provide future medical students with valuable insight into patient care and the daily operations of a GP practice. But before you decide whether to take on work experience students in your practice, consider the following advice.

Understanding confidentiality

Teenagers vary widely in their levels of maturity and responsibility, so you need to be happy the pupil is mature enough to behave appropriately and recognises the need for confidentiality.

The school the pupil attends may be situated within the practice area, or the student may live nearby, so it is possible they are acquainted with some of the patients. In such cases, it may be best to avoid offering a placement.

Consider restricting work experience opportunities to sixth form students who are already applying to study medicine.
Before making any decision, consider inviting the pupil to the surgery so you can find out more about them and their career aspirations, and assess the appropriateness of the placement.
Make it very clear what would be expected of the pupil and what they could expect from their time at the practice.
They should also be required to sign a confidentiality agreement before beginning work, setting out what sorts of procedures they would be sitting in on and making sure they understand and ensure any information remains strictly confidential. It can be difficult for teenagers to fully appreciate the full extent of the duty of confidentiality – even the fact that a person is registered at a practice is confidential.

Obtaining patient consent

Make it clear to your patients if your practice accepts work experience pupils. You could do so by placing a notice in the waiting room, explaining why you think it may be a valuable learning experience and stressing that a pupil would only be invited to sit in on a consultation with the patient's consent.

Refer to the GMC's guidance about informing patients of their right to refuse to take part in teaching or research.

Whenever a third party is present in a consultation, the patient should be told exactly who the person is and given ample opportunity to object. Individual patients attending the GP should have the situation explained and be asked for their consent when making their appointment.

The MDU recommends pupils' attendance be confined to pre-booked clinics, as this allows patients to decide whether they wish to take part or not.

You may need to exercise your own discretion in deciding whether the student's presence will not be appropriate in certain consultations. For example, some surgeries may make the decision to exclude third parties from consultations with young people of a similar age, or anybody else who you feel might be nervous about voicing an objection or be reluctant to discuss their case in full.

Communicating openly

Receptionists should explain the identity and status of anybody sitting in on a consultation to the patients. The pupil's identity and a note of the discussion should be on each individual patient's record.

You should also remind each patient on their arrival in the consultation room, and make it clear that the student can be asked to leave at any time if the patient is not comfortable with their presence.

Referring to the pupil as a 'prospective medical student' could be misleading to some patients; it should be made clear that the student will shortly be sitting their A levels and has applied for a place at medical school.

GPs need to consider whether some patients may feel awkward about saying they don't wish to have a work experience pupil present, and the effect that asking the question may have on the doctor/patient relationship. Patients should be told that they can withdraw their consent at any stage, even during the consultation, and that if they refuse permission for the pupil to be present this will not in any way affect the care they are given.

You might wish to consider drawing up a consent form regarding the presence of a third party in a consultation which patients can sign and which you can retain in their medical records. Again, reiterate that the patient can withdraw their consent at any stage, even during the consultation.

Your practice may also wish to check with your public and/or employee liability insurers whether they would have any concerns about pupils being in the practice for work experience.

Pupils in the practice

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