What Medical Evidence Do UK Universities Accept for Mitigating Circumstances?
                     T H E  G P  C L I N I C   •   S T U D E N T  G U I D E
Mitigating
Circumstances
What Medical Evidence Do UK Universities Accept?
17 UK university policies 5 features of strong medical 2 universities that address compared evidence online doctors
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What Are Mitigating Circumstances?
Serious, unforeseen events outside your control that affect your ability to study, submit work I F  Y O U R  C L A I M  I S  A C C E P T E D
or sit an exam. Also called extenuating or exceptional circumstances.
Coursework extension
More time to hand in your work
Illness Hospitalisation
Deferral
Take the assessment later as a first attempt
Long-term condition 
Bereavement
flare-up Resit without penalty
No cap or penalty on your mark
The common thread is evidence. Your own university’s current policy is the final authority on what it will accept.
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What Counts as Acceptable Medical Evidence?
Independent author
A GP, hospital doctor or other qualified professional — not a friend or relative. Other documents often accepted
Dates • Hospital admission or discharge letters
The dates of the illness or consultation, matching your assessment date. • Specialist appointment letters
• Counsellor letters for mental health claims (Liverpool, 
Dundee, Manchester)
Nature of the illness • NHS app printouts (Nottingham)
A diagnosis or clear description showing you were unwell at the time.
Impact or opinion
A clear medical opinion on the likely impact on your studies.
Very short illness? A doctor’s letter is not always 
Authenticity needed — some universities allow limited self-
Original, unaltered documents on headed paper, signed and dated. certification.
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How UK University Policies Compare
University Accepted medical evidence Self-certification Online doctor notes
Independent, signed, dated letter; must confirm circumstances were 
Nottingham witnessed at the time Generally not accepted Accepted if UK-based and CQC-regulated
Coventry Doctor’s note from an independent third party; no retrospective evidence Not mentioned Online-only notes not accepted
Independent evidence from a GMC-recognised practitioner; claim 
Liverpool normally within 5 working days Not mentioned
Not mentioned; no face-to-face consultation 
can lead to rejection
Surrey Signed, dated GP or specialist letter giving the dates and impact on work 1 per semester, up to 5 working days Not mentioned; check with administration
Letter from the last 3 months covering the full period; claim within 5 
UCL working days Delayed Assessment Scheme, up to 3 a year Not mentioned
Westminster Medical certificate or doctor’s letter with dates and a medical opinion Cannot be used as medical evidence Not mentioned
Summary of a 17-policy comparison (read 30 October 2026). Always check your own university’s current policy.
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What Evidence Universities Reject
Reported-only notes Retrospective notes Prescriptions alone Photos or videos
A note saying you reported feeling Evidence must match the assessment Prescriptions, medication photos or Images of your condition are rejected 
unwell won’t normally be accepted. date; post-dated notes are often appointment confirmations on their by several universities.
refused. own.
Non-clinician statements Altered documents Minor illness Untranslated evidence
Letters from family, friends or academic Amended documents are inadmissible Everyday problems unlikely to disrupt Documents not in English need an 
staff don’t count. and may trigger misconduct rules. your work are usually excluded. accredited or certified translation.
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Can You Use an Online Doctor’s Note?
It depends on the university. Of the 17 policies reviewed, only two address online doctors directly — and they disagree.
Nottingham Coventry Most others
Accepts online doctor certificates, provided Says online-only medical notes (for example Ask for a qualified or GMC-recognised 
they are UK-based and CQC-regulated. Push Doctor) are not acceptable evidence. practitioner and don’t mention online 
services. Several want a practitioner who saw 
you at the time.
Ask in writing first: email your student office to check they’ll accept a letter from a UK GMC-registered doctor who consulted you by video, and keep 
their reply with your claim.
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How the Rules Change by Situation
Long-term International 
Exams Coursework Mental health
conditions students
Attending can count Short extensions are often Independent evidence is Conditions with Evidence not in English 
against you: it means handled separately and needed, not self- adjustments in place are needs a certified 
declaring yourself fit. If usually requested before description. Exam nerves often not a new translation, sometimes at 
too ill to sit, get medical the deadline. Longer ones or self-diagnosed stress circumstance, unless there your cost. Overseas 
evidence the same day. need a doctor’s letter. aren’t accepted without a is an unforeseeable flare- practitioners must be 
diagnosis. up. qualified.
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Getting Evidence and Submitting a Claim
Read your policy Get a consultation early W H E N  T O  A C T
Find the mitigating or extenuating circumstances page; A professional who assesses you at the time can Same day
note evidence rules and deadlines. describe your condition and its dates. Too ill to sit an exam? See a doctor and ask for dated 
evidence.
Before the deadline
Request extensions before the due date.
Ask for the right content Check the provider type
Dated, signed, on headed paper: illness, dates affected Confirm whether online doctors, counsellors or other Within ~5 working days
and likely impact on study. professionals qualify. Many universities accept claims up to this point.
Within 2 weeks
Some require claims or evidence by then.
Submit on time Keep originals
Deadlines range from days before an assessment to Send unedited documents, with a translation if needed, Before results
days after it. and follow up. After results or the exam board, claims are usually too 
late.
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Key Takeaways
Independent and dated Contemporaneous Content matters
Evidence should come from an independent Several universities reject notes that don’t show a A note saying only that you “reported feeling unwell” 
qualified professional, on headed paper, signed and consultation at the time of the assessment. is often refused.
dated.
Self-certification is limited Online doctors vary Deadlines are strict
Some universities allow it for short illnesses, with Nottingham accepts UK-based CQC-regulated notes; Many set cut-off dates, some only days after the 
caps; others don’t accept it at all. Coventry doesn’t. Ask yours in writing. assessment.
If your claim is rejected: read the outcome letter, gather new independent evidence and appeal within the short window — never alter existing documents.
T HE  G P  CL I N IC   •   M I T IG AT I N G  C IR CU M S TA N CES  GU ID E 9
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