Fitness to Study Policy

1. Purpose

This Policy sets out the manner in which St. George’s University (“University”) identifies and responds to concerns about a student's fitness to study. It is designed to be supportive rather than punitive and aims to help students access the assistance they need while maintaining the safety and wellbeing of the University community.

2. Scope

This Policy applies to all registered students of the University, whether studying on campus, on clinical placement, or engaged in any University-related activity. It covers circumstances in which a student's physical health, mental health, or behaviour raises concern about their ability to:

• engage effectively in academic study, clinical training, or assessment;
• live and participate safely in the University community, including in on-campus housing;
• manage their own health and safety without unreasonable risk to themselves or others; or
• refrain from placing disproportionate demands on University staff or fellow students.

This Policy does not replace disciplinary procedures for academic misconduct or breaches of the Student Code of Conduct. Where a fitness to study concern and a disciplinary matter arise from the same facts, the Vice President of Student Affairs shall determine which process takes precedence.

3. Guiding Principles

1. Support first. The University's primary objective is to support the student in continuing or returning to their studies wherever reasonably possible.
2. Proportionality. Any action taken shall be proportionate to the level of concern and limited to what is necessary to protect the student and others.
3. Fairness and transparency. The student will be informed of any concerns, given the opportunity to respond, and kept informed of decisions at each stage.
4. Confidentiality. Information relating to a student's fitness to study shall be kept confidential and shared only with those who have a legitimate need to know.
5. Reasonable adjustments. Before concluding that a student is unfit to study, the University will consider whether reasonable adjustments to the student's program, assessment, or environment would enable the student to continue. This obligation applies in conjunction with the University's duties under applicable disability legislation and the University's accessibility and accommodations policies.
6. Right to be accompanied. At any formal meeting under this Policy, the student may be accompanied by a person of their choosing, such as a faculty advisor, student representative, family member, or personal supporter. Legal representatives are not permitted at internal meetings. Where the person who raised the concern is also the student's faculty advisor, the student shall be entitled to select an alternative companion.

4. Definitions

Fitness to Study means a student's capacity to engage in academic study, clinical training, or University life without unreasonable detriment to their own health, safety, or wellbeing, or that of other students, faculty and staff, once any reasonable adjustments have been considered.

Designated Officer means the faculty or staff member assigned to manage the student's case at the relevant level, as set out in Section 6 below.

Fitness to Study Panel means the panel convened at Level 4 of Section 6 below to determine whether a student should be suspended, required to withdraw, or permitted to continue subject to conditions.

Working Days means days on which the University's administrative offices are ordinarily open for business, excluding Saturdays, Sundays, and public holidays observed by the University in Grenada.

5. Risk Levels

Concerns about a student's fitness to study are classified into four risk levels. The appropriate level is determined by the nature, severity, and persistence of the concern, not by the student's diagnosis or condition.

6. Procedure

The levels set out in this Section 6 are not required to be followed sequentially. The University may initiate or escalate proceedings at any level it considers appropriate to the nature, severity, and immediacy of the concern, without first exhausting lower levels. 

Risk Assessment. Before any formal action is taken at Level 2 or above, the Designated Officer (as defined below) shall ensure that a documented risk assessment is completed. The risk assessment shall identify:

• the nature and severity of the risk to the student and to others;
• the measures already in place to manage the risk;
• the further measures that may be required; and
• the person or persons responsible for implementing those measures.

6.1 Level 1: Informal Support

1. Initiation. Any member of faculty or staff or a fellow student may raise a Level 1 concern with the student's faculty advisor, Course Director, or the Office of Student Affairs.
2. Response. The Office of Student Affairs will arrange an informal conversation with the student to understand the circumstances and identify available support, which may include referral to Psychological Services or Student Accessibility and Accommodations Services.
3. Record. A brief written note of the conversation and any agreed actions will be placed on file. The student will receive a copy.
4. Outcome. If the concern is resolved, no further action is taken. If the concern persists or escalates, the matter proceeds to Level 2.

