It’s almost impossible to get rid of unprofessional medical students

Removing medical students who behave unprofessionally from the programme is too difficult, says Gerda Croiset, pro-dean at the Faculty of Medical Sciences.

Mario Maas, the national chair of the medical examination boards, feels this should change. He shared his concerns in a piece published in the Volkskrant. Medical students can be removed from their programme through a legal arrangement called the Iudicium Abeundi. But it’s only allowed when a student has put a patient’s safety at risk.  

Maas also wants to be able to get rid of students who display morally reprehensible behaviour, who manipulate their colleagues, make remarks of a sexual nature, or who talk aggressively to patients.

Improvement process

Croiset agrees. Physicians who performed badly were shown to display poor behaviour during their studies, too. Students like that do get singled out now, she says, during the course on professional development, which is embedded in the entire curriculum. These students then enter an improvement process. 

However, this doesn’t always have the desired results. Both Maas and Croiset emphasise that there are very few students who actually need this. ‘99 percent of students do just fine’, says Croiset. ‘But there’s still that one percent that just doesn’t have it in them to be a doctor or a dentist.’ 

They usually succeed in getting through to someone like that, she says. They’ll finish their bachelor’s and then move on to something different. But occasionally, this doesn’t work, and students keep making mistakes across various internships, without realising their behaviour is the problem. 

Disciplinary board

The board of directors has the authority to remove students like that from the programme, but they can appeal this decision with the disciplinary board in The Hague. Cases like that are perhaps even more complicated than dismissal procedures for poorly functioning employees, says Croiset. Because kicking someone out of the programme for their attitude and behaviour ‘is nearly impossible’.

After all, everyone has the right to education, says Croiset. ‘That means someone will have to behave particularly poorly to forfeit that right.’ But at the same time, someone like that shouldn’t be allowed to work with patients, she feels. ‘Their attitude and behaviour should be impeccable.’ 

She also feels it’s a matter of trust between colleagues. ‘Everyone should be able to depend on each other. Otherwise, you’ll end up making medical mistakes.’


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