Could one badly judged email, social media post, or rough patch at work put your psychology career at risk before it even begins? In this episode of Psychology, Actually, Dr Marianne Trent joins Nicholas Stöckling to explore fitness-to-practice proceedings for trainee psychologists and other pre-qualified healthcare professionals.

They unpack what actually triggers FTP concerns, how the process differs across universities, why communication issues and unmanaged health conditions are common flashpoints, and how neurodivergent trainees can be disproportionately affected. Nicholas shares practical advice on social media conduct, self-disclosure, engaging with proceedings, and when to seek legal support. A must-listen for trainees, supervisors, and anyone supporting students through clinical training.

#FitnessToPractice #TraineePsychologist #ClinicalPsychology #FitnessToPractise

Highlights

• 00:00 Introduction
• 00:20 The pre-qualification "grey zone" explained
• 01:52 Why there's no standardised university FTP process
• 04:15 Juggling training, placements and personal life
• 05:34 Common examples of FTP issues for trainees
• 11:01 What kind of psychologist should training produce?
• 12:20 Cultural norms, swearing and miscommunication
• 15:44 The stress of undergoing an FTP investigation
• 16:51 Are universities there to support or to protect the public?
• 20:09 Why FTP processes vary so much between universities
• 22:01 Employer vs university: who's really accountable?
• 27:01 Can stage one concerns be resolved without escalating?
• 27:45 How careful do trainees need to be on social media?
• 29:31 Does a "views are my own" disclaimer protect you?
• 31:15 Do failed assignments lead to fitness to practise?
• 34:11 AI note-taking: help or new FTP risk?
• 36:16 Can a trainee refuse to engage with proceedings?
• 37:57 Should you self-disclose struggles early?
• 42:08 Advice for trainees facing FTP concerns
• 45:49 Where to find Nicholas Sterling

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This content is for informational and educational purposes only. It does not constitute medical, psychological, or professional advice. Any actions taken based on this content are at your own risk.

© Dr Marianne Trent

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 practise 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 Stöckling as we explore what really triggers fitness to practise concerns, what happens next, and how trainees can protect themselves without feeling terrified of making a mistake. I'm Dr. Marianne Trent, and this is Psychology Actually. 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 Stöckling, who is a legal advisor and the founder of NS Consulting. Hi, Nicholas.

Hi, Marianne. 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 practise proceedings. Now, something that people might not be aware of is that there are still fitness to practise proceedings going on and standards that you need to maintain even before you become professionally regulated with the HCPC. And so what we are finding is that people that are trainee clinical psychologists or trainee paramedics or whatever are coming up against fitness to practise proceedings and then finding, oh, I kind of fit in the middle of everything, so I'm not yet under HCPC. I don't necessarily feel like the uni are on my side, maybe my placement supervisors are maybe not on my side and they're feeling really quite unsupported. So what we're looking to do is have a broad conversation around pre-qualified fitness to practise 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 regulatory support that you have when you're with an institution. For example, the HCPC, you feel like you're in limbo a little bit, so you're actually entitled to support from the university. And at the same time, they are regulating and making sure that they adequately prepare professionals as they move forward. FDP 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 trainees is that they're not being regulated by the HCPC, therefore meaning that the standards that existed with the HCPC while incorporated into the university programmes are not actually. It's not as clear to them actually 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 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 are run, should you fall into FTP problems. And I think that leads to a bit 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 and 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 practise, of your traineeship for clinical psychologists, for example, if you are 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 challenges that you've never faced before. And that's when things, health issues can become a problem. That's when issues related to communication might be emphasised, and that's when you can fall fail of the FTP regime. So it's something that people have very little knowledge about this student FTP regime.

Yeah, I think it is the ambiguity, isn't it? It's like you don't necessarily know where you're aiming for. I think it just reminded me of all of the different plates that I had spinning when I was a trainee. 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 are suddenly 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 trying to slot into university life, so the demands of academia and the interactions you might be having with your personal tutor, and then actually attending university lectures and seminars as well. And then 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 that you've somehow got to try and bolt into all of those. So obviously it's a lot. Without breaking any confidentiality, if we could just give a couple of examples of the kind of fitness to practise things that you are 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 trainee's completion of their course. So you can imagine the trainee 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 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. The fact that you are now taking on caseloads yourself becomes a serious factor, as I said. And if you have any, for example, issues with anxieties, issues with the communication, as I mentioned before, some neurodivergence, ADHD, autism, and whether it's also mental health issues, whether you've actually acknowledged that with the university, and some people have, some people haven't, some people have reasonable adjustment and they've done it and they've acknowledged and it's part of the process, other people haven't.

