The common consensus has it that school days are the happiest days of our lives. Whether or not dental school days count in this context is probably a matter of personal choice and individual experience. For some, certainly, the heady combination of youth, moving out of home, new friends, colleagues and experiences represent some of their most joyous times. For others the pressures that those same circumstances create mean that the stresses begun then run, or will run with them into professional life. Not unhappy but not perhaps unbridled euphoria either.

A year or so ago I raised the matter of professional behaviour amongst students and young dentists in particular but also in the profession as a whole.1 Prompted then by the General Dental Council's (GDC) consultation on its document Student fitness to practise, my return to the subject now follows the recent launch of the completed publication.2 Although stated on page 2 (of the 28 page document) as being 'advisory' rather than 'mandatory' there can be little doubt to the reader that the comprehensive nature of the text and the body of detail behind it means that anyone inclined to not take that 'advice' will be running a serious risk of falling foul of the system. Not least is the explanation that the derivation of the document comes from the government White paper Trust, Assurance and Safety – The Regulation of Health Professionals in the 21st Century which requires healthcare regulators to ensure the safety of patients being treated by healthcare students. Significant too is acknowledgement to the General Medical Council and the Medical Schools Council who have also recently published similar guidance.

Not a twitter

What emerges from the guidance is in essence a mini-version of the GDC's grown-up equivalent Standards for dental professionals, but this is no Twitter summary of a longer blog. On the contrary, this is a very detailed point by point recipe of how students should behave, conduct themselves in their professional and private lives and hold themselves accountable for their own actions as well as observing those of others. Education providers 'should' (advice remember, not mandation) make sure that admissions and/or enrolment information, student handbooks and information about rules and regulations includes statements about the responsibilities of students to develop professional values.

On one hand it may seem a reasonable entreaty but on the other it is in essence requiring the provision to sixth-formers and other, younger potential dental professionals (for this covers all dental team members not just dentists) of heart-stopping detail. The risks of transgressions, the composition of student fitness to practise panels, sanctions that are available for imposition and the possibility of expulsion from the course are all laid out in, well, almost clinical precision.

To me, the sadness of all of this is not that it is necessary, because it has always been necessary to have such safeguards in place, but that we have come as a society to regard it as no longer a matter of professional regulation but as bureaucratic dictat. Yes, I am sure it is merely 'advisory' but the suspicion that lingers as to why it is not mandatory is only because the powers that be do not have the financial resources to make it such. I suspect that if students had to pay an annual retention fee (and who knows what may happen in a cash-strapped GDC future?) we might soon have a thriving undergraduate fitness to practise industry to rival the current burgeoning tumbrel of their qualified colleagues.

And yes, I know that all this is credited with having stemmed from Shipman, the Bristol child heart cases and the politically generated spin of public distrust but do patients really have such misgivings about students that we need a 28 page document to rectify it? And, actually, is that in any way more reassuring than building a trustworthy relationship with the student professional and her or his teachers, mentors and trainers? It is, I am afraid, another example of encroachment by government on the independence of the professional. But I write this in the very earliest hours of the formation of the new coalition government where the change that was on the lips of so many candidates in the general election campaign seems to have taken turns and forms which were unimaginable only a few weeks or even days previously. Is it possible that in due course some such similar changes in values can take place in this arena too?

Let us be clear, I am not advocating returning to old values under which the apparent conspiracy of professional collusion allegedly thrived. Instead I am suggesting that we could begin to build a fresh professionalism which is forward-looking and which germinates on trust and consensus rather than growing from a dank and foreboding regulatory mire. It will take time and it will take some courage to establish but maybe, just maybe, our current and future students are the people who can take this fitness to practise 'advice' and convert it into a more meaningful form of understanding. If they do, the days will be happier for sure.