Faizal and Tek are fourth year Medical Students. They are Malaysian and are studying in Ireland through a government programme. Three mornings a week, the students have lectures in the teaching facility at the University Hospital.
The University operates a sign-in policy and there are attendance requirements to complete the year. A fire drill is conducted one morning and the students congregate at the assigned safety area. The lecturer uses the sign-in sheet to confirm everyone has been safely evacuated.
Tek’s attendance is confirmed but Faizal cannot be located. On closer inspection, the lecturer notes similarity in penmanship used to sign both Tek and Faizal’s name. She looks back over previous sheets and notes this is a recurring pattern.
She challenges Tek on this point after class and he explains that Faizal has not been well for a number of week: Faizal’s mood is low, his sleep disturbed, he has lost interest in his studies and can’t see the point in continuing.
Tek explained that this happened in first year too and Faizal recovered after a couple of months, though needed to repeat some exams. Tek admits his error but explains that it would cause Faizal and his family much embarrassment if Faizal had to leave the course.
(Before reading further, take a moment to reflect on the scenario presented above, and the issues which you think this scenario raises)
In the above scenario, there are a number of factors to be considered. In the first instance, Tek should not have played any role in falsifying his colleague’s attendance record, or misleading the University in any way.
Tek could have advised Faizal to seek pastoral, and possibly clinical, support through the University which has support structures in place. Doctors are obliged to raise concerns regarding the conduct or wellbeing of colleagues and fellow students at the earliest opportunity, and with patient safety as the over-riding priority.
The falsification of the attendance record, which may have been done with misguided good intentions, still amounted to falsification of official University training documents.
Falsification of documentation is a serious transgression of a doctor’s responsibilities, and could have serious personal, professional and patient safety implications.
Faizal had a responsibility to manage his own health by seeking support at the earliest opportunity from the University to ensure he received whatever assistance was required.
Doctors and students may sometimes be reluctant to confront or recognise their own limitations, or be reluctant to seek help, but it must be remembered that support is always available, and that their duty as doctors or future doctors must outweigh any personal reservations.