In 2016, at the end of two years of working as a doctor in a paid medical internship, my Head of Department at Addington Hospital required me to repeat my training after he wrote that I have “a complete lack of basic history taking and examination skills required even of a medical student”. I had to cancel my new job, which was supposed to start the following week, put my life on hold, and accept a black mark on my record that might prevent me from furthering my career in medicine as a specialist.
The committee of inquiry into my supervisors’ conduct by the Health Professions Council of South Africa (HPCSA) was not interested in whether my HOD’s absurd assessment was fair. The HPCSA’s own assessment had already shown it was untrue. Instead the inquiry focused on what I had done to provoke my seniors into attacking me like this.
The HPCSA chairperson criticised me for sharing a collegial joke with my HOD and said my HOD was ‘hurt‘ because he felt I was undermining his authority. (The chairperson’s example of how I caused this pain was my submission of a sick note to the wrong person shortly after I arrived at the hospital.) The HPCSA’s formal report also referred to a ‘provocative’ email (VIEW email) that I sent. At one point the chairperson suggested that I should be apologising to my seniors for what happened.
It is awkward and embarrassing to be publically stating my case anyway. But my call for change loses credibility if there are serious questions about where I am coming from, and the doctors involved have demonstrated a clear appetite for attacking my competence in public (see MEDIA STATEMENT).
I also think it’s important to clearly warn other junior doctors: your track record and your evidence mean nothing. Your senior doctors will still have unrestricted professional power to mess with you.
Evidence of my competence
I submitted the following documents to the HPCSA:
The most relevant parts are presented below:
LETTERS OF REFERENCE FROM BEFORE ADDINGTON HOSPITAL
(These are from my 20 months of internship in Johannesburg. I transferred to Durban to complete the last four months after my husband started working there.)
LETTERS OF REFERENCE FROM AFTER ADDINGTON HOSPITAL
(The last two are from after my initial HPCSA submission.)
RECORDINGS OF WITNESSES AT ADDINGTON HOSPITAL
Following my logbook comments, things got very weird and I began recording all my meetings with senior staff. Here are two examples of what they said about my second-to-last rotation:
“You’ve had a good rotation… You worked well, you worked hard, that’s good.”
“I’m a bit sad that for someone with your capability it didn’t end up going as smoothly as some of the other people who are less capable than you, far less hardworking than you, less keen than you.”
(I submitted these and other recorded communication without permission to avoid people being victimised for voluntarily supporting me.)
RECORDINGS OF MY FORMER HOD’S OWN WORDS
I first heard that I wasn’t signed off just one week before I was due to finish my internship, when I received my logbook back from my second-to-last rotation.
It came out of nowhere. No problems had been noted in my mid-rotation assessment, and I got 75% for an exam at the end of the rotation. And my former HOD had specifically stated that I would be signed off as soon as my intern group submitted some statistics (see part in TRANSCRIPT/RECORDING).
I had been in two different meetings with him to discuss how things had gone while I was in his department, following comments I made in my logbook. In these meetings, and in subsequent correspondence, I faced a strikingly creative range of criticisms, in a clear attempt to intimidate me. But the recordings show that my former HOD never once discussed my competence. Among other things, I was accused of:
- dereliction of duty and undermining my HOD’s authority, for handing in a sick note to the wrong person
- sexually harassing my HOD, when I used the placating phrase ‘I think you’re fantastic’ in an email (VIEW) containing constructive criticism
- compelling my husband to trespass on hospital property and physically intimidate the HOD (my voice recording of this incident suggests otherwise…)
- insulting every person in the hospital including the cleaner in the kitchen, when I wrote comments about discrimination
- damaging the hospital’s reputation across the whole country, by speaking aloud about my concerns while at work
Again: During hours of wide-ranging discussion about my time in his department, he didn’t take a single opportunity to mention problems with my competence.
Evidence of my incompetence
My former HOD submitted a 54 page document, containing statements from 18 doctors. He appears to have misled his colleagues into believing he was accused of racist comments, which was never the case (see HPCSA COMPLAINT), although I had previously noted sexist and racist comments by another doctor in his department (see EMAIL). So there are eight statements pointlessly defending his political correctness. He also submitted a statement signed by eight interns asking not to be involved in any discrimination investigations. Which leaves two items of relevance:
ONE INCONCLUSIVE WITNESS STATEMENT
This comes from a former colleague who I had considered a friend and who had previously complained about harassment from the same doctor I commented about in my logbook. She makes a show of supporting the HOD but provides little justification for his decision.
Basically, I’m a better doctor than I thought if the three incidents she describes in her statement are the worst things I did. And if they really are grounds for someone to repeat their training, then no doctor I know should be allowed to practise.
She describes two administrative communication errors, acknowledging that such errors are unavoidable. She then misrepresents an incident in which another doctor missed a potential injury while presenting a patient. After raising the missed injury with the responsible intern, our HOD had asked me a follow-up question which I answered correctly, but in insufficient depth for his satisfaction. He then opened the question to the rest of the intern group, none of whom provided the particular answer he was looking for. Needless to say, they were all signed off. As I noted in my HPCSA submission, the incident was discussed on our intern WhatsApp group, and can be easily verified:
AN ATTEMPT TO UNDERMINE ONE OF MY WITNESSES
The HOD procured what appears to be a completely different, contradictory statement from the external specialist who had assessed my competence for the HPCSA’s internship sub-committee. In the first assessment the specialist said my competence was ‘above average’; in the second he rates me poorly and declines to sign me off. Compare:
The specialist’s second report is dated two months after he submitted his official report to the HPCSA, by which time I was already registered as a medical officer. The staff at Addington Hospital were the only people who received it, with the chairperson of the HPCSA’s internship sub-committee confirming that it was never officially submitted.
When queried (see email above), the specialist claims that the second document deals with my readiness for specialised training in his field, so it doesn’t contradict his first assessment, which covered internship training. Note that I had not expressed interest in specialist training.