The risk assessment shall be recorded in writing and a copy retained on the student's file. A further risk assessment shall be conducted if the concern escalates or a new concern emerges. Where a matter is referred to a Fitness to Study Panel under Level 4, a copy of the most recent risk assessment shall be provided to the Panel.

6.2 Level 2: Formal Support Meeting

1. Initiation. The Office of Student Affairs will refer the matter to the Vice President of Student Affairs (or designee), who serves as the Designated Officer.
2. Meeting. The Designated Officer will arrange a formal meeting with the student. The student will receive at least five (5) Working Days' written notice, including a summary of the concerns, sent to the student's University email address. The student may be accompanied in accordance with Section 3(f). If the student fails to attend the meeting without reasonable excuse after having been duly notified, the Designated Officer may proceed in the student's absence.
3. Support and Action Plan. Following the meeting, the Designated Officer will prepare a written Support and Action Plan (“Plan”), setting out:
   • the concerns identified;
   • the support to be provided (e.g., counselling);
   • specific actions required of the student;
   • a review date, normally within four (4) to six (6) weeks.
4. Review. At the review date, the Designated Officer will assess whether the student has engaged with the Plan and whether the concerns have been resolved. Possible outcomes are:
   • concern resolved: no further action;
   • concern improving: Plan continues with a further review date;
   • concern unresolved or escalated: referral to Level 3, together with the documented risk assessment.

6.3 Level 3: Case Conference

1. Initiation. The Vice President of Student Affairs will convene a Case Conference, which will include the Vice President of Student Affairs (or designee) (as Chair), the student’s Course Director (or designee), and a medical professional. Where the Vice President of Student Affairs served as the Designated Officer at Level 2 for the same student, a designee who was not previously involved in the case shall serve as Chair.
2. Student participation. The student will receive at least seven (7) Working Days' written notice that a Case Conference will convene, sent to the student's University email address, including a summary of the concerns and any reports to be considered. The student may attend the Case Conference and make oral representations, and may submit a written statement and supporting documentation at least two (2) Working Days before the Case Conference. If the student fails to attend after having been duly notified, the Case Conference may proceed in the student's absence.
3. Medical evidence. The Case Conference may request that the student provide a medical report or consent to a medical assessment by a University-appointed practitioner. Refusal to provide evidence or attend an assessment may be taken into account in reaching a decision, but the student will not be penalised solely for exercising their right to decline.
4. Possible outcomes:
   • revised Plan with additional conditions;
   • voluntary temporary withdrawal with agreed conditions for return;
   • referral to Level 4 together with the documented risk assessment.
5. Written decision. The student will receive the Case Conference's decision in writing within five (5) Working Days.

6.4 Level 4: Fitness to Study Panel

1. Composition. The Fitness to Study Panel will be convened by the Dean (or designee) of the School to which the student belongs and will comprise:
   • the Dean (or designee) (as Chair and a non-voting member of the Panel, except that the Chair shall have a casting vote in the event of a tie);
   • a member of the Office of Student Affairs; 
   • the Director of University Health Services (or designee);
   • a senior faculty member of the student’s School who has not been previously involved with the case.
2. Procedure. The student will receive at least ten (10) Working Days' written notice that the Panel will convene, sent to the student's University email address, including all documentation to be considered. The student may submit a written statement and supporting documentation at least two (2) Working Days before the Panel convenes. The student shall have the right to attend the Panel hearing and make oral representations. The Panel may also hear from those who have been involved at earlier levels. If the student fails to attend after having been duly notified, the Panel may proceed in the student's absence.
3. Possible outcomes:
   • continuation of studies with binding conditions and a monitoring plan;
   • mandatory medical leave from studies for a specified period, with conditions for return. 
   • required withdrawal from the University, where the Panel determines that no lesser measure is sufficient to manage the risk to the student or others.
4. Written decision. The Panel's decision, with reasons, will be communicated to the student in writing within seven (7) Working Days.
    

