The Aspiring Psychologist Podcast - Fitness to Practice for Trainee Psychologists: What No One Tells You

Starting point is 00:00:00 Could one badly judged email, one social media post or one period of struggling at work put your psychology career at risk before it's even begun? Most trainees will never face fitness to practice proceedings, but if concerns are raised, the process can feel frightening, confusing and surprisingly difficult to navigate. Today I'm chatting with legal advisor Nicholas Sturkling as we explore what really triggers fitness to practice concerns. What happens next and how to trainees can protect themselves without feeling terrified of making a mistake. I'm Dr. Marianne Trent and this is Psychology Actually.

Starting point is 00:00:42 Hi, welcome along to psychology. Actually, I'm Dr. Marianne Trent, a qualified clinical psychologist. I'm delighted to be welcoming back to the podcast, Nicholas Sterling, who is a legal advisor and the founder of NS Consulting. Hi, Nicholas. Hi, Mary Ann, it's nice to see you again. It's great to be back to discuss some really interesting points. Absolutely. And I should have said probably that you specialise in supporting people going through fitness to practice proceedings. Now something that people might not be aware of is that there are still fitness to practice proceedings going on and kind of standards that you need to maintain even before you become professionally regulated with the HCPC. And so what we're

Starting point is 00:01:27 finding is that people that are trainee clinical psychologists or the trainee paramedic, or whatever are coming up against fitness to practice proceedings and then finding, oh, I kind of fit in the middle of everything. So I'm not yet under HCPC. You know, I don't necessarily feel like the uni are on my side, maybe my placement supervisors and maybe not on my side. And they're feeling really quite unsupported. So what we're kind of looking to do is have a broad conversation around pre-qualified fitness to practice proceedings today, aren't we, Nicholas? I guess it's a really interesting area where people are really in a sort of grey zone where they don't have all the the regulatory support that you have when you're when you're with an institution for example the

Starting point is 00:02:13 hcpc you you feel like you're you're in limbo a little bit so you you you're actually entitled to support from a university and at the same time they are regulating and making sure that they they adequately prepare professionals as they move forward pfdp process applies to both pre-regulated and regulated practitioners. Yeah, okay, but the HCPC aren't there for you until you're regulated, which puts you in a, I think, a tricky position. Yeah, I mean, I guess the kind of work I deal with at the moment when it comes to students or those who are beginning their training, trainees, is that they're not being regulated by the HCPC,

Starting point is 00:03:00 therefore meaning that the standards that existed with the HCPC while incorporated into the university programs are not actually that it's not as clear to them actually what they're in time what they should be doing so I guess the first issue that I think we probably should look at is really the fact that there's no there's no national university FTP regime so we're well aware when we're practitioners with the HCPC or any other regulator the standards you have to adhere to and you also know enforcement of those standards is going to be with the HCPC or with the dental organisations or with the doctors. Now the problem is when we have students who are in this grey zone there's no single statutory body. There's no single guideline about how these processes

Starting point is 00:03:46 are run should you fall into FTP problems and I think that leads to some unfairness across the board in terms of different universities address FTP in a different way issues in relation to how they deal with neurodivergence in terms of how they deal with people of different backgrounds. That can depend on what university you go to. We know when we're in the HCPC, these are the standards, this is how it's regulated, this is how it's enforced. When you're in the university process, it is unclear and that can lead to a lot of anxiety with students, particularly when you combine that with being in the last year of your practice,

Starting point is 00:04:25 of your traineeship, for clinical psychologists, for example, if you're in the last six nine months, we all know how hectic that period is in your life. You obviously know that better than me, but you're managing family, work, caseloads, new, you know, new challenges that you've never faced before. And that's when things, you know, health issues can become a problem. That's when issues related to communication might be emphasized. And that's when you can fall of the FTP regime. So it's something that people have very little knowledge about this student FTP regime. Yeah, I think it is that ambiguity, isn't it? It's like you don't necessarily know where you're aiming for.

Starting point is 00:05:03 And I think it just reminded me of all of the different plates that I had spinning when I was a trainee. So I'd moved away from my family and my support systems to come and do the course. I was single when I first started the course. And then you're suddenly kind of trying to immerse yourself in cohort life. So with the people that are on your training in your year at the same time. You're also kind of slot into university life, so the demands of kind of academia and, you know, the interactions you might be having with your personal tutor and then actually attending university lectures and seminars as well. And then you've, of course, once you get to the right stage of things, you're starting placements and you've got work with your clients and then you've got work within your team, your MDT, and then you've got the actual client work as well. And then you've actually got your own life as well

Starting point is 00:05:58 that you've somehow kind of got to try and bolt into all of those. So obviously it's a lot without breaking any confidentiality. If we could just give like a couple of examples of the kind of fitness to practice things that you're seeing or that might be common to see for people pre-qualification, if you can, Nicholas. Yeah, I mean, you've summed it up perfectly about how that works, that stage of the trainees' completion of their course.

