Background

Lisa arranged a clinical elective in a remote town in South America through a family connection – a relative who was a practising doctor in that region. She wanted to explore the use of holistic and alternative medicine in underserved communities.

During her placement, she worked closely with a local doctor who specialised in alternative therapies, such as homeopathy and acupuncture. She observed patient consultations and was gradually invited to assist in suggesting treatment plans – many of which included non-conventional interventions.

Allegations

While the experience was educational for Lisa, questions soon arose regarding her scope of practice and her legal and professional position in providing such care abroad.

A patient from the community she was helping raised a concern about her involvement in recommending a homeopathic remedy that led to delayed conventional treatment. This prompted an enquiry from the General Medical Council (GMC) into her conduct.

How Medical Protection helped

Lisa was a Medical Protection member, so she’d already asked for advice before embarking on the elective. An adviser explained how important it was to understand the GMC’s guidance, especially when it came to practising within her levels of competence.

When Lisa rang the advice line to inform Medical Protection what had happened, she was assigned an expert team who guided her through the investigation process.

A medicolegal consultant helped her demonstrate insight into the incident and reinforce her understanding of professional standards. An adviser helped her compile evidence of her reflection and learning from the experience and there was medicolegal representation on hand in case the complaint escalated to a tribunal hearing.

Outcome

The GMC acknowledged that Lisa had acted with good intent and under local supervision and guidance. However, it was clear that there had been a lack of clear boundaries in terms of Lisa’s role and responsibilities.

No further action was taken, but Lisa did receive a warning to be more careful about any future clinical roles she carried out abroad.

Learning points

• Medical students must ensure they do not act beyond their level of training – even when abroad and under the supervision of a local doctor.
• Recommending or advising on alternative medicines can fall outside of the GMC’s recognised good medical practice – especially if it delays conventional care.
• It’s essential to have the right protection in place when doing an elective – especially when practising or volunteering overseas – to protect against any potential complaints or legal claims.
• Early advice and guidance from Medical Protection can help members avoid any risky situations and ensure they are working within their professional boundaries.