7. Emergency Interim Measures

Where there is an immediate and serious risk to the student or others, the Vice President of Student Affairs (or, in the Vice President's absence, the Provost or a person designated by the Provost) may impose interim measures before the procedures in Section 6 are completed. Suspension from studies is appropriate where the student's continued engagement with their program overall poses an immediate and high-level risk to the student or to others. Exclusion from specific University facilities, activities, accommodation, or clinical placements is appropriate where the risk is associated with particular aspects of the student's studies, specific facilities, or specific individuals, such that removing the student from those activities or locations manages the risk without withdrawing the student from their program altogether.

Interim measures are precautionary, not disciplinary. They will be reviewed within five (5) Working Days of imposition, and the student will be given an opportunity to make representations before or at that review.

8. Return to Study

A student who has been placed on mandatory medical leave under this Policy must apply to the Office of Student Affairs for permission to return. The application must include:

• medical or professional evidence, where appropriate, that the student is fit to resume;
• evidence of engagement with any conditions attached to the mandated leave.

The Office of Student Affairs may attach conditions to the student's return (e.g., a phased reintegration, ongoing support arrangements, or a monitoring period). A student may not return before the review date specified in the mandated leave decision, even where the student considers that their health or circumstances have improved, unless the Vice President of Student Affairs determines that exceptional circumstances warrant an earlier return. The student will receive the decision in writing within ten (10) working days of the application. A student whose application to return is denied may appeal the decision in accordance with Section 9.

9. Appeals

A student may appeal a decision made at Level 3 or Level 4, or a denial of an application to return to study under Section 8, on one or more of the following grounds only:

1. a procedural irregularity that materially affected the outcome;
2. new evidence that was not reasonably available at the time of the decision and that could materially affect the outcome;
3. the decision was disproportionate in light of the evidence.

Appeals must be submitted in writing to the Office of the Provost (or designee) within ten (10) Working Days of receipt of the written decision. The Office of the Provost (or designee) shall communicate the appeal decision to the student in writing within fifteen (15) Working Days of receipt of the appeal. The Office of the Provost (or designee), upon considering the student’s appeal, may uphold the original decision, substitute a different outcome, or remit the matter for reconsideration. The decision of the Office of the Provost (or designee) is final within the University's internal processes.

10. Confidentiality and Data Protection

All personal data processed under this Policy, including health and medical information, will be handled in accordance with applicable data protection laws, which may include the Family Educational Rights and Privacy Act (FERPA), the EU General Data Protection Regulation (GDPR), the Data Protection Act of Grenada, and any other data protection legislation applicable to the student or the processing activity. The University will:

• obtain the student's explicit consent before processing sensitive personal data, except where processing is necessary to protect the vital interests of the student or another person or to fulfil the purposes of this Policy;
• share information only with faculty and staff who have a legitimate need to know in order to fulfil the purposes of this Policy;
• retain records in accordance with the University's Data Retention Schedule; and
• permit the student to exercise their rights under FERPA or local data protection laws, including the right to access and correct their personal data.

11. Relationship with Other Policies

Where a conflict arises between this Policy and another University policy, the Vice President of Student Affairs shall determine which policy applies and/or takes precedence. Where a student is enrolled in a programme subject to fitness to practice requirements imposed by an external professional or regulatory body, staff shall consult the Vice President of Student Affairs before initiating proceedings under this Policy to determine whether the matter is more appropriately addressed under the applicable fitness to practice process. Actions taken under this Policy are not disciplinary and shall not be recorded or reported as such to any professional or regulatory body.

Notwithstanding the initiation of any procedure under this Policy, a student shall not be precluded from applying for a medical leave of absence pursuant to other applicable University policies. Where such an application is approved, the procedure under this Policy shall be stayed for the duration of the approved medical leave of absence. Any medical leave of absence approved during the pendency of proceedings under this Policy must include conditions for the student's return which the student shall be required to satisfy before resuming studies. Section 8 (Return to Study) of this Policy shall apply to the student's return following such a medical leave of absence, and the University may, upon the student's return, resume the procedure under this Policy at the level at which it was stayed if the concerns giving rise to the original proceedings have not been resolved.

12. Review of This Policy

The University shall review this Policy at least once every three (3) years, or sooner if required by changes in applicable law, regulatory guidance, or accreditation standards.