Starting point is 00:06:23 So you can imagine the training is seeing the finishing line. And obviously this has been the buildup to their life's expectation, particularly in my experience with psychologists, because it's part of it becomes essentially an integral part of who they are. So they can see the finishing line. They're putting in all this hard work. And then the stress starts to become a major factor. Anxiety becomes a factor.

Starting point is 00:06:45 The fact that you're now taking on case load yourself becomes a serious factor, as I said. And if you have any, for example, issues with anxiety, is this with the communication, as I mentioned before, some neurodivergence, ADHD, autism, and whether it's some mental health issues, whether you've actually acknowledged that with the university, and some people have, some people have, some people have, some people have, some people have reasonable adjustment and they've done it, and they've acknowledged it that's part of the process, other people haven't. So this can be sort of accentuated and accelerate at this point in time. And in my experience with my diverse range of clients, it tends to be in this final phase,

Starting point is 00:07:20 where things can really reach a point of becoming an FTP matter. So the types of issues that I deal with regularly often relate to communication. Now I think using that as the first example, and I'll move on to some others later. So communication can be how you deal with your supervisor. Communication can be how you're dealing with other students. Communication can be how you're dealing with clients. Now, anecdotally, and also in discussing with other colleagues, it's my experience that, you know, an over-proportionate representation of clients that I have are people who are

Starting point is 00:07:57 neurodivergent in this area. And while that's obviously not a topic for everyone, I think it's worth understanding for practitioners as well as people who run, who have trainees himself or, you know, people having difficulty with anxiety, people having students really having difficulty, some other, unmanaged health condition. So those that I see that have reached this stage, generally if it is not to do with a dishonesty, a clear dishonesty, they've plagiarized, they've they've stolen something. And you know, that their FTP matters and universities deal with those and they, you know, rightfully should not be admitted if they've really broken the rules. But those sort of clear-cut

Starting point is 00:08:37 cases are less interesting, I think, because we all know when someone's stolen a computer or someone's forged notes on a you know that's we don't want that type of person you know there may be some other issues involved but you know we can't accept that in terms of public protection but if you have someone who's communicating in their mind appropriately with staff but in the eyes of the staff there's a rudeness there's a lack of transparency that can escalate quite quickly and I think that's worth with people understanding that what can start off as being a communication issue and email inappropriate emails can when the process begins which is normally it's raised with the student there's a complaint

Starting point is 00:09:21 raised and it goes to an informal meeting and that informal meeting is intended to solve that problem there might be some sort of improvement plan it's it's really how can we help the student that's the mentality of the university that how do we help the student past this stage but if the the student does not really have the same understanding of the issues that they may have presented, for example, if they are, have some neurodivergence or if they just view their whole incident differently, that can escalate because the way these matters stop at each step in the process, stage one, which is the informal process and then stage two, which becomes an FTP process, is the idea of insights. So you need to not only understand you've made a mistake, but have

Starting point is 00:10:03 rectified and remediated that mistake. So issues of communicate, issues of health issues as well in terms of unmanaged conditions. They often lead to FTP matters. But I think the most interesting one is in terms of attitudinal issues, because what the universities will say is they will say, well, this person is not presenting as professional. And that's an interesting idea, which I'm sure you have some points about, in terms of what kind of psychologist are we trying to create?

Starting point is 00:10:33 What do we want to go out into the world? Is the university educating and creating a particular type of psychologists or is it also, its perfunctory role is also to regulate? And they can sort of cross parts and they can become complicated. So, you know, are we trying to create a psychologist who fits a professional norm moving forward or are we trying to create someone who understands the various conditions that exist in psychology? There's something that I'm sure you can comment on. And there can be a bit of a diversion there. So FTP processes when someone is acting, what do I say differently, eye contact, can they actually, you know, are they masking, using a psychological term? And are they

Starting point is 00:11:16 going to be able to be an appropriate, safe psychologist? And I would argue that some of these people are being falling out of the FDP process and are being excluded from the profession because of whatever nuanced difference they may have. So that's a broad discussion that maybe you can comment on in terms of what type of psychologists we're wanting and whether whether the current system, the current regime is adequately preparing the profession for what these types of people are producing. Yeah, that is a really good point. And, you know, I do so much work around inclusion and how a psychologist don't all need

Starting point is 00:11:51 to look the same. And I'm aware that people might have been qualified for a longer period of time, might have different views around what, you know, is good enough for a psychologist or what the standards should be for a psychologist. and I'm really aware of the emerging literature around use of swearing, for example, and actually lots of clients can't find it really helps them let their guard down if a clinician will swear when they're talking to them. But obviously, you know, some people are sweary than others.

