A critical task for university based professional training programmes is ensuring that students are fit to practice. Yet, in comparison with other aspects of professional training such as curriculum development or assessment, the literature on fitness to practice procedures remains sparse. This article reports the findings of a preliminary, narrative review of the literature which aimed firstly to identify what research has been undertaken in the area of fitness to practice within university settings, and secondly, to explore the experiences of university staff who are involved. Eight themes were identified from the literature: the impact on individuals, criteria for referral, fitness to practice processes, analysis of fitness to practice outcomes, factors affecting outcomes, the emotional toil in failing students, racially minoritised students and criticisms of fitness to practice procedures. It was noteworthy that the review did not locate studies which directly explored the experiences of university staff who initiate, investigate or participate in fitness to practice procedures. This omission is important to address in order to ensure universities have effective procedures and that staff receive appropriate support. Recommendations are made for future research in this area.