Practitioner reprimanded for inadequate supervision of an IMG

09 Dec 2019

A medical practitioner has been reprimanded and fined $10,000 after a tribunal found he failed to provide adequate supervision of an international medical graduate (IMG).

The State Administrative Tribunal of Western Australia (the tribunal) found in July 2019 that Dr Edward Bebawy Soloman had engaged in professional misconduct as the supervisor of an IMG in that he:

• failed to provide adequate supervision or oversight in accordance with the IMG’s approved supervision level and their conditional registration
• failed to provide supervision in accordance with the 2016 Guidelines – Supervised practice for IMGs, and
• breached the supervision agreement and undertaking provided to the Medical Board of Australia (the Board).

Dr Soloman had successfully completed the Medical Board of Australia’s online education and assessment module for supervisors of IMGs. He had also signed documents, including a Supervisor’s Agreement to be the Principal Supervisor of an IMG who required level 2 supervision who was to be employed at the practice where he was working part-time and a Principal Supervisor’s Undertaking.

The Board’s guidelines for supervised practice for IMGs describes level 2 supervision as, ‘The supervisor shares with the IMG, the responsibility for each individual patient. The supervisor must ensure that the level of responsibility the IMG is allowed to take for patient management is based on the supervisor’s assessment of the IMG’s knowledge and competence’.

The guidelines also require that the supervisor is physically present with the IMG at the workplace for a minimum 80 per cent of the time and, if not present, always be accessible by telephone or video link. The IMG must also inform their supervisor about the management of individual patients daily.

By signing the agreement and undertaking, Dr Soloman agreed to provide supervision to the IMG according to the supervised practice guidelines and to ensure that the IMG practised as per the work arrangements approved by the Board. He had also agreed to inform the Board if he was no longer able or willing to undertake the role of the IMG’s supervisor.

On 1 June 2017, the IMG applied for provisional registration as a medical practitioner and provided the documents signed by Dr Soloman in support of their application. On 12 July 2017, Dr Soloman ceased working at the practice.

On 21 July 2017, the IMG was granted provisional registration subject to conditions. The Board noted that the IMG would only practise with supervision of a Board-approved supervisor with level 2 supervision.

Dr Soloman completed work performance reports for the IMG from August 2017 to January 2018 and in March 2018 advised the Australian Health Practitioner Regulation Agency (Ahpra) in writing that the IMG had been under his supervision for more than 12 months and would continue under his supervision until they obtained general registration.

The IMG confirmed to Ahpra in June 2018 that they had not received the required level 2 supervision from Dr Soloman and that he had left the practice on 12 July 2017. Dr Soloman advised in a letter to Ahpra in September 2018 that his failure to supervise the IMG according to the supervised practice guidelines was due to his misinterpretation of the guidelines and his failure to request clarification following their imposition in 2016. He advised that he was available to help the IMG by telephone and that other medical practitioners were onsite at the practice to provide clinical help when needed.

The tribunal found that Dr Soloman knew or ought to have known that his supervision of the IMG was inadequate and did not meet the requirements of level 2 supervision as per the guidelines.

The tribunal ordered that Dr Soloman:

• be reprimanded
• pay a fine of $10,000, and
• have conditions imposed on his registration requiring Dr Solomon to complete a program of education in relation to ethical practice and his professional obligations as a medical practitioner.

Dr Soloman was also ordered to pay $6,500 towards the Board’s costs.

The tribunal’s full decision can be found on its website at www.ecourts.justice.wa.gov.au.