Starting point is 00:12:20 Some people find that very, very offensive. And I can imagine that if someone was very sweary, you know, in interpersonal meetings in the corridors and in MDT meetings, that might come across as antagonistic or rude. Well, in actual fact, for lots of people, it's just a way of punctuating almost and adding nuanced to discussions or really trying to connect with someone.

Starting point is 00:12:44 It isn't necessarily supposed to be offensive in the way that other people might view it as offensive. So I think even that is a good example about how there can be that miscommunication and maybe just different comfortability curves, I think, with, normal human behaviour? Absolutely. I think that's a great example.

Starting point is 00:13:04 You know, I personally, I'm Australian, so I grew up in a culture where, you know, it is a means of lowering barriers and that's just the way it is. You know, when you're in a familiar situation, when I'm with my parents, that we tend to, the language is different as when I'm in a court and it can often be a way of showing, hey, we're letting our guard down. So it's something I actually really identify with. In terms of Yeah, the communication norms and generally what norms are, and the reason why it's interesting to me as a legal practitioner is when FTP is about regulating accepted norms, which it is,

Starting point is 00:13:43 and we understand that there are certain standards that must be upheld, we need to also have some form of flexibility in there as well. So I know, for example, I have some clients of different ethnic backgrounds, different religions, and there has, While there's no overt discrimination, obviously that's a much more serious matter, there is a gentle, I would argue on the behalf of some universities, not all, and obviously these places are some of the forefront

Starting point is 00:14:11 thinkers about how we deal with discrimination and how to best equip students. So I don't want to label all, you know, universities are great places. That's the ones that eventually where they made, there may be some slight issues is, you know, accepting that some supervisors, some members of academia, outside of strict guidelines, you know, may not actually, may see norms in a slightly different way to, to some of these students or some of these trainees. Okay, so I mean, another example of this idea of norms and, you know, people's perceptions and I would argue their lived experiences,

Starting point is 00:14:48 using a case example I've had, is with a clients who, um, who felt excluded, from group work felt somewhat not discriminated because discrimination would obviously be a far more serious matter and then we're bringing in you know that that becomes a different level of complaint by the student but really feeling feeling that her experience as her in this example her but i've had other examples with a male their experience was that there was a lack of real recognition of how others felt others did others dealt with them during Ramadan in this particular example but I've had other examples where they were going through a personal issue and people were not actually communicating with them

Starting point is 00:15:34 appropriately so that led to a distrust from the behalf of the client which led to lashing out at various people and led to an escalation very quickly so in terms of what you know this this client was this client was perceived as rude during this time period and again this may be a particular example but I think it sort of exemplifies the types of of issues that we're dealing with every, every trainee is an individual person with their own individual idiosyncrasies or their own individual cultural identity. And having a, you know, being able to listen to these people having their lived experiences as psychologists and not having a standard of particular psychologists that we all need to, that the university is trying to produce,

Starting point is 00:16:17 I think is something universities could strive towards a little bit more because they're the ones tend to fall foul of this FTP process, particularly in terms of universities. Yeah, yeah. And I want to just obviously give a nod to the fact that this is a really difficult, really stressful experience for the person that's undergoing the FTP investigation, but also probably for the people around them at having to raise that. This isn't something that people do lightly. And I think I've spoken publicly already that I had an experience on one of my placements.

Starting point is 00:16:51 where at my mid-placement review, the question was, you know, is there a chance that the trainee might fail this placement? And the answer was yes. And I was like, I was horrified because it hadn't been communicated to me before. And my experience after that was that I really just found everything very difficult after that for a number of weeks until it was resolved. And it can kind of make you a little bit paranoid about whether other people are thinking that you're not good enough or whether other people have been part of this and having conversations about you and comparisons to other people that might be seeming to get it right more effortlessly. It isn't easy and it can impact on not just your work, but all of your outside life as well.

Starting point is 00:17:32 It isn't easy, isn't Nicholas? Absolutely. I mean, I guess that raises the greater question of what is the purpose of these universities. Are they there to support students or are they there? to protect the public. And I think obviously it's a twofold process. They're there to support students create the right type of professionals that we all want to see, particularly in, in, you know, vital roles such as psychology or across the healthcare profession. You're dealing with vulnerable people and your role is really important. But I guess in terms of how do we

Starting point is 00:18:03 support a student through a process, how do we support a student in whatever may be happening in their personal lives, whatever may be happening in their physical and mental health, while at the same time ensuring that wait a sec once they're they're finished with the process once the the trainees has completed their training they're going to be safe because that's really a really really important factor and i think everyone understands that and that's you know it's often a question that when i feel when i hear anger from clients whether there be trainees or whether they're qualified um registrants once they have an understanding of of the idea that the hcpc or in this circumstance that the university is that there they're

