A medical inquiry has heard that a Nigerian doctor, Francis Megwa, who was employed as a senior house officer at University Maternity Hospital, Limerick, knew “near nothing” and was unable to take blood samples and insert intravenous drips and had to ask what an obstetrician was.
Megwa is accused of two counts of poor professional performance over a period spent working in UMHL between July 9, 2018, and August 14, 2018.
A sitting of the Irish Medical Council’s fitness to practise (FTP) committee was told that Megwa had failed to demonstrate the skills, knowledge, and competence expected of a non-consultant hospital doctor working in the area of obstetrics and gynaecology.
Irish Examiner reported that the evidence heard by the inquiry said that his skills were assessed as being equivalent to those of a final-year medical student.
Counsel for the IMC, Neasa Bird BL, said Megwa had failed to show his basic competency in taking a patient’s clinical history, in diagnosing symptoms, inserting cannulas, and in prescribing common medication.
He was also charged with being unable to give a clear history about a pregnant woman who had presented at the hospital with vaginal bleeding or estimated her level of blood loss as well as failing to recommend appropriate treatment for her.
The inquiry heard Dr. Megwa had very limited experience working in hospitals and only as an unpaid intern, observer, and volunteer since qualifying as a doctor in Romania in 2015.
Dr Megwa had described himself as a senior house officer in his job application to the HSE because he felt it was the “most appropriate term.” However, the IMC stressed that it was making no allegation that Dr Megwa had attempted to mislead anyone about his qualifications or experience.
Former chief clinical director of UL Hospitals Group, Dr Gerard Burke, said he had issued Dr Megwa with an oral warning and confined him to an observer role after receiving complaints about his competence after just one week of working in the hospital.
Dr Burke said he felt obliged to refer the matter to the Irish Medical Council over concerns that he would end up working in another hospital in Ireland.
Burke said he was very surprised to find out that Dr Megwa appeared to have almost no medical knowledge for someone who had spent five years in a medical school.
He told the inquiry that the doctor did not seem to know much about drugs and summed up Dr Megwa as seeming to know “near nothing.”
“I never came across the like of it before,” Dr Burke observed. “I never encountered this situation where you have to explore someone’s basic medical knowledge.”
One member of the FTP committee, Dr Máire Milner, said Dr Megwa was completely honest in his CV about his experience and the fact that he had written “shadowing” about his previous hospital roles should have rung “a giant alarm bell.”
Dr Burke, who did not interview Dr Megwa for his role as SHO, accepted that the interview process was flawed. The inquiry heard Dr Megwa was hired by UMHL because of a shortage of applicants who had completed their intern year.
A clinical midwife manager at UMHL, Valerie McInerney, said other staff had expressed concerns to her about Dr Megwa’s ability and level of skills in assessing patients.
When prescribing paracetamol for a patient, Ms McInerney said Dr Megwa was unaware of the correct dosage and frequency of the medication. She recalled he had also asked what an obstetrician was when one had been sought by a GP in a referral letter to the hospital.
A specialist registrar, Dr Laura Linehan, said Dr Megwa had incorrectly diagnosed a 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, while he had also struggled to write a prescription for a woman with a urinary tract infection.
Dr Linehan said she had reported her concerns because she did not believe Dr Megwa should be allowed to work on his own in the hospital’s maternity emergency unit because of the risk of harm to patients.
But Megwa said he had made progress during his time in UMHL and he was heartbroken and felt betrayed after being placed on paid leave and subsequently having his employment terminated.