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A FITNESS TO practice inquiry in front of a Medical Council has found Dr Mohamed Abdelrahman guilty of professional misconduct on three counts..
Dr Abdelrahman, a 27-year-old Sudanese national who has been based in the Obstetrics and Gynaecology department at Letterkenny General Hospital since January 2016, had already admitted that he failed to inform the Medical Council that he had been refused registration by the British General Medical Council (GMC) on two occasions.
RTÉ News reports that he has now been found guilty of professional misconduct.
Earlier this afternoon, the committee heard from an expert witness of his worries that the failings of the Donegal-based doctor charged could impact upon patient welfare.
This afternoon Professor Stephen Lane, a consultant respiratory physician at Tallaght Hospital, told the inquiry that he would have “grave misgivings” about Dr Abdelrahman in light of his transgressions.
“It was well known to (Dr Abdelrahman) that he had failed in his application to the GMC a number of times with regard to his English language skills,” Lane told the inquiry.
That act is professional misconduct in my view.
Lane said that he saw a pattern of “a certain amount of recidivism” in Abdelrahman’s actions, given he had applied to the GMC seven times and had failed to inform the Medical Council of having failed in those applications twice.
When counsel for Abdelrahman John Freeman told Lane that his client’s behaviour with regard to the GMC was irrelevant to this inquiry, Lane replied: “I have a problem with the recidivistic nature of the prolonged number of applications made in quantifying the degree to which he departed from the norm.”
This is a particular problem when it has gone on for a number of years.
When Freeman contended that the charges facing Abdelrahman in no way relate to “poor clinical performance”, Lane replied: “I don’t accept that there is no relevance to protection of patients here, I think that anyone who has shown poor conduct on a number of occasions… I would have concerns that would translate into poor medical performance.”
It’s an honesty issue.
Lane said that he could understand someone “perhaps fudging the date they took an exam” as being an example of less serious misconduct.
“But when you’ve got seven applications made to a licensing body like the GMC then that is a serious issue,” he said. Replying to this, Freeman once more stressed that his client faces no charges regarding his dealings with the GMC.
Lane replied that “as a peer medical practitioner these two instances would make me very concerned”.
“So to summarise, these actions represent a serious falling short in standards, professional misconduct which has already been admitted to?” Freeman said.
“The issue is we have a doctor working in a country for a long time who has falsified his application and then again with its renewal, that is a problem that needs to be addressed,” Lane replied.
Lane further claimed that the fact English isn’t Abdelrahman’s first language was of no relevance.
“That fact isn’t important,” he said. “We have many of these types of application coming through.”
References
The inquiry also heard a number of references as to Dr Abdelrahman’s character from Freeman.
Dr Eddie Aboud, a colleague of Abdelrahman’s at Letterkenny General Hospital, described him as “a good SHO (Senior House Officer), keen to learn, who has improved his ability and knowledge in the last six months”.
“The practitioner is a quiet character but does his work well,” Freeman read.
If I were asked would I hire him again, the answer is yes.
That reference was given in light of Abdelrahman discussing his dealings with the GMC with Dr Aboud, Freeman said.
Several references were read from Sudanese medical professionals based in Khartoum, who had known Abdelrahman during his academic studies.
“Yes I believe him to be of good character,” read one. “I believe he understands the faults in his actions and will not commit them again.”
Abdelrahman’s university tutor in Khartoum meanwhile described him as being “of good character, he realises his mistakes”.
I would recommend him for any position in the future.
A representative of the University of Khartoum had submitted a reference describing Abdelrahman as “academically one of the most distinguished and outstanding students – competent, talented, and brilliant”.
Closer to home, Dr Micheál Newell of NUI Galway, said that he would be “delighted” to recommend Abdelrahman.
“I have every confidence in his ability to excel in his chosen medical career,” said Newell.
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Newell met Abdelrahman when he registered for a medical masters degree in Galway in September 2015, and it was understood that the reference was given in an academic context said Freeman, notwithstanding the fact Newell is also a qualified medical doctor and was aware of the nature of the Medical Council’s inquiry.
Earlier
The committee had this morning heard that Dr Abdelrahman’s refusal by the GMC in November 2012 was based on his failure to reach required standards on an English language competency test, known as IELTS, which is a minimum requirement for practicing doctors in the UK.
He subsequently contended that he had successfully appealed his scores on the IELTS test, and that they had been upgraded to a sufficient level to allow him pass minimum competency.