Starting point is 00:18:41 performing a role that we all support which is protecting the public. It's about how that is actually managed and whether enough is done to to make sure that they're being supported through the process while also managing what is essentially future risk. That's the thing that's quite complicated to assess particularly for clients is when we're looking at remediation or insight in terms of an FTP matter it's not how you are now. You may have said I'm sorry for that particular issue. I will improve my communication, I'll improve my note taking, I'll improve my punctuality, my data protection, whatever it may be, but I haven't rectified, I haven't remediated the issue that exists. So that's managing that for universities is very difficult. I don't deny that, you know,

Starting point is 00:19:27 they do their best. But I think when we have a system which is completely different across, I mean, not completely different, but varies across universities, not a standardized HCPC system, how students, trainees, various people, whatever stage of their training they may be, how they deal with the FTP process varies. So when I, and the reason why a lot of practitioners, in terms of legal advisors or solicitors, steer away from students is not necessarily because of the fact that students don't make, you know, they don't, they're not in need of assistance, it's that it's, you have different guidelines for every university.

Starting point is 00:20:06 So am I dealing with Reading today? am I dealing with Swansea? Am I dealing with and that that's to me feels a little bit unfair because you have a standardized system once they're registered but before registration it's not standardized and how well people are deal how well panels or universities deal with reasonable adjustment how well they deal with or how forcefully they enforce some of their say note-taking guidelines and these types of things vary and I'm not sure that's fair and I have colleagues who who work in the industry and deal a lot with students and they would argue that it's that it's a rogue world. I wouldn't go that far, but they'd argue that this is, it's a bit of a, it's in the

Starting point is 00:20:46 nether region there. You don't really know what you're going to deal with and that's not the right word. I enjoy, I enjoy the nether regions. Let's leave it in. So you're in sort of a grey zone there, meaning that's, you know, you, you don't know what laws are being enforced. You essentially have to look at each guideline and that can go through each individual university processes, university guidelines, how they run it and there's variations and how they enforce it is different. And I would argue, and some of my colleagues would argue quite strongly that that's that's inherently unfair and they make whatever decision they want. And if there's a personal problem with that particular

Starting point is 00:21:25 trainee, then that's going to override anything else. And if that straight trainee, for example, has needed extra supervision for whatever reason and it's caused a bit of a disruptance, disruptions in the course and there may be yeah a lot of people unhappy with that person's behavior but it doesn't necessarily mean they're not going to be a great psychologist that personal that personal relationship can't be overlooked so when the for example a trainee may be at a final hearing uh FTP final hearing at university FTP proceedings and the main evidence is being presented by a supervisor now we this may be very evident a very qualified eminent fantastic at her job his job whoever it may be but

Starting point is 00:22:04 But if there's a personal issue with there, then that is going to influence how the panel view that. And that's something that does not happen at the HCPC regulatory proceedings or in a higher proceedings. So I think it's something that could be addressed either through associations like the ACP UK or various representative bodies, about how can we manage this better?

Starting point is 00:22:26 Because to me, it feels unfair and it's disproportionately affecting those of different ethnic backgrounds, of who have new, neurodivergence who may not conform to what we see society's norms. So it's something that I think should be looked into. Yeah, I think another issue that I kind of struggled to get my head around is the fact that for people that are not self-funding, their employer will be the NHS, certainly for

Starting point is 00:22:54 training clinical psychologists anyway. But it might well be that the procedures are being raised by a university. And I presume, it's been too long, I can't remember, I don't know if I signed some stuff to say that I would be a good girl when I was training with my university as well as my employer, or whether I only signed a contract with my NHS. I feel like I only did that. But it might have changed more recently. But then you're in a position where the university are not your employer and yet are obviously holding you to account. And then you might be in a position where you don't really have much control because of the power different, especially if maybe you're, like you said, if you're, you and your supervisors just don't get along.

Starting point is 00:23:39 And like, you know, if you met each other a hundred times across different years, you still would hate each other. Like it's just a personality mismatch. And then there really is inequity. Absolutely. 100% agree. Absolutely. I mean, that's sort of conflict between employer and university, particularly in the final years,

Starting point is 00:23:57 the final months of training. which is across all professions, but it's quite volatile in my experience with psychology, particularly clinical psychologists, because you know, you're on the cold face, you're dealing with vulnerable people, and also your employer is, they're trying to run an organisation. So the fact that you're in your final year of training, there is an understanding, hey, wait a second, this person is learning, but in the eyes of an underfunded NHS trust or in a particular department, they need this person to do their job properly, that they're relying on them to have that particular the caseload 510 whatever the caseload may be and the student may not be ready for that so the