And 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 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 a 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 over proportionate representation of clients that I have are people who are 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 themself or people having difficulty with anxiety, people having students really having 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 plagiarised, they've stolen something and their FTP matters and universities deal with those and they rightfully should not be admitted if they've really broken the rules.

But those sort of clear cut cases are less interesting, I think, because we all know when someone's stolen a computer or someone's forged notes, we don't want that type of person. There may be some other issues involved, but 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 people understanding that what can start off as being a communication issue in email, inappropriate emails, when the process begins, which is normally it's raised with the student, there's a complaint 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 really how can we help the student?

That's the mentality of the university. How do we help the student past this stage? But if the student does not really have the same understanding of the issues that they may have presented, for example, if they 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 insight. So you need to not only understand you've made a mistake, but have rectified and remediated that mistake. So issues of communication, 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?

What do we want to go out into the world? Is the university educating and creating a particular type of psychologist or its perfunctory role is also to regulate? And they can sort of cross paths and they can become complicated. So 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? And it'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 I say, differently, eye contact, can they actually. Are they masking, using a psychological term, and are they going to be able to be an appropriate, safe psychologist? And I would argue that some of these people are being fully fouled the FTP process and are being excluded from the profession because of whatever nuanced difference they may have.

So that's a broader discussion that maybe you can comment on in terms of what type of psychologists we're wanting and 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 I do so much work around inclusion and how psychologists don't all need to look the same. And I'm aware that people that might have been qualified for a longer period of time might have different views around what 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 find it really helps them let their guard down if a clinician will swear when they're talking to them. But obviously some people are swearier than others. Some people find that very, very offensive. And I can imagine that if someone was very sweary in interpersonal meetings in the corridors and in MDT meetings, that might come across as antagonistic or rude, when in actual fact for lots of people, it's just a way of punctuating almost and adding nuance to discussions or really trying to connect with someone.

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 just different comfortability curves, I think, with normal human behaviour.

Absolutely. I think that's a great example. I personally, I'm Australian, so I grew up in a culture where it is a means of lowering barriers and that's just the way it is. When you are in a familiar situation, when I'm with my parents, 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 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, 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 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 thinkers about how we deal with discrimination and how to best equip students.

So I don't want to label all. Universities are great places. The ones that eventually, where there may be some slight issues is accepting that some supervisors, some members of academia outside of strict guidelines may see norms in a slightly different way to some of these students or some of these trainees. Okay, so I mean another example of this idea of norms and people's perceptions, and I would argue their lived experiences using a case example I've had, is with a client 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 that becomes a different level of complaint by the student. But really feeling that her experience as her and 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 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 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 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 issues that we're dealing with. Every trainee is an individual person with their own individual idiosyncrasies or their own individual cultural identity and being able to listen to these people having their lived experience as psychologists and not having a standard of particular psychologists that the university's trying to produce, I think is something universities could strive towards a little bit more because they're the ones that tend to fall fail of this FTP process, particularly in terms of universities.

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 having to raise that. This isn't something that people do lightly. I think I've spoken publicly already that I had an experience on one of my placements where at my mid-placement review, the question was, is there a chance that the trainee might fail this placement? And the answer was yes. 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. It isn't easy, is it 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 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 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 or mental health, while at the same time ensuring that, wait a sec, once they're finished with the process, once 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 it's often a question that when I hear anger from clients, whether they be trainees or whether they're qualified registrants, once they have an understanding of the idea that the HCPC or in this circumstance that the universities, they're 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 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 managing that for universities is very difficult. I don't deny that 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 and not a standardised HCPC system, how students, trainees, various people, whatever stage of their training they may be, how they deal with the FTP process varies. 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, they're not in need of assistance. It's that you have different guidelines for every university. So am I dealing with Reading today? Am I dealing with Swansea? Am I dealing with. And that to me feels a little bit unfair because you have a standardised system once they're registered, but before registration, it's not standardised and how well panels or universities deal with reasonable adjustment, how well they deal with, or how forceful do 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 work in the industry and deal a lot with students and they would argue that it's a rogue world. I wouldn't go that far, but they'd argue that it's in the nether region there. You don't really know what you're going to deal with and that's not the right word.