When the GMC asked for proof of this appeal, Dr Abdelrahman submitted a score sheet covered in sellotape, with the relevant scores both indistinct and to be found on creases on the page that were also covered in sellotape, and that one of the relevant scores was off centre on the certificate.
Abdelrahman explained the condition of the certificate as explained by the fact he had spilt tea on it. He was unable to produce proof of his having paid for such an appeal. This explanation was deemed to be “implausible” by the GMC, which stated that Abdelrahman had “embarked on a course of unacceptable conduct in order to mislead the GMC”, and that he had shown “no evidence of insight into or remorse for his actions”.
“Victim of fraud”
On the basis of this, the GMC refused Abdelrahman’s application and suggested that he had not proved his competency. Abdelrahman contended at the time that he believed his inability to produce sufficient evidence of his competency was a result of his being a victim of fraud in Sudan.
Abdelrahman’s original IELTS scores would have been sufficient for him to be declared competent in the eyes of the Irish Medical Council, the required scores here being less stringent than in the UK.
All told Abdelrahman applied to the GMC seven times. Four times he sought exempt status relieving him of the need to prove his proficiency in English. These were all refused. Three times he applied for registration as a medical practitioner, although one of these applications made in 2013 was withdrawn after it was found the IELTS scoresheet submitted had been tampered with in a similar fashion to that of the 2012 application.
Abdelrahman’s final application to the GMC, made in August 2014, was made after he had retaken the IELTS test and achieved the necessary scores. On this occasion he was refused given the historical issues surrounding his previous application.
During this two-year period the doctor had applied for a number of medical positions in the UK while saying that he was an officially registered medical practitioner there which was not the case.
Though he had received a number of offers, these had all been withdrawn once due diligence showed he was not in fact registered. He has never worked in the UK.
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The specific charges Abdelrahman faced today relate to alleged professional misconduct and poor professional performance concerning his failure to admit to the Irish Medical Council when applying for medical registration, and renewal of same, that he had previously been refused by the GMC.
It is also alleged that having been refused by the GMC for a second time in April 2015 Abdelrahman once more failed to notify the Medical Council of same.
“Accepts the allegations”
Defending the doctor, barrister John Freeman said that his client “accepts without equivocation” the factual allegations of the Medical Council.
Freeman contended that at the time of the initial application to the GMC “Dr Abdelrahman was a very young practitioner and this is at the root of the issues”.
“He received his degree at age 22 and was the same age when he applied to the GMC,” he said.
Freeman said that Abdelrahman has an excellent academic and medical record and is held in good standing by the Sudanese Medical Council. “His work in Donegal has proceeded without incident and there are no issues surrounding his medical competency,” he said.
There are no medical competency concerns or anything of that nature.
His engagement with the Medical Council was not full and frank and does not reflect the standard expected of a doctor in Ireland.
He accepts all of that without quibble.
“This has been a chastening experience for him,” Freeman said. “There is no possibility or risk or recurrence.”
Freeman requested that his client be heard under Section 67 of the Medical Practitioners Act 2007, which in certain circumstances allows for a subject to undertake not to repeat the conduct of which he is accused.
In recognition of this, Abdelrahman would undertake to:
Fill out all future Medical Council forms with a senior colleague and with legal advice
Undergo counselling regarding ethics and take record-keeping courses
Accept all censure from the Medical Council
Agree to make a contribution to a charitable cause that would correspond to the maximum fine under section 71 of the Act
Consent to the publication of the outcome of his hearing (ordinarily, the Council’s judgement in fitness to practice inquiries is not published in this manner)
“On this basis (Abdelrahman) accepts the findings of the medical inquiry and accepts that his conduct has fallen below the standard expected,” Freeman said.
Counsel for the Medical Council, Eoghan O’Sullivan, said that the Council cannot accept that the inquiry be heard under section 67 due to “the seriousness of the allegations”.
“If the Council does go down this route I’ll need further instruction, but I don’t think it’s an appropriate manner in which to deal with this matter,” he said.
O’Sullivan also drew note to the fact that a book of references as to Abdelrahman’s character “make no mention of the allegations in front of the committee today”.
Following deliberation, the committee elected not to deal with the hearing under section 67 in order that it might hear the evidence of the Council’s witnesses against Abdelrahman.
With the inquiry finding Abdelrahman guilty of professional misconduct, a report will now be sent to the full Medical Council to decide on any sanctions.
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