Starting point is 00:24:33 academic requirements from the university are too great um considering that the employer is actually asking yeah well you're running a caseload now and the university and they're expecting a certain standard and what i would argue and what i do argue in final hearings regularly and in our submissions and in our appealed is that this person is still learning um and so you know they're not the finished product yet they're not the finished professional and then i think feel like the conflict between the placement and the necessity to use their hands, their man hours, the fact that they're needed on the ground because of underfunding, I would argue, and I'm sure that a lot of your listeners would agree with that. They're asked to do too much too soon, and that

Starting point is 00:25:14 leaves them open to, first of all, burnout, which is obviously a very common thing. In my experience, I've seen people just quit the profession. I really have seen that happen. And also, you know the expectations of maintaining this standard they've never met before because I've never done it before and in other professions I give the example of a radiologist who I work with in their final year in their placement you know if they're taking a scan for example and determining whether this thing is you know what's the type of growth it is or for example whether it's whether it's a tear or whether it's a break now that's probably going to be looked at by someone else briefly because it's not just a client-facing direct role I imagine there's

Starting point is 00:25:55 there's an extra layer of supervision. But if you are alone, your supervisor can't sit in on your one-on-one session. So it's a different type of, you know, it's real and it happens immediately. So there's no means of sort of supervising that aspect of it. And that can very quickly lead to conflict between both, between the university and the employer. Essentially, the employer going, well, I've got to raise this complaint because, look, you haven't done your job properly. I've got to tell your university because they're asking how you're going and I'm running the report. And then all of a sudden you're in the process. And it's hard to get out of because once you're on that FTP track.

Starting point is 00:26:34 And again, if you don't want to scare people, trainees and students, the majority of people will never encounter any FTP proceedings university. I mean, it's, but it does happen. And when it does happen, my advice would be from the outset is, you know, the university present this initial informal chat as not being part of an FTP process, because it's not really. But things that happen in that first informal meeting will dictate which track it goes on. Once you're in that FTP process and the formal investigation is undertaken, yeah, the advice is to try and get some help, whether it's through your student representatives or through legal advice or some people who understand this process.

Starting point is 00:27:10 And I think that in certain circumstances, my colleagues will agree with me here. There's a did that universities can be somewhat disingenuous by saying this is not adversarial, we're trying to help you. but the repercussions and the sanctions that they can impose are severe and can really affect your future ability to practice. So to try and exclude legal representation from the very stages of the process, which they actively do. They say, no, I don't think you should bring someone. Some laws actually say within the university you can't bring someone is problematic. And that's something I think the ACP should look into and various other organisations as well. Yeah, thank you for that.

Starting point is 00:27:45 I thought what we'd do is we'd go on to a little quickfire round. Absolutely. see how we get on with that. Okay, so with the fitness to practice for trainees, is it possible that it goes to stage one, you put some kind of procedures in place to change things, and then it never goes any further and it's just resolved and done? Absolutely. And I'd argue that's the most common way that these things resolve themselves. So the stage one issues may be in terms of lateness, maybe in terms of social media, slightly inappropriate communication, they're resolved.

Starting point is 00:28:19 you'll apologise, you write the appropriate letter, you show demonstrative learning, and then it finishes. So yeah, absolutely. That's the aim and the objective of the university at that stage. Thank you. Next question. With social media, is it true that even as pre-qualified staff, we need to be really careful about what we're putting out there into the world? Absolutely. I mean, I would argue that it's almost on a part because, and obviously, obviously with younger trainees, they will be more versed in how this, in this world, it's literally part of society now, much more than when I was at university. But in terms of data protection, in terms of identification issues, well, obviously you won't necessarily, hopefully you won't

Starting point is 00:29:09 identify a client, your other colleagues, group photos, in terms of whether other people have have agreed to be involved in this particular chat, you know, being, you know, very wary also of your opinions. If you're going to be focal about a particular political opinion, whatever that may be, make sure that it's, that it's, first of all, adheres to the standards of your particular traineeship, so whatever the NHS may be, whatever hospital you're working, whatever you're doing, private practice, whatever it may be. Yeah, just be very wary and just stay clear of at this stage on the public account of making you know we don't want people to be robots not have political opinions but yeah just be careful privacy data protection and also yeah some of the comments that you

Starting point is 00:29:54 know you make can if someone picks it up maybe it's someone else in you that you have there's a personal issue with or someone it doesn't necessarily have to be your university that has actually picked out hey that comment was inappropriate maybe someone else you don't even know they can raise that complaint to the university so that applies to pre-register registered it's it's really a a major source of FTP complaints for the HCPC and also for universities. Thank you. Would it be enough to add to your social media bio? Views are my own, not my employers. Is that enough to cover a trainee or someone who's not yet qualified or even someone who's qualified for that matter? Is it enough? No, does it help potentially? Yes. I mean it is a