I enjoy the nether regions. Let's leave it in. Okay.

So you're in sort of a grey zone there, meaning that 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 inherently unfair and they make whatever decision they want. And if there's a personal problem with that particular trainee, then that's going to override anything else. And if that straight trainee, for example, has needed extra supervision for whatever reason and has caused a bit of a disruptance in the course, and there may be a lot of people unhappy with that person's behaviour, but it doesn't necessarily mean they're not going to be a great psychologist, that personal relationship can't be overlooked.

So when, for example, a trainee may be at a final hearing, FTP final hearing at university, FTP proceedings, and the main evidence is being presented by a supervisor. Now this may be very evident, a very qualified, eminent, fantastic at her job or his job, whoever it may be, but if there's a personal issue 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 organisations like the ACP UK or various representative bodies about how can we manage this better? Because to me it feels unfair and it's disproportionately affecting those of different ethnic backgrounds who have neurodivergence, who may not conform to what we see as society's norm. So it's something that I think should be looked into.

Yeah. And I think another issue that I kind of struggle to get my head around is the fact that for people that are not self-funding, their employer will be the NHS, certainly for trainee 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 are 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 difference, especially if maybe you are, like you said, if you and your supervisors just don't get along and if you met each other a hundred times across different years, you still would hate each other.

It's just a personality mismatch. And then there really is an inequity.

Absolutely. 100% agree. Absolutely. I mean, that sort of conflict between employer and university, particularly in the final years, 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're on the coalface, you're dealing with vulnerable people, and also your employer, they're trying to run an organisation. So the fact that you are 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 caseload, five, 10, whatever the caseload may be, and the student might not be ready for that. So the academic requirements from the university are too great, considering that the employer is actually asking, "Yeah, but you're running a caseload now and they're expecting a certain standard." And what I would argue, and what I do argue at final hearings regularly and in our submissions and in our appeals is that this person is still learning.

And so they're not the finished product yet. They're not the finished professional. And then I 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 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 the expectations of maintaining this standard that they've never met before, because they've never done it before. And in other professions, I'll give the example of a radiologist who I work with, in their placements, if they're taking a scan, for example, and determining what the type of growth it is, or for example, whether it's a tear or whether it's a break, 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 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.

It's real and it happens immediately. So there's no means 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 writing 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, and again, we don't want to scare people, trainees and students, the majority of people will never encounter any FTP proceedings university, but it does happen. And when it does happen, my advice would be from the outset is 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.

And once you're in that FTP process and the formal investigation is undertaken, the advice is to try and get some help, whether it's through your student representatives or through legal advice or people who understand this process. And I think that in certain circumstances, my colleagues will agree with me here, the 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 practise. So to try and exclude legal representation from the various 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 it's something I think the ACP should look into and various other organisations as well.

Yeah. Thank you for that. I though what we'd do is we'd go onto a little quick fire round. Absolutely. And we'll see how we get on with that. Okay. So with the fitness to practise 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 would argue that's the most common way that these things resolve themselves. So the stage one issues maybe in terms of lateness, maybe in terms of social media, some slightly inappropriate communication, they resolve it, you 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 par because, and obviously with the younger trainees, they will be more versed 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, while obviously you won't necessarily. Hopefully you won't identify a client, your other colleagues, group photos in terms of whether other people have agreed to be involved in this particular chat, being very wary also of your opinions. If you're going to be vocal about a particular political opinion, whatever that may be, make sure 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 or whatever you're doing, private practise, whatever it may be. Yeah, just be very wary and just steer clear of at this stage on your public account of making.

We don't want people to be robots, not have political opinions, but yeah, just be careful. Privacy, data protection, and also some of the comments that you make. If someone picks it up, maybe it's someone else that there's a personal issue with It doesn't necessarily have to be your university that has actually picked up, "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-registered, registered. It's really 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 on 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 disclaimer that legally doesn't really count for anything. Obviously, it depends on the type of work you're doing, but 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, potentially that's not going to be a problem. And you're saying, this is not what my employer says. But if it's a strong view either way, political, social, then yeah, that's not going to save you from any sort of FTP process.

I was raised in a way that told 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 onto.

