A junior doctor who was fired by University Maternity Hospital Limerick (UMHL) for lacking basic medical knowledge claims he had always made the hospital authorities aware of his lack of experience.
Dr Francis Megwa told a medical inquiry that the panel who interviewed him for the job of senior house officer (SHO) at UMHL in April 2018 knew about his limitations but he still believed he was expected to improve “in days rather than months”.
A hearing of the Irish Medical Council’s fitness to practise (FTP) committee was informed that Dr Megwa had never worked in a paid role in a hospital since qualifying as a doctor in Romania in 2015.
“This was the level of experience I had before taking up the job which they knew,” Dr Megwa said.
A consultant gynaecologist and obstetrician who interviewed Dr Megwa for his post at UMHL in April 2018, Mendinaro Imcha, admitted the recruitment process could have been better but stated it had improved since the hospital had hired him.
The Nigerian-born doctor, who was placed on call on his first day in the job, is facing two charges of poor professional performance over his time working at UMHL between July 9, 2018, and August 14, 2018.
The IMC claims he failed to demonstrate basic competency in taking a patient’s clinical history, in diagnosing symptoms, inserting cannulas, and in prescribing common medication.
He is also charged with being unable to give a clear history about a pregnant woman who had presented at UMHL with vaginal bleeding or estimate her level of blood loss as well as failing to recommend appropriate treatment for her.
The inquiry heard earlier evidence from witnesses that Dr Megwa knew “near nothing”, was unable to take blood samples, and had to ask what an obstetrician was.
He was accused of incorrectly diagnosing the woman who was 35 weeks pregnant with a condition associated with the first weeks of pregnancy when she was actually suffering from a potential emergency complication.
The inquiry heard Dr Megwa had described working as a SHO with the Royal Infirmary of Edinburgh Scotland because he felt it was the “most appropriate term”.
Dr Imcha said his CV stated he had previous work experience as an SHO and had completed an internship at his medical school in Romania.
He was also registered with the Irish Medical Council (IMC) and had an EU medical qualification.
The FTP committee heard Dr Megwa had been ranked fourth out of five candidates on a panel to fill vacant SHO posts at UMHL.
He had been scored 55 out of 100 for his medical and diagnostic skills, 60 out of 100 for decision-making and initiative, and 70 out of 100 for communication and personal skills.
The interview panel had noted Dr Megwa was “short of experience but eager to work and learn”.
A member of the FTP committee, Veronica Larkin, said there appeared to be “a big mismatch” between the marks scored by Dr Megwa and his subsequent work performance.
Dr Imcha admitted she was “surprised and worried” when she was alerted within a few days of Dr Megwa taking up his post about problems with his performance, although she still wanted to give him a chance.
However, Dr Imcha said a decision was taken to assess the SHO’s competence after she was notified that his performance had not improved and other staff remained concerned about his treatment of patients.
Dr Imcha recalled how Dr Megwa, who had already been given an oral warning, struggled to answer questions based on what a final-year medical student should know, while she was also concerned that he was unable to specify the speciality he had done during his internship.
The consultant said she had made a complaint to the IMC about Dr Megwa as he lacked the basic knowledge expected of someone who had been to medical school for five or six years and completed an internship.
“We felt it may not be safe for him to continue,” she recalled.
Dr Imcha said she was unaware that Dr Megwa complained that he was shaking and panting with nerves during his assessment meeting.
Dr Megwa said he had learnt to take blood and fit cannulas after just a few days working at the hospital but claimed the only people who really helped him at UMHL were his fellow SHOs.
The hearing was adjourned until a future date.