Starting point is 00:30:37 disclaimer that legally doesn't really count for anything. Obviously if your work, it depends on not the type of work you're doing, but I think, I think we all know the answer is essentially that's not going to prevent a complaint being made if what you're saying is completely unreasonable and irresponsible. So no, within reason, if it's a nuanced idea about, say for example, you may be critical of the NHS and how they're operating certain procedures, yeah, potentially that's not going to be a problem. You're saying this is not what my employee says, but if it's a strong view either way, political, social, then yeah, that's not, that's not going to save you from any sort of FDP process. I was raised in a way that kind of told

Starting point is 00:31:20 me, never slate your employer on internal emails, never say that you wish you didn't work there, never criticise your employer publicly because otherwise that can be used against you, and that's something I've definitely held on to. I mean, whether it's a wise career choice is, is a different issue, whether you slagging off the head of the hospital, but whether they're two separate issues, you may lose your job and you may be asked to find separate employment, but that's not necessarily going to be an FTP issue. Does it go to your competency? Does it go to your learning? I'd argue not, depending obviously what they said. But yeah, you probably get sacked, but you won't have any problems with FTP. Okay, thank you. Is it true that some universities

Starting point is 00:32:05 have a very low tolerance for failed academic assignments and that even as few as two or three failed academic assignments can lead to fitness to practice that ultimately leads to you not finishing your course. I mean in my experience no that's not necessarily the the case in my experience the types of matters as they relate to clinical practice and proficiency will need to be broad wide ranging and serious so obviously depends on depending how important those particular academic tasks were, if that were your major component, and you've tried it again and then again and again.

Starting point is 00:32:44 But generally, the university FTP processes, and then eventually the HCP, they're not there to try and punish individual mistakes. That's really not the purpose of the whole process. And I'd argue at university stage, it's absolutely not the purpose. So I have no students who are now clients or trainees who are now clients,

Starting point is 00:33:04 where they've failed, or two things. It's generally a broad pattern of behaviour, serious misconduct, dishonesty, these types of matters, major communication issues. The ones that go to the end and you end up being excluded from the course, which is one of the options opening. And if you get excluded from a course, it's very difficult to find another placement in a different university. It's not impossible, but in my experience, it can lead to at least a very long gap in your ability to become a professional but overall it really is it's the serious matters to do with this honesty repeated failings um for example note taking one example that i can think of is repeated issues

Starting point is 00:33:46 in terms of not in insufficient notes but in complete notes or no notes whatsoever so for example a student a trainee in their last couple of of may have five or six uh students my five or six clients they're very hectic they've got academic work going on they've got work at home they're stressed they're not sleeping enough they meet a vulnerable teenager in this circumstances they meet a vulnerable teenager that he says some very important information that needs to be passed on to the next um psychologists who will see him as it may not necessarily be that that front-facing psychologist and there's no no there's no note at all and this if this happened once maybe that can be rectified. If this happens again and again and again, this becomes a public safety issue.

Starting point is 00:34:32 I think we can all understand that. Well, wait a second, this person was in a very vulnerable state, and that note could have potentially prevented a major catastrophe or, you know, endangered life. So I do understand why they do this, but overall two or three mistakes are not going to cost you your ability to be registered and shouldn't really lead you to the FTP track. That would be my answer to that. Thank you. So with the rise of AI supported note taking, do you think that will lead to less fitness to practice issues or do you think that could potentially cover up the disclosure of other fitness to practice issues? Yeah, very interesting question. And it's, it's, I fear that, I, I envision that that's going to be an avalanche of future cases and how that, you know, how AI is managed within

Starting point is 00:35:27 clinical settings is going to be something that is going to be yeah going to be a lot of my work and really lead to a lot of fdp cases at the moment the issues in relation to that i can see in relation to a i know taking really if it's a accepted um a recognized and safety proof a i system that's being used and is and is being supported by whatever institution is and you using it appropriately then i think it's actually a real asset and a real help and what i can see is people who had time management issues and I have clients who wish and they've said to me they wish these systems were in place before they had their problems because a lot of the issues was purely time management. So do I think there's there's going to be an improvement in terms

Starting point is 00:36:10 of FTP issues? I think it could work two ways. Some people who time management was the issue. It's going to definitely help them. They won't fall of the FTP matters. In terms of AI generating false notes, I mean, how we actually, how we determine that, that could be some dishonesty issue. And if we find out retrospectively that these notes are actually not an accurate reflection of the meeting, then you go into dishonesty. And any dishonesty across the board anywhere, and that's where I think AI can be a problem as it may lead to some dishonest submissions. It may be some dishonest note taking or some, then that becomes a problem.