I mean, whether it's a wise career choice is a different issue, whether you're slagging off the head of the hospital, but they're two separate issues. You may lose your job and you may be asked to find a 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 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 practise that ultimately leads to you not finishing your course? I

Mean, in my experience, no, that's not necessarily the case. In my experience, the types of matters as they relate to clinical practise and proficiency will need to be broad, wide ranging and serious. So obviously depending how important those particular academic tasks were, if they were your major component and you've tried it again and again and again, but generally the university FTP processes and then eventually the HCPC, 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 where they've failed one 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's the serious matters to do with dishonesty, repeated failings. For example, note taking, one example that I can think of is repeated issues in terms of not insufficient notes, but incomplete notes or no notes whatsoever. So for example, a student, a trainee in their last couple of 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 psychologist who ill see him because it may not necessarily be that front-facing psychologist.

And there's no note, there's no note at all. And if this happened once, maybe that can be rectified. If this happens again and again and again, this becomes a public safety issue. 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 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'd 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 practise issues or do you think that could potentially cover up the disclosure of other fitness to practise issues?

Yeah, very interesting question. And I envision that that's going to be an avalanche of future cases and how AI is managed within clinical settings is going to be something that is going to be a lot of my work and really lead to a lot of FTP cases. At the moment, the issues that I can see in relation to AI and note-taking are really, if it's an accepted, a recognised and safety proof AI system that's being used and is being supported by whatever institution is and you're 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 going to be an improvement in terms 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 fail of the FTP matters. In terms of AI generating false notes, I mean 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 is it may lead to some dishonest submissions, it may be some dishonest note taking or some. Then that becomes a problem. Dishonesty is frowned upon as we understand and the punishment is 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 practise proceedings?

I mean, absolutely they can. And everyone has the right to do whatever they wish to do. And that's also the case 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, disengage and not have any contact with the university and later on with the HCPC, it's really going to be frowned upon. And guess what that goes to is what we discussed earlier, this idea of insight. So if you don't 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 have a finding without you there. And then that can potentially lead to a full FTP investigation and you still don't engage, as is your right, you are likely to be either suspended from the course depending on the seriousness of the matters. But what I suggest to all clients post-registration, pre-registration, actively engage, actively engage. You can disagree, you can absolutely disagree, and that's where you 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 a wise 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 quick fire 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 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 an actual physical ailment. 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 bud early, get there early. And it doesn't necessarily have to be the instalment of reasonable adjustments, which is something universities can offer, which are actually not as difficult to have put in place as people may think. So essentially reasonable adjustments are something that they're there to help university students. But if you are struggling psychologically, if you have, for example, an undisclosed or unknown mental health issue or neurodivergence or something else in your life, death of a 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 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. Obviously there's a lot of support systems within that reaching out first and foremost to your supervisor, letting them know, "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 particularly with burnout, mental health issues, once 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 to been addressed very early in proceedings in terms of an unmanaged health condition. Had they reached out at that stage, we could have potentially stopped everything that came hence forth because actually all of this could have been done appropriately with proper support.

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 you're struggling, then it could look like that actually I'm just not up to scratch. Actually, I don't care. And I'd strongly advise people to reach out as soon as it has a visible effect on their work. If you're managing, fine, but as soon as it actually visibly affects your ability to practise 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 the people that you 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 own path through studies, particularly in a stressful job like psychology. 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 your cohort doesn't want to support you, when you eventually get there, maybe they weren't really the people you wanted to 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 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 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. It might be an informal meeting as we discussed, that informal meeting is informal, but you're essentially on the pathway towards a formal FTP hearing. 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, 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 full 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 role we're in, how serious is this. I'd definitely have a discussion with those that you're working with closely if you're at the end of your training. Obviously it depends who raised the complaint, but if your supervisor who's actively with you on a daily basis and it's unrelated to that supervisor, hate having a chat to them if you're at that stage of the proceedings.

And from that point onwards, if it does decide to go into a formal investigation 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 it. 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 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, 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. 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. 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. It's 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, S-T-O-C-K-L-I-N-G. And you can find me on LinkedIn and I'd be more than happy to help.

Perfect. Thank you so much. And I will 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 at 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 Stackling. Please do go and check him out on LinkedIn. He really is a safe port in the storm if you are struggling with fitness to practise concerns. This was not my first chat with Nicholas. We did speak earlier more generically about fitness to practise 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 compassion from their peers as well. We've also been trialling 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-psychologist.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.