What are the consequences for a 4th year Bachelor of Medicine, Bachelor of Surgery (MBBS) student who prescribes antibiotics to a patient with a cough, resulting in successful treatment, despite lacking the legal authority to do so?

From the Guidelines

A fourth-year medical student should immediately stop prescribing medications, as this practice is illegal and constitutes practicing medicine without a license. The punishment for unauthorized prescription can include fines, academic disciplinary actions, potential expulsion from medical school, and in serious cases, criminal charges that could permanently affect their medical career. According to a study published in the British Journal of Pharmacology 1, medical students should be encouraged to practise relevant clinical skills, such as taking medication histories and writing new prescriptions, under supervision. However, this does not grant them the authority to prescribe medications independently. The student should disclose this activity to their clinical supervisor or medical school ethics office, as transparency may mitigate consequences. Some key points to consider include:

• Medical students can only provide medical advice under direct supervision of licensed physicians
• Prescribing authority is granted only after completing medical school, passing licensing exams, and obtaining proper credentials
• Even if the treatment was successful, the legal and ethical violations remain serious because prescription medications carry risks of adverse effects, drug interactions, and potential harm if inappropriately prescribed
• The student should understand that clinical knowledge alone is insufficient for independent practice, as prescribing requires integration of comprehensive patient assessment, medical history, and potential contraindications that students are still learning to master. In real-life clinical medicine, it is crucial to prioritize patient safety and adhere to legal and ethical guidelines, even if it means seeking guidance from licensed professionals rather than taking independent action.

From the Research

Legal Implications of Prescribing Medication

• The question of a 4th-year MBBS student prescribing antibiotics to a person with cough raises concerns about the legality of such actions, as it is not within their legal scope to prescribe medication 2.
• There is no direct evidence in the provided studies that addresses the specific punishment for a 4th-year MBBS student prescribing medication illegally.
• However, it is clear that prescribing skills of medical students, including those in their 4th year, are not always satisfactory and may require further training and evaluation to minimize prescription errors and irrational prescribing 2.

Stopping Prescription

• A study on how medication prescribing is ceased suggests that effective interventions to stop prescribing include patient-mediated interventions, manual reminders to prescribers, and educational materials given to patients 3.
• In the context of a 4th-year MBBS student, stopping prescription before it is legally allowed may not be directly addressed, but the importance of proper prescribing skills and the potential consequences of illegal prescribing are highlighted 2, 4.

Educational Preparation

• The educational preparation of medical students, including those in their 4th year, is crucial in ensuring they have the necessary skills to prescribe medication safely and effectively 2, 5.
• Studies suggest that nursing students, who also play a critical role in medication management, require comprehensive educational preparation to develop their understanding and skills in this area 5.
• The importance of collaboration between universities and clinical placement settings in providing adequate educational preparation for students is emphasized 5.