Starting point is 00:36:47 Dishonesty is frowned upon as we understand. And the punishment is, yeah, severe sanctions in relation to dishonesty. So it's going to be a space we're definitely going to need to watch, both as clinicians and also as legal advisors. It's interesting. We're not sure where it's going yet. Thank you. Next question. Can a trainee refuse to engage in fitness to practice proceedings? I mean, absolutely they can. Everyone has the right to do whatever they wish to do. That's also the case at once registered. If you don't want to engage in any process, there's no legal obligation for you to do so outside of a criminal. investigation. However, if you do decide to remove yourself disengaged and not have any contact with the university and later wrong with the HCPC, it's really going to be frowned upon. And I guess what that goes to is what we discussed earlier, this idea of insight. So if you don't

Starting point is 00:37:38 think you did anything wrong, and it may be the case, and the facts may come to prove that later on, but you just say, look, this is unfair, I'm not engaging with it, I didn't do that. And the process starts, level one, tier one, however you want to view it, and then potentially you don't turn up. I don't want to go there. I don't agree. You guys can all go do whatever you want. Then eventually they're going to make, they're going to have a finding without you there. And then they're going to potentially lead to a full FDB investigation. You still don't engage, as is you're right. You are likely to be either suspended from the course if you, depending on the seriousness of the matters. But what I suggest, all clients post, post registration, pre-registation,

Starting point is 00:38:19 actively engage. Actively engage. You can disagree. You can absolutely disagree. And that's where have your viewpoint heard, but a lack of engagement shows a lack of respect to the university, to the institution, to clients, again, depending on the issue, but I think it's legally not otherwise move and I would not suggest you can disagree and get some support in how you respond, but yeah, if someone's raised a complaint, they need to have it heard properly. Thank you. This might well be the last of our quickfire round questions, but if someone is struggling personally and they're recognising that because they've got some insight, is it better for them to just self-disclose that or to wait for proceedings to maybe be started against them

Starting point is 00:38:59 by someone else? I mean, I think it's a common occurrence in relation to health. And health can be in terms of how you're managing your caseload, how you're managing your studies. It doesn't have to be actual physical ailments. It can be anxiety. It can be sleep. It can be whatever's happening in your personal life if you feel like you can't meet the requirements of the course, which happens to many people across various sectors across all sorts of higher level education. My advice would be really nip it in the butt early, get there early. And you know, it doesn't necessarily have to be a the installment of reasonable adjustments, which is something universities can offer, which I actually not as difficult to have put in place as as one piece that people may think.

Starting point is 00:39:47 So, you know, essentially reasonable adjustments are something that they're there to help university students but if you are struggling psychologically if you have if you have for example an undisclosed or or unknown mental health issue or neurodivergence or something else in your life of death of death of family member a lot of people say well that's my business i don't want to get involved but if that's going to have a noticeable impact on your on your ability to complete the coursework or particularly during the final stages of your placement absolutely reach out and that can be reaching out to various people within the university there's obviously there's a lot of support systems within there, reaching out first and foremost to your supervisor, letting them know,

Starting point is 00:40:25 can I take, can I get extra time off? There's a lot of things that can happen before it escalates, because once that escalation happens, and I've seen it, you know, particularly with burnout, mental health issues, once that, once that we've reached that stage, it becomes like a deck of cards. Things start falling down very, very quickly and I've noticed something that had been addressed very early in proceedings in terms of, you know, an unmanned, managed health condition can had they had they reached out at that stage we could have potentially stopped everything that came went henceforth because actually all of this could have been done could have been done appropriately with proper support

Starting point is 00:41:02 and universities are essentially supportive places supportive institutions that's the experience I had that's the experience most people have but if you don't tell people struggling then it could look like that actually I'm just not up to scratch actually I don't care and you know I strongly advise yeah people to reach out as soon as it becomes as soon as it has a visible effect on their work. You don't have to, if you're managing, fine, but as soon as it actually visibly affects your ability to practice

Starting point is 00:41:29 or to complete work, then yeah, reach out immediately. Yeah, I think we can get in our own heads as well, can't we be thinking like, well, I started with my cohort. I really want to graduate with them and be able to all celebrate together. But actually, we're all on our own journey. And if you need to take some paid sick leave out from the course to really get yourself well, I would always advocate for that. Look after yourself first and know that actually, you know,

Starting point is 00:41:57 the people that you've started training with might still come and celebrate you outside your graduation ceremony on the day that you graduate because they're not going to forget that you exist. You're still part of that. And actually you being happy, healthy, well and thriving in your training is what everybody wants for you. Absolutely. I mean, from my experience, everyone has their different, their own their own path through studies, particularly in a stressful job like psychology,

Starting point is 00:42:32 you know, looking after yourself is fundamental, also for your ability to safely look after other people. It's a different job, it's a different calling if you want. So yeah, absolutely. People get there when they get there and if you go, what doesn't want to support you, when you eventually get there, maybe they weren't really the people you wanted to hang out with, hang out with anyway. Such great advice, Nicholas. All right, so before we say goodbye, at least for now, can you let us know if someone is, you know, at the beginning of this or kind of aware of someone else in their team who's going through this, what advice would you have for them? Yeah, I guess it's a question I get asked retrospectively from, from, from, from,

Starting point is 00:43:16 from trainees and also from employees, what could we have done differently? I guess my answer would be when the concern is originally raised and you now have joined the process, so essentially you're now in the proceedings. There may be an informal meeting, as we discussed, that informal meeting is informal, but you're essentially on the pathway towards a formal FTP hearing.

