Wednesday 29 March 2017

Doctor 'failed at most basic duties'

'Desperation' to recruit junior medics resulted in references going unchecked

Edel O'Connell

A doctor who had difficulty carrying out basic tasks, such as scrubbing-up for surgical duties, was employed at a hospital without any reference being obtained.

Dr Emmanuel Gbadebo Alabi (49), a Nigerian living in Cork, was yesterday found guilty of poor professional performance following an Irish Medical Council fitness-to-practise inquiry in Dublin into two allegations concerning his competency.

During a brief telephone conversation at the start of the hearing, Dr Alabi, who did not attend, claimed he could not afford to hire a legal team as he was unemployed.

In July 2010, Dr Alabi was employed for a six-month posting at the Our Lady's of Lourdes Hospital in Drogheda as a junior doctor.

Soon after starting his job, it came to the attention of his superiors that he was having difficulties carrying out basic tasks, including recording a patient's history and inserting intravenous lines.

According to one clinician, Dr Alabi did not seem to have even a basic understanding of how to scrub up in advance of assisting him with a caesarean section, and had in fact "barely washed his hands".

The doctor, who is currently unemployed, qualified as a medical doctor in Belarus in 1994 before returning to Nigeria, where he held various junior doctor co-ordinating posts in obstetric and gynaecology departments.

In 2004, he successfully completed the Professional Linguistic Assessment Board (PLAB) exam -- the main route by which international medical graduates demonstrate they have the necessary skills and knowledge to practise medicine in the UK.

He then worked sporadically as a clinical attachment in a number of Cork and Waterford hospitals between 2005 and 2007.

Supervised

Clinical attachments are similar to intern posts, where a doctor observes the work of other doctors in order to learn. They are not allowed to treat patients and must be supervised at all time by a consultant. They do not get paid by the hospital.

A clinical attachment is seen by foreign doctors who trained overseas as a good way to learn about procedures in Irish clinical practice. It is intended to build confidence and improve chances of passing exams and obtaining jobs.

Dr Alabi later worked for two months as a locum in Mayo General Hospital in Castlebar, before applying for the job at Our Lady of Lourdes at the beginning of 2010.

Giving evidence yesterday, a consultant obstetrician at the Drogheda hospital, Marie Milner, admitted that as a result of "desperation" to recruit junior doctors at the time she did not call his previous employer for a reference.

"We were in a situation, which was nationwide, where there was huge pressure to recruit junior doctors," said Dr Milner.

"We were in an extraordinary situation where we were so short, and it would be extraordinary for me to appoint someone without having spoken to where they worked previously, but that is what occurred.

"We were desperate to have junior docs on our books. We would have done anything we could have done to make him fit, if not for all the duties then for at least some of them."

After five days, Dr Milner approached Dr Alabi with her concerns about his performance, to which he responded with "complete amazement".

A plan was put together to supervise and train the doctor for four weeks. However, when the doctor failed to display any improvement, his position was terminated.

No incidents of patient harm were reported during Dr Alabi's tenure. Giving evidence, consultant Dr Yayha Kamal, who was supervising Dr Alabi, said the doctor's clinical knowledge "was not at all what would be expected".

"If I was asking him very basic questions he was not able to answer me and did not give me suitable responses," he said.

Dr Kamal said Dr Alabi acted more like "a beginner or a layman" when asked to insert intravenous lines into a patient's arm.

"On one occasion he assisted me for an elective caesarean. He hardly washed his hands and then started to dry them up. I showed him how to put on the gloves and had to talk him through why we scrub. As soon as he had scrubbed up he was touching his nose with his gloves. I was shocked to see a doctor doing that."

Irish Independent

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