Students · Fitness to practise

Student Fitness to Practise: How University Panels Work and What They Mean for Registration

Q: Does the GMC or NMC investigate students?

No. Your university or education provider handles student fitness to practise. The regulator considers your history when you apply to register.

Q: Do I have to declare a student fitness to practise outcome when I register?

Usually, yes. GMC guidance says matters considered by a formal panel or hearing should be declared unless the outcome was no further action. NMC registration relies on your institution's declaration of your health and character.

Q: Will a warning as a student stop me registering?

Not necessarily. Regulators consider the seriousness of the concern, your insight and whether you declared it. In 2025, fewer than 0.1% of GMC provisional registration applications that included a fitness to practise declaration were refused.

Q: Can I be removed from my course for a social media post?

It is possible where posts raise serious professionalism concerns. But in Ngole v University of Sheffield, the Court of Appeal overturned a removal because the university's process was unfair and never explained the real concern.

Q: Do I need to declare spent convictions to my university?

Health and care courses are generally exempt from the usual rules on spent convictions, so you may be asked about them. In HA v University of Wolverhampton, the court upheld a university's right to ask.

Q: What if I have a health condition?

GMC student guidance says that if there are no conduct concerns and you are seeking and following treatment and managing any risk, your fitness to practise is unlikely to be called into question.

Q: Can I challenge a university fitness to practise decision?

Yes. Use the internal appeal first, then complain to the OIA in England and Wales. Courts treat judicial review as a last resort.

Who handles concerns about medical, nursing, dental, pharmacy and allied health students, what each regulator expects, the outcomes a panel can reach, what you must declare when you apply to register, four court decisions about student cases, and how to respond and challenge a decision.

Reviewed October 2026 against GMC, NMC, HCPC, GDC and GPhC guidance, GMC and OIA data and court judgments

University or regulator? Outcomes and registration Appeals and the OIA

Short answer: while you are a student, concerns about your conduct, health or professionalism are handled by your university or education provider through its own fitness to practise procedure, not by the regulator. Those procedures follow your future regulator's standards and guidance. Outcomes range from no action or a warning to conditions, suspension or expulsion from the course. Formal outcomes usually have to be declared when you apply to register, and the regulator will consider them then. Most concerns are resolved with support and learning, and honest, early engagement with the process makes a significant difference.

Key takeaways

Your university, not the regulator, runs student fitness to practise. But your regulator's standards apply.
A student fitness to practise outcome can follow you to registration. GMC guidance says formal outcomes should be declared unless the outcome was no further action.
Very few students are refused registration. In 2025, 5.4% of UK medical graduates declared a concern to the GMC, and fewer than 0.1% of those were refused.
Not declaring something to your university is itself a common route into fitness to practise.
Universities must follow their own published procedures fairly, and courts have overturned decisions where they did not.
In England and Wales, the Office of the Independent Adjudicator (OIA) reviews complaints after internal appeals. Fitness to practise made up 2% of the 3,613 complaints it received in 2024.

This guide is for students and those supporting them. Once you are registered, your regulator handles concerns, as explained in our complete guide to fitness to practise.

Who handles student concerns, regulator by regulator

Regulator	Who runs student FtP	What the regulator says
GMC	Medical schools	Joint GMC and Medical Schools Council guidance, Professional behaviour and fitness to practise, sets out how schools manage concerns. It "only applies to medical students. Once a doctor is registered, the General Medical Council monitors their fitness to practise."
NMC	Approved education institutions and practice learning providers	They "are required to have a local fitness to practise panel to consider health or character issues". Your institution provides a supporting declaration of your health and character when you register.
HCPC	Education providers	Guidance on conduct and ethics for students (September 2024) explains how the HCPC's standards of conduct, performance and ethics apply to students on approved programmes.
GDC	Dental schools and training providers	Student professionalism and fitness to practise guidance, based on the standards required of registered dental professionals.
GPhC	Schools of pharmacy and training providers	"All Fitness to Practise (FtP) hearing outcomes imposed by the education or training providers must be reported to the GPhC once the hearing has concluded."

What leads to student fitness to practise

Student cases often start with matters that seem small at the time. The court decisions later in this guide involve four of the most common triggers.

Academic dishonesty

Cheating in assessments, plagiarism or falsifying placement records. Treated as a probity issue, not just an academic one.

Failing to declare

Not disclosing a caution, conviction or other matter when applying or during the course.

Conduct online

Social media posts that raise questions about professionalism or respect for others.

Placement conduct

Behaviour towards patients, service users or staff, confidentiality, or attendance on placement.

Health not managed

A health condition affecting safety where the student is not engaging with support or occupational health.

Conduct outside study

Criminal matters or behaviour in private life that could affect public trust.

Health on its own is not a concern GMC student guidance says that provided there are no concerns about the student's conduct, "they are seeking and following treatment and advice, and taking steps to manage any potential risks to patients, it's unlikely their fitness to practise will be called into question" (para 14). Our guide to health and fitness to practise explains how this works after registration.

The outcomes a student panel can reach

GMC and Medical Schools Council guidance sets out the outcomes available to medical schools. Other professions use similar ladders under their own providers' procedures.

No actionFitness to practise not impaired, and no risk to patients or public confidence.
WarningBehaviour "is a significant deviation from expected standards", but fitness to practise is not impaired.
Referral to a panelFrom an investigation, where fitness to practise "may be impaired".
UndertakingsAgreed commitments, where they "offer sufficient safeguards" and the student shows insight.
ConditionsImposed by a panel to protect patients while in force.
SuspensionThe breach is serious, "but not fundamentally incompatible with the student continuing".
ExpulsionThe student "has behaved in a way that is fundamentally incompatible with being a doctor".

