MEDICAL students have faced "unfair and in some cases inhumane treatment" during an online exam, which saw some would-be doctors failed for putting on a jumper and others left to urinate in their seats.

The fiasco emerged as thousands of final year medical students sat a crucial end-of-degree exam, known as the situational judgement test (SJT).

The compulsory 140-minute test is an essential career requirement for entry into NHS as a junior doctor.

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For medical students, the SJT score makes up 50 per cent of their national ranking with the other 50% coming from their academic performance over their five-year degree.

However, as the Herald revealed in November, the SJT - which is set nationally by the UK Foundation Programme Office (UKFPO) but was previously delivered by universities - has been outsourced for the first time to US firm Pearson Vue, due to the pandemic.

This enabled tests to be sat remotely by students, via laptops at home.

Confusing and seemingly arbitrary rules, however, have seen some would-be doctors disqualified by online invigilators mid-test for removing their jumper, using a pen and paper, or turning to switch of a noisy clock.

Some students were failed for taking a toilet break without permission, while others - fearing disqualification - wet themselves instead.

Glasgow Times: Becky Bates and Tinaye MapakoBecky Bates and Tinaye Mapako

In a statement, UK co-chairs for the BMA medical students's committee, Becky Bates and Tinaye Mapako, said they had been "shocked and distressed" by some candidates' experiences.

They added: "They indicate the treatment for some medical students undergoing exams has been unfair, unacceptable, and in some cases inhumane."

Yesterday they wrote to the UKFPO warning that a "blanket policy to refuse toilet breaks" could discriminate against disabled students and called for a review of how Pearson Vue has delivered the SJT. 

One medical student, who shared her experience anonymously on Twitter, wrote: "I was terminated part way through after my online invigilator saw me using blank paper to work through a question.

"There was no clear guidance that blank paper was not allowed (e.g. it was not included in multiple lists of prohibited items sent to candidates - although these lists did clearly prohibit items like 'firearms', 'barrettes' [hair clips], and chewing gum)."

She said it took weeks of emailing the UKFPO, including sending a legal letter, before she was granted permission to sit the remainder of the test.

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She added: "In the meantime I was made aware of many similar cases. Other causes of revoked exams have included putting on a jumper, turning around to turn off a noisy clock, receiving a cold call through a 'safe exam browser' (candidate thought it was the invigilator), and playing a multimedia video question out loud (instead of via headphones).

"Another student's exam was revoked after he tried to contact the proctor numerous times to request to use the toilet, was ignored, and then did so anyway to avoid wetting himself.

"Multiple other students in this position did not have their exams revoked because they chose to urinate in their seats. I can't imagine how demeaning and humiliating this must be."

As students' rankings are so heavily weighted towards the SJT score, those with low or incomplete scores will be less likely to secure placements in their preferred trust or health board areas.

Some medical students are considering deferring applications until next year, in order to re-take the SJT in a non-online setting.

Glasgow Times: In past years the SJT was delivered by university medical schools, although it is set nationally by the UKFPOIn past years the SJT was delivered by university medical schools, although it is set nationally by the UKFPO

One GP, whose daughter's SJT exam was stopped a third of the way through after an invigilator saw her jotting notes down on a sheet on paper, said the experience has been "shocking" at a time when the NHS desperately needs new doctors.

She said: "These are hard-working idealistic youngsters who were planning to join the NHS as junior doctors in August to help cope with the pandemic, within a decimated workforce.

"They have been told that they may or may not be able to get a job somewhere in the UK...but the likelihood is that, because of this shambles, these students, if allowed to work at all, would be sent to jobs in deaneries far away, that they struggle to fill, rather than posts they applied for and were well on track to get, near their support network, which within the context of a pandemic and what they will therefore need to face as juniors, is so important."

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A junior doctor working in Scotland added: "I am horrified that the new influx of doctors who we desperately need this August are being subject to this disorganised that has been outsourced to a massive private company who have let the students down."

Lewis O’Connor, chair of the BMA’s Scottish Medical Students Committee, said: “These reports are obviously very concerning, and whilst we have not had them raised with us directly, we are seeing the issue being discussed across social media.

"We would urge medical students in Scotland who have experienced anything like this whilst sitting their SJT to contact their local BMA reps urgently so we can look into it for them.”

Glasgow Times: Lewis O'Connor, chair of the BMA's Scottish medical students' committee urged any students in Scotland who are affected to contact the trade unionLewis O'Connor, chair of the BMA's Scottish medical students' committee urged any students in Scotland who are affected to contact the trade union

Pearson Vue has already faced criticism over the delivery of online barrister exams in England, after technical problems left around 500 students unable to complete the exams and some candidates complaining that they had to urinate into buckets because they were not allowed toilet breaks.

The outcry prompted hundreds of medical students to book to sit the SJT at one of Pearson Vue's UK test centres - instead of online - but a shortage of places led to some Scottish students travelling hundreds of miles from Glasgow to Wigan or Harrogate, while English counterparts were travelling to Inverness.

UKFPO insists that problems only affected a small number of students, but did not respond to queries from the Herald about exactly how many.

They are offering re-sits to affected students "as a gesture of goodwill".

Mike Masding co-chair of the UKFPO, said: "Out of 8000 UKFPO applicants a small number were disqualified by the testing invigilator for prohibited actions.

"We are working with individual applicants whose tests were discontinued and where appropriate will offer the option to re-book.

"All applicants were given guidance in advance of the test but we will continue to work with partners to review the process and ensure all applicants are fully supported."