Confidential report reveals medical students' blatant disregard for patient privacy

Updated Friday 29 April with link to internal report (scanned PDF)

An internal report by the Office of the Prime Minister’s data protection unit catalogues a whole list of misdeeds by medical students at Mater Dei hospital: including disregard for patient privacy, and instances where patients have been forced to undergo medical tests against their will.

MaltaToday has seen a copy of the report, which raises serious concerns on how medical students have unrestricted access to patients’ files containing confidential information, even when patients want to keep this information strictly between them and their doctor.

The same report also reveals how too much access is given to the medical students at the detriment of the patients’ privacy.

Specific areas of concern include access to rooms containing patients’ data and files, and claims that whilst staff do not approve of this action, medical students have the run of the hospital premises at all times.

“With the presumption that MDH is a teaching hospital, [it] gives them an automatic right to such information without the patient’s consent,” the report notes.

“Even though Mater Dei is a teaching hospital, it does not mean that medical students and other medical professionals – including other hospital staff – have an automatic right to patient data.”

Moreover, the report insists that “the concept that medical students have an automatic right to a patient’s file is incorrect.”

“This practice carried out throughout the hospital is unacceptable and only those who have access rights are to enter rooms where patient data and files are stored.”

The worrying revelations of the report include instances when consultants were seen “intimidating the patient”, and forcing the patient to give his/her consent to let students to carry out tests.

The report refers to a specific incident where an elderly patient was admitted to the Accident and Emergency Department and kept overnight for observations.

During her stay, a number of medical students approached the patient asking for consent to perform tests on her.

At one point, the patient was tired and refused to have further tests carried out.

However, the students continued to insist and warned the patient: “just remember that one day in the near future, you [the patient] might be under our care as medical doctors, so you’d better approve consent.”

The report claims that “such behaviour is deplorable and should never happen, let alone in a state-funded hospital.”

The report reveals that medical students were seen going in and out of wards wearing no identification tags. The report says patients were misled by the lack of tags, thinking the students were their medical officers.

 “Patients are misled, thinking that students were actually their treating medical officer.”

The report also refers to special cases patients who would be swamped by a number of students, at times reaching groups of 20.

“[They] would carry out investigations on the patient’s records without the patient’s consent, and the patient is not aware for what purposes it is collected.”

The report includes incidents when medical students “not under the firm” visited these patients on hearing of their condition.

Commentingon the report’s findings, the Ministry of Health told MaltaToday “access to clinical systems is being monitored closely”, when asked what action has been taken.

MaltaToday also contacted Jacob Vella, president of the Malta Medical Students Association and Martin Balzan, president of the Medical Association of Malta.

On the easy access to confidential data, Vella admitted there are no restrictions for clinical students to access the files.

“But as students we have our code of ethics and ethical obligations just as doctors have when accessing such files.”

Vella argued that at the end of the day, access to files helps students in their medical studies.

Balzan was of the same opinion, saying one cannot “block the medical students”.

“The overriding priority is that our students are taught how to do their job. Lack of access would hinder their learning,” he said, adding he is not aware of “such a fundamentalist approach in other countries.”

On the report’s reference to the intimidation of patients, Vella said this could have been an individual case: “Usually a student asks for the patient’s permission and if the patient declines, the student respects that decision”.

Defending the incident, Balzan, said the statement could have been misinterpreted: “I know nothing of this particular incident, however the students could have been misquoted.”

He added: “We usually encourage patients to contribute to the students’ learning by letting them perform tests.”

Regarding the fact that students refrained from wearing tags, Vella argued that if students are not wearing their tags in the hospital, they would have no access to the wards.