Expert 'surprised' at skill level of doctor fired by Limerick Hospital

Professor Michael O’Connell, who was called as an expert witness by the IMC, said Dr Megwa did not appear to be “on top of” the case of the pregnant woman with vaginal bleeding.

University Maternity Hospital Limerick.

One of the country’s top obstetricians and gynaecologists has expressed surprise at the consistent lack of basic medical knowledge shown by a junior doctor employed at University Maternity Hospital Limerick three years ago.

Professor Michael O’Connell, the master of the Coombe Women and Infants University Hospital, said Dr Francis Megwa demonstrated skills which he would associate with “a very average to poor medical student”.

While he understood that Dr Megwa might lack experience, Prof O’Connell said he was concerned that the doctor had shown no insight into his lack of basic medical knowledge.

Dr Megwa is the subject of an inquiry by the Irish Medical Council over the five weeks he spent working as a senior house officer at UMHL before his employment was terminated by the hospital in August 2018 following complaints by other healthcare staff.

The Nigerian-born doctor, who qualified in medicine in Romania in 2015, is charged with poor professional performance over his alleged failure to demonstrate the skills, knowledge, and competence expected of a non-consultant hospital doctor working in obstetrics and gynaecology.

He also faces the same charge for being unable to give a clear history about a pregnant woman with vaginal bleeding and failing to recommend appropriate treatment for her.

Evidence has been heard that Dr Megwa failed to show basic competency in taking a patient’s clinical history and in diagnosing symptoms, as well as in inserting cannulas and prescribing common medication while working at UMHL.

On the third day of the inquiry, Prof O’Connell, who was called as an expert witness by the IMC, said Dr Megwa did not appear to be “on top of” the case of the pregnant woman with vaginal bleeding.

That constitutes a significant risk,” he said.

Prof O’Connell said he believed it would still be “a significant challenge” to get Dr Megwa up to the level of an intern.

Asked how common it was for doctors working in Ireland to lack such basic skills and knowledge, Prof O’Connell said it was unusual and it would cause “alarm bells” to see such problems arise so early after a doctor started working in a hospital.

However, Prof O’Connell said he thought UMHL had acted quickly once it became aware of issues with Dr Megwa, and he believed the hospital had been “very fair” in offering him support and supervision.

He believed part of the problem was that Dr Megwa did not appear “to appreciate the gravity of the situation”.

However, he did not regard Dr Megwa’s failure to fit a cannula as constituting poor professional performance, but was “a skills deficiency that needed to be addressed”.

Prof O’Connell noted that while Dr Megwa has described working as a senior house officer, he believed the doctor’s true role was one of clinical observer with no medical autonomy.

In a statement, Dr Megwa said he had been honest with UMHL at all times about his level of experience, and pointed out that he had not been accused of misleading anyone about his training and skills.

Dr Megwa said it was unfortunate that such information was not passed on to hospital staff.

He described the accusation that he did not know what an obstetrician was as “absurd”, as he had just been unable to understand a nurse’s accent.

Dr Megwa claimed the worst allegation was that he did not know how to correctly prescribe paracetamol when even laypersons knew such information.

After his job interview, Dr Megwa said he believed the hospital was ready to train and teach him to become a successful doctor.

Instead, they reported me to the IMC,” he remarked.

Counsel for the IMC, Neasa Bird BL, said Dr Megwa had openly and frankly admitted his own lack of experience and skills.

Ms Bird suggested he had applied for the job as a senior house officer “to get a missing year of internship” that he had lacked.

A ruling in the case will be delivered at a later date.