'Patients have right to refuse students' tests' - University of Malta

The University of Malta has said patients have the right to refuse being tested by medical students and that they cannot be coerced into doing anything against their will, in a reaction to a confidential report of the Office of the Prime Minister in 2009 which catalogues the disregard for patient privacy by medical students.

The report raised 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.

“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.”

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. Allegedly, the students warned the patient that s/he might be under their care in future as medical doctors "so you’d better approve consent.”

The health ministry called the “single observations” illustrated in the report as “not representative of the great majority of medical students” and that they did not give a true picture of the situation in 2009, “let alone today”.

The ministry said action was taken to make doubly sure that all ethical duties are effectively communicated to all clinical students. “MDH management does not tolerate any shortcomings by students and if any specific case is brought to the attention of MDH management then all necessary disciplinary and/or corrective measures will be taken as necessary,” it said in a statement.

The University of Malta also said the issues had been raised at a meeting between the Mater Dei CEO and director of information management and the dean of the Faculty of Medicine & Surgery.

“All the issues were addressed and the necessary corrective action was taken. In addition, in July 2010, the medical council subsequently issued a booklet entitled ‘Guidelines for Medical and Dental Students: Professional Values and Fitness to Practice’.”

In another reaction, the Malta Medical Students Association said only students within the last three years of their studies “have access to wards, patients and data”.

“Since the issue of the report, considerate revision of medical education and hospital administration protocols have been enacted,” the MMSA said in a statement.

The MMSA said that amongst the reforms to their privileges, every clinical medical student is to sign a document as agreement to abide by all data protection hospital policy and government legislation.

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.

The MMSA said that students were given identification tags which must be put against a sensor at the ward door in order to gain access to it. “Students are not allowed to take files out of the ward where the patient is residing. Moreover, the medical curriculum goes specifically into patient-professional communication, ethics and behaviour by including numerous sessions throughout the year and five 3-day seminars through the 5-year course.”

The MMSA said these sessions commence as from the first year, to make sure that disregard of psychological and social issues do not occur once qualified.

The students’ association also defended data access, saying this gave students the opportunity to start relating medical findings to the patient’s symptoms and findings from a physical examination.

“One other diagnostic ‘test’ performed by students is supervised blood sampling. Postponing such crucial training to the time when one is a qualified junior doctor will only lead to the doctor not having the necessary skills and attitude required. This process is also guided by the Malta Medical Council under a set of published guidelines for medical students.”