Junior doctor in maternity ward is suspended from practise

Junior doctor in maternity ward is suspended from practise
Generic image of hospital corridor

By Ann O'Loughlin

A junior doctor in a hospital maternity unit has been suspended from practising here by the High Court after other doctors raised serious concerns, within days of his starting employment, he lacked basic medical competency and was a danger to patients.

The doctor graduated from medical school in an east European country in 2015 and said he was never taught how to examine a pregnant woman, the court noted.

The suspension order was sought by the Medical Council, and granted by the president of the High Court, to protect the public. It applies pending a fitness to practice inquiry into complaints by two obstetricians about his practice.

Mr Justice Peter Kelly said such employment was not "isolated" and he has encountered other cases where registered medical practitioners "with little knowledge of the basics of medicine" are nonetheless recruited to work in hospitals here.

His judgment expressing serious concerns that "defective" recruitment and interview procedures has led to employment of persons "wholly unsuitable for appointment and an obvious danger to patients" should be sent to the Minister for Health and the acting CEO of the Health Services Executive, he directed.

The judgment noted the doctor never previously worked in any paid capacity in any other hospital anywhere and two consultants said he did not meet the "most basic" standards of competence of doctors practising "at this very junior level".

Some of his junior colleagues here said they witnessed "wild" clinical assessments by him, made without taking any history or examining a patient.

The application for the order was heard and granted in private last month but, on Wednesday, the judge directed his judgment be made public on condition the doctor is not identified.

The doctor had attended an earlier meeting with the Medical Council but did not attend the court hearing or provide sworn evidence.

The judge said the doctor was recruited despite never being registered to practice medicine in the country where he received his medical degree or in his native country.

While he had self-described himself as having been a senior house officer in a UK hospital, a letter from the NHS made clear he was merely an observer in a department of medicine and was to have no hands on contact with patients.

The doctor had said he applied for every SHO job on the HSE website but kept getting replies he lacked experience. He was ultimately shortlisted for an interview as a result of which he began employment in a particular hospital earlier this year.

Generic image of hospital ward
Generic image of hospital ward

Within days, it was clear issues arose about his competence and experience, the judge said.

Two consultants raised concerns about his basic competencies, including history taking, taking blood tests, insertion of IV cannulas, how to prescribe drugs and knowledge of drugs. As a result, he received an oral warning and was directed not to prescribe drugs and to work only under supervision.

Mr Justcie Kelly said matters did not improve as a result of which complaints were made by the two obsetricians to the Medical Council.

The consultants alleged, among various complaints, the doctor did not know about basic management of eclampsia, struggled to list the causes of a post-partum hemorrhage and had said a pulmonary embolus would be treated with aspirin.

It was also alleged a supervisor found him give a diagnosis of implantation bleed to a woman at 35 weeks gestation with placenta previa.

The doctor had told the Medical Council he made clear when interviewed here he lacked experience and that it was an observership he held in the UK. He also said he was nervous and overwhelmed when asked by the consultants here about his medical knowledge.

He added there were "gaps in my training" but he was still studying and going to courses.

Mr Justice Kelly concluded the public interest required the doctor be suspended from practice pending further order.

The judge wondered how the interview panel could have awarded him 55 out of 100 marks for clinical medical and diagnostic skills when his lack of those "was so obvious within days of his coming to work in the hospital".

He also wondered how the interview panel concluded the doctor was "short on experience" when he had "none at all".

The panel had described him as "eager to learn", he said.

"But learn at whose expense?" he asked.

That should not be at the expense of "unwitting patients" who are entitled to expect they will be dealt with by registered medical practitioners who are not lacking in the basic competencies required of a doctor in the hospital, he said.

He hoped the authorities involved in recruitment of junior hospital doctors will review recruitment procedures and particularly the conduct of interviews so as to ensure what happened in this case will not recur, the judge added.

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