Starting point is 00:43:38 I would at the very least reach out to student services, student representatives, student bodies to say, hey, wait a second, is this something I need to treat seriously? because what I find with trainees and with students at the beginning and trainees at the end is that there's a complete lack of understanding of this FTP process. And I understand it. I understand that people have never encountered this before. It's an abstract concept, current impairment.

Starting point is 00:44:01 What does this actually mean? So you can have these sort of small complaint that had to do with an email you sent what you wore, social media posts, some data protection, an essay that you submitted that they have their doubts about, and it may be quite minor. And maybe that first stage is just a very small stage. But even if you think it's not that important, actually, there's nothing to it, I'd reach out to someone who has a bit more experience. Now, whether that's a practitioner or a legal advisor or someone within the university, at least, particularly at that first stage, so they can give you some perspective of what realm we're in, how serious is this?

Starting point is 00:44:40 I'd definitely have a discussion with those that you're working with closely. If you're at the end of your training obviously depends who raise the complaint but if if you're supervisor who's you know actively with you on a daily basis and it's unrelated to that supervisor hey having a chat to them if you're at that stage of the proceedings and and from that point onwards if it does decide to go into a formal investigation and and or for example the student representative body or the student support service said hey this is pretty serious I think you should get some advice before that first hearing the tier one hearing then reach out to a

Starting point is 00:45:15 If you get told or you have the feeling that actually wait a second, this has to do with dishonesty, this has to do with something that they're taking very seriously. And the fact that they've raised a complaint and they've called a hearing suggests there's something to it. They're not just raising a complaint because you said the, you know, one inappropriate thing or you were late repeatedly. That can be done informally. That can be done with a chat. Hey, supervisor coming in. You're turning up late.

Starting point is 00:45:38 You need to pick up your game. If it's reached that stage one, definitely reach out. I have clients who reach out to me at stage one. So we're always open to that. But the student bodies are definitely worth discussing. And once the decision has been made at stage one, that there's a formal investigation, I'd absolutely seek out professional advice.

Starting point is 00:46:01 Again, who that's with is entirely up to you, but someone who has a rigorous understanding of the university guidelines and the fact that the FTP processes are different depending on which university you're in. So yeah, reach out particularly post-stage one, but if you can make some inquiries in terms of pre-stage one. Because once you're on that track, even if the university call it informal, there's notes from that. And there's eventually going to be leading you towards, hopefully not, but can potentially be leading you towards a full FTP university hearing. Thank you so much.

Starting point is 00:46:35 And with that in mind, could you please let our listeners and our viewers know where people can find out more about you and your work? Yeah, absolutely. If people want to reach out, even for some informal advice or just to have a chat in relation to these issues or any other issues, I can be found on LinkedIn, which really probably the best place to find me and show some of the services they offer and some of the work that I do. And that's Nicholas Stockling, St-O-C-K-L-I-N-G. And you can find me on LinkedIn. And I'll be more than happy to help. Perfect. Thank you so much. And I'll link LinkedIn in the show notes and in the description with the video. Thank you so much for your time and for the work that you do in supporting people in a really vulnerable time of their lives, Nicholas. Thank you very much. It's been a really interesting discussion. I think it's something that hopefully was helpful for various people, the various stages of their professional training. Absolutely will be. Thank you again for your time. All the best. You too. Thank you so much again to my guest, Nicholas Sturkling. Please do go and check him out on LinkedIn. He really is a safe port in the storm if you are struggling with fitness.

Starting point is 00:47:41 to practice concerns. This was not my first chat with Nicholas. We did speak earlier more generically about fitness to practice for HCPC registered clinicians and you can check those details out on screen. If you are an aspiring psychologist yourself and even if you are a trainee psychologist, you might well find the aspiring psychologist membership helpful. Some people do choose to stay in the membership during training because they really welcome that kind of personal approach, support and kind of compassion from their peers as well. We've also been trialing, doing some one-to-one time included in the membership at no extra cost. So please do keep your eyes peeled on the page www. Aspiring hyphen Psychology.

Starting point is 00:48:36 ologist.co.uk for more information or if you've got any questions you can reach out to me at any time or on social media where I'm Dr. Marianne Trent everywhere.

The Aspiring Psychologist Podcast - Fitness to Practice for Trainee Psychologists: What No One Tells You

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