What happens when you apply to register

GMC

Declared and considered

The GMC "will consider any issue that calls their fitness to practise into question" when students apply for provisional registration (para 20). Matters "considered by a formal panel, committee or hearing" should be declared, "unless the outcome … was no further action" (para 21).

NMC

Your institution vouches for you

Your education institution provides a supporting declaration of your health and character. When assessing character, the NMC also checks whether you disclosed any charge, caution, conviction or conditional discharge to your education institution.

540UK medical graduates (5.4% of applications) declared a fitness to practise concern when applying for provisional registration in 2025

<0.1%of those applications led to provisional registration being refused

Source: GMC, declaring your fitness to practise (provisional registration). In 2022, the GMC processed 7,943 applications and refused 3, after updated guidance more than halved unnecessary declarations and cut health declarations by 63%.

The GMC also says that telling it something "doesn't mean we won't approve your application". It may ask for more information or documents. Its "What to tell us when you apply" tool explains what does and does not need declaring, so students do not over-declare well-managed conditions.

A student outcome is not a bar to registration in itself. What matters is the seriousness of the concern, what you have learned from it, and whether you declare it fully. An outcome that was handled well and declared honestly is usually far less of a problem than one that is left off a form. Our guide to failure to disclose shows how seriously regulators treat omissions on registration forms.

Four court decisions about student cases

Real case · Court of Appeal · 2019

Ngole v University of Sheffield [2019] EWCA Civ 1127

The facts. A social work student posted religious views about same-sex marriage on a public Facebook page. The university's fitness to practise committee found he lacked insight and removed him from the course, and an internal appeal upheld that.

The outcome. The Court of Appeal allowed his appeal. The university had taken the position that any public expression of those views would breach professional guidance, and "at no stage" made clear "that it was the manner and language in which he had expressed his views that was the real problem". The court said "it was the University and its processes which could be said to lack insight", and that his apparent intransigence was "an understandable reaction".

The lesson: a fair process explains the real concern and gives the student a chance to engage with it. Students, in turn, should show willingness to reflect on how they express themselves, even where they hold their views sincerely.

Real case · High Court · 2018

HA v University of Wolverhampton [2018] EWHC 144 (Admin)

The facts. An applicant to a pharmacy degree did not disclose two convictions from when he was 14, saying he had relied on advice from a probation officer. The university's fitness to practise panel found impairment based on dishonesty and failure to declare, and excluded him from the course.

The outcome. The High Court dismissed his challenge. The university was entitled to ask about spent convictions because it acts as a "gatekeeper" for the profession (para 111), and its form made clear that "spent convictions are to be disclosed" (para 125).

The lesson: health and care courses are exempt from the usual rules on spent convictions. Read the disclosure question carefully, and if unsure, disclose and explain.

Real case · High Court · 2020

AW v St George's, University of London [2020] EWHC 1647 (Admin)

The facts. A medical student returning from a long interruption of studies for medical treatment was required to attend an occupational health assessment. She cancelled it and did not return on the expected date, and the university terminated her registration on the course.

The outcome. The High Court quashed the termination. The university had not made clear that missing the assessment or re-enrolment date would lead to termination (para 95). A university "should act consistently with its published policies" (para 78), and students should be told of concerns in enough detail to respond.

The lesson: universities must follow their own procedures and give fair warning. Students should keep every letter and ask in writing what will happen if a deadline is missed.

Real case · Court of Appeal · 2018

St George's, University of London v Rafique-Aldawery [2018] EWCA Civ 2520

The facts. A medical student whose registration was terminated after a fitness to practise finding involving cheating and dishonesty submitted psychiatric evidence four months after the hearing. The university refused to reconsider. He began court proceedings while also complaining to the OIA.

The outcome. The Court of Appeal held that "judicial review is a remedy of last not first resort" and that the OIA "is … a suitable alternative remedy to judicial review. It is relatively swift and cost effective" (para 18).

The lesson: raise health and other mitigation at the time, not after the decision, and use the internal appeal and the OIA before considering court.

If you face a student fitness to practise process

Read your university's procedure. It sets out the stages, deadlines and your rights. Universities are expected to follow it.
Get support early. Your students' union advice service, personal tutor and, where you have student membership, your defence organisation or union can help.
Raise health or personal circumstances at the start. Evidence submitted after the decision may not be considered.
Engage and reflect. Panels look for insight. Explain what happened, what you have learned and what you will do differently. Our reflective practice course can help you structure written reflections.
Be honest about everything. An omission discovered later usually causes more harm than the original concern.
Use the internal appeal. Most universities allow appeals on grounds such as procedural error, new evidence or a disproportionate outcome.
Then the independent complaints scheme. In England and Wales, you can complain to the Office of the Independent Adjudicator once internal procedures are complete. In Scotland and Northern Ireland, complaints about universities go to the public services ombudsman.

The OIA's Good Practice Framework includes a section on fitness to practise, which expects providers' processes to be fair, prompt and proportionate. It describes these processes as being about "ensuring the safety of the student and those around them" while balancing "fairness to the individual student whose career is at risk".

3,613complaints received by the OIA in 2024, up 15% from 3,137

2%of complaints received related to fitness to practise

Source: OIA annual report for 2024.

Frequently asked questions

Does the GMC or NMC investigate students?