PUBLIC RECORD Dates: 25/06/2018-02/07/2018 Medical Practitioner s name: Dr Kashif SAMIN GMC reference number: 6058386 Primary medical qualification: Type of case New - Misconduct Review - Conviction / Caution MB BS 2001 University of Peshawar Outcome on impairment Impaired Impaired Summary of outcome Erasure Tribunal: Legally Qualified Chair Medical Tribunal Member: Medical Tribunal Member: Mr Damian Cooper Dr Alan Shepherd Dr Helen Denley Tribunal Clerk: Mr Stuart Peachey Attendance and Representation: Medical Practitioner: GMC Representative: Not present and not represented Ms Shirlie Duckworth, Counsel Attendance of Press / Public In accordance with Rule 41 of the General Medical Council (Fitness to Practise) Rules 2004 the hearing was held partly in public and partly in private. 1
Overarching Objective Throughout the decision making process the tribunal has borne in mind the statutory overarching objective as set out in schedule 1, Medical Act 1983 (the 1983 Act) to protect, promote and maintain the health, safety and well-being of the public, to promote and maintain public confidence in the medical profession, and to promote and maintain proper professional standards and conduct for members of that profession. Determination on Facts - 27/06/2018 Background 1. In October 2013, Dr Samin was appointed as a Speciality Doctor, Dermatology at Ysbyty Glan Clwyd. 2. Prior to the events which are the subject of the hearing, a Health Board investigation into Dr Samin s contract with Betsi Cadwaladr University Local Health Board, as a Locum General Practitioner ( GP ) revealed comments on a publiclyavailable personal profile on social media and online advertisements. 3. The initial concerns were raised with Mr Mr B, Investigation Officer, on 10 May 2017 by Ms G, Medical Workforce, Ysbyty Glan Clwyd. 4. Dr Samin is suspended from the Medical Performers List (Wales) and is currently abroad. The Outcome of Application(s) Made during the Facts Stage 5. The Tribunal granted the GMC s application, made pursuant to Rule 15, 31 and 40 of the General Medical Council (Fitness to Practise Rules) 2004 as amended ( the Rules ) that service had been effected and to proceed in Dr Samin s absence. The Tribunal s full decision on the application is included at Annex A 6. The Tribunal granted the GMC s application, made pursuant to Rule 34 (13)(14) of the Rules for Ms C to give her evidence via Telephone Link. The Tribunal s full decision on the application is included at Annex B. 7. The Tribunal granted the GMC s application, made pursuant to Rule 41 of the Rules for parts of the hearing to be heard in private. The Tribunal s full decision on the application is included at Annex C. 2
8. The Tribunal refused Dr Samin s application for an adjournment and his application to participate in the hearing remotely via Telephone Link. The Tribunal s full decision on the application is included at Annex D. The Allegation and the Doctor s Response 9. The Allegation made against Dr Samin is as follows: 1. On 21 July 2017, you informed the (the Tribunal ): a. in your sworn evidence that you were not working in the terms set out in Schedules 1-3; To be determined b. in your submissions to the Tribunal that you currently worked for one day per month. To be determined 2. You were contracted to work as a General Practitioner at 4 Seasons Medical Centre Ltd: a. from 21 July 2016; To be determined b. at the time when you made the statements to the Medical Practitioners Tribunal referred to in paragraph 1; To be determined c. for four sessions (16 hours) per week (Wednesday and Thursday). To be determined 3. Your statements referred to in paragraph 1 contained information which you knew to be untrue. To be determined 4. You created a publicly available CV on a recruitment website (BAYT.com) which stated that you: a. had 46 years, 3 months experience; To be determined b. had an article entitled Primary Crohns Disease of the Appendix published in the Journal of Gastroenterology; To be determined c. had a Masters degree in Aesthetic Medicine/Dermatology from Queen Mary University, London. To be determined 3
5. You placed an advert on the Yell.com website for the company Derma Aesthetics Ltd which stated that you were a Fellow of the American Association of Aesthetic Surgeons. To be determined 6. You created a Facebook profile and stated that you studied: a. for a MSc in Anti-aging, Regenerative Medicine and Medical Aesthetics at Queen Mary University, London; To be determined b. Aesthetics at the State University of New York Downstate Medical Center College of Medicine; To be determined c. Medical Aesthetics at the American Academy of Aesthetic Medicine. To be determined 7. In July 2013, you submitted a job application form, to Betsi Cadwaladr University Local Health Board for the position of Speciality Doctor, in which you stated that you: a. obtained an MSc in Emergency Medicine from Manchester Metropolitan University in 2015; To be determined b. had an article entitled Primary Crohns Disease of the Appendix published in the Journal of Gastroenterology. To be determined 8. You knew that the claims about your qualifications and experience as referred to in paragraphs 4-7 were untrue. To be determined 9. Your actions described at paragraphs 1 to 8 were dishonest To be determined The Facts to be Determined 10. As there have been no admissions to the Allegations, the Tribunal will therefore carefully consider this case in its entirety. Factual Witness Evidence 11. The Tribunal received evidence on behalf of the GMC from the following witnesses: 4
Ms A, Practice Manager at 4 Seasons Medical Centre Limited, in person; A witness statement, dated 18 August 2017, and a supplementary witness statement, dated 15 January 2018; Mr B, Investigation Officer at Betsi Cadwaladr Univeristy Health Board, in person; A witness statement, dated 22 November 2017; Dr D, Clinical Lead for Managed Practices at Betsi Cadwaladr University Health Board, in person; A witness statement, dated 7 November 2017; and Ms C, UK Compliance and Legal Manager at Yell Limited, via Telephone Link; A witness statement, dated 17 April 2018. 12. The Tribunal also received evidence on behalf of the GMC in the form of witness statements from the following witnesses who were not called to give oral evidence: Mr F, Records and Information Compliance Manager at Queen Mary University of London, dated 4 April 2018; Ms H, Freedom