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Practice dilemma: Student wants work experience

You are approached by a pupil from a local college who wants to sit in on consultations for work experience. What are your responsibilities regarding patient confidentially? Our legal expert gives advice.

You need to be happy that he is mature enough to behave appropriately, recognises the need for confidentiality and that his school or college takes a responsible attitude towards his conduct [1]. If you decide to go ahead, the pupil should be required to sign a confidentiality agreement before beginning work.

It may be best not to offer work experience to anyone living within or near the practice area in case they encounter someone known to them.

If your practice decides to accept a work experience pupil you need to make this clear to patients. You must stress that the pupil will only be invited to sit in on a consultation with the patient's express consent.

The MDU recommends that pupils' attendance be confined to pre-booked clinics, as this allows patients ample time to decide whether to agree to their presence. Receptionists should explain to patients the identity and status of anybody sitting in on a consultation.

It is important that the pupil's identity and a note of the discussion appear on each individual patient record.

Patients should be told 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 may decide that the pupil's presence will not be appropriate in certain consultations, particularly if his presence might inhibit disclosure of relevant medical information by the patient.

Dr Wendy Pugh, MDU medico-legal adviser

Dr Wendy Pugh