Disabled student “unfairly disadvantaged”, excluded from Warwick Medical School

A disabled student from the University of Warwick Medical School (WMS) had her mitigating circumstances rejected twice, a decision that has been questioned by members of staff outside of the School.

Alice, whose name The Boar has changed, alleges that the University have not made suitable adjustments to account for her disability after it initiated a Fitness to Practice (FTP) review against her earlier this year. The female student claims this led to her failing her exams, and following the rejection of her mitigating circumstances, she was required to withdraw from the University.

While the Medical School have twice rejected mitigation for new symptoms Alice suffered throughout the year that arose due to the stress of the FTP proceedings, its decisions have been challenged both times by an independent panel within the University. These new symptoms included depression, insomnia and anxiety.

When her case was sent to a Preliminary Review Panel (PRP) for the first time in September, the panel determined that they “wished for Warwick Medical School to review the case with the advice to make decisions commensurate with severe mitigating circumstances”.  This recommendation suggests that Alice may not have received mitigation proportionate to what her condition warranted.

Upon a second review in October, the panel referred the case back to the Board of Examiners again, concluding that mitigating circumstances should still reconsider the “accumulative negative impact” Alice experienced as a result of FTP proceedings. Nonetheless, a reconvened Mitigating Circumstances Panel (MCP) concluded that Alice should still be required to withdraw.

As Alice has now witnessed two PRPs – comprised of academics outside the student’s own school suggest that she ought to be granted mitigating circumstances, she believes she is a victim of discrimination.

While it is within the remit of the PRP to refer cases back to Exam Boards for further consideration, the University said that the panel “do[es] not make a recommendation”, despite the PRP having done so twice.

Diagnosed with a long-term health condition and mobility issues that require her to use a wheelchair, Alice is keen to stress how disabled students across all disciplines are greatly disadvantaged. However, she had hoped a medical school, with a greater understanding of her challenges, would have been more aware and accommodating.

This is indirect discrimination, and I do not believe the School are as ‘disability aware’ as they should be

– Alice

“Whether there is conscious bias or not,” she says, “the Medical School are applying policies and procedures that are not fit to support independent student needs. What may be appropriate for an able-bodied student may not be appropriate for someone in a wheelchair, nor for a student with a different disability.

“This is indirect discrimination, and I do not believe the School are as ‘disability aware’ as they should be.”

The inciting incident was an instance of ill-health during an exam, after which she was accused of unprofessional behaviour by some members of staff after declining their offers of assistance. Alice, however, states that she thought the assistance offered was not appropriate for her condition.

Having handled her disability and other conditions for several years, she asserts that any refusal of the School’s “help” did not demonstrate a lack of professionalism, which she was accused of as part of Health Welfare and Professionalism (HWP) proceedings, but rather demonstrates her ability to attend to her own needs.

After the inciting incident Alice faced an HWP group procedure, where she was asked to reflect upon her “health” and “professionalism” as factors potentially hindering her fitness to practice.

Allegations made by the School against Alice’s attitude, she claims, are unfair and evidence a lack of understanding of her disability.

In a second instance where Alice was accused of being unprofessional, she deferred submitting an “optional” self-referral to the HWP board as a result of ongoing personal circumstances, including a major acute flare up of her condition and anxiety relating to accessibility issues she was having with her community accommodation. The board told Alice that this deferral “demonstrated a lack of insight into [her] professionalism and health issues”.

She told The Boar: “It comes down to the University thinking I couldn’t handle being a doctor because of my condition. What people fail to realise is that I am more than just my disability. I used to be able to walk, and I was a dancer; regardless of my disability, I used to be resilient, and I still am. It has not defined me, and being precise and self-aware about what my disability requires in fact demonstrates my own foresight, not a lack of professionalism.”

“When I’ve spoken to patients”, she says, “they’re really positive about my disability; but here, and when I speak to other professionals, it’s as if they’re not judging my personal qualities. They seem to be thinking, ‘if this were me, how would I cope as a doctor with all of these challenges?’, and then projecting their insecurity onto me.”

The student claims that, despite speaking to staff about her deteriorating mental health, she was not once directed to Wellbeing Services

In addition to Alice’s statements in defence of her own health and professionalism, at the FTP panel hearing on 12 March the board saw a letter of support from her bedside tutor.

This stated that Alice had “established good relationships and empathised well with patients…I have seen nothing to justify denying her access to patients.” Nonetheless, it was deemed that Alice’s fitness to practice “may be impaired”, and that she would be subject to an investigation.

Although she was required to withdraw in August this year, Alice has had the legal support of a solicitor since March and will be submitting a complaint to the University on the grounds of “discrimination, harassment and bullying”.

This solicitor has also called into question university procedure used by the academic registrar to overturn the PRP’s decision. While two different PRP boards recommended that Alice’s mitigating circumstances be reviewed, the registrar on the first occasion declared that the panel were acting “outside of their remit” in making such a recommendation and thus demanded that Alice submit a fresh appeal. Submitting a new appeal meant that Alice could not start her course again.

FTP hearings in the Medical School are brought against students “where evidence such as, but not limited to issues of: behaviour, attitudes, dishonesty… or illness likely to pose a risk to the student themselves, their colleagues or others,” exists that suggests an impairment of their fitness to practice.

On the WMS Moodle webpage, there is a section dedicated to understanding FTP procedures, including a section on ‘myth busters’. Two examples of such myths include: “the myth that students should not tell their schools about a health concern, or that students often get expelled through student fitness to practise procedures.”

Alice was accused of being unprofessional after she deferred submitting an “optional” self- referral… [while experiencing] a major acute flare-up

The student further claims that, despite speaking to staff about her deteriorating mental health in relation to her HWP and FTP proceedings, she was not once directed to Wellbeing Services for support.

On other occasions, Alice also maintains that the University contravened procedure that allows students to submit information on their health requirements only once, and so not be required again to specify their needs to members of staff, where the condition is ongoing.

During her two years at WMS, Alice suffered one major acute flareup of her illness. This was adjusted for by allowing Alice to repeat a year; however, during this repeat year, her symptoms of depression, anxiety and insomnia were not mitigated for. She attributes these conditions to the additional stress that the review procedures placed on her wellbeing, which the University refused to mitigate for.

Alice alleges that WMS referred to the HWP and FTP processes as a “normal” level of stress that she was expected to deal with. Alice strongly refutes this justification.

She asserted: “This notion clearly does not take into account the disadvantage at which I’m already placed by having a disability. This, again, is indirect discrimination.”

An anonymous member of staff who sits on mitigating circumstance panels (not from the Medical School) told The Boar that this case is a prime example of why mitigating circumstance panels should comprise members of staff from the Health Centre and Wellbeing team, who would be better equipped to deal with cases such as Alice’s.

In relation to their own mitigating circumstance experiences, the staff member said that there had been a lot of tension within their department about academic and administerial staff sitting on such panels; that they often felt panels lacked “experts” capable of assessing a student’s health; and that they felt it unfair on such staff to bear this responsibility.

The University of Warwick declined to comment any further as of 29 November 2019 as “external appeal processes are available”, although Alice received a ‘completion of procedures’ letter on 27 November.

What may be appropriate for an able-bodied student may not be appropriate for someone in a wheelchair

Alice told The Boar: “I do not feel I have been heard or that issues relating to my disability have been fully acknowledged and understood. I also do not believe that adequate procedures are in place at WMS in line with the Equality Act 2010.

“Although I value my privacy, I feel that I can no longer keep quiet so as to prevent this from happening to other students. Often when things happen to us in life we feel isolated and think ‘I am the only person who this is happening to’. It is not until we speak out that we find that there are others experiencing similar situations.

“In my eyes, silence is condonence. If by speaking out I help another person it’s a job well done… I am doing this to enable other students to have the confidence to break the silence and to prevent these injustices from occurring in the future. This has had a severe detrimental impact on my physical and mental wellbeing as well as my existing disability and no student should be treated in this manner.

“Again, another incident has occurred at the University which has not been addressed satisfactorily; it reminds me very much of the group chat scandal. This maltreatment should not be allowed to occur, and certainly should not be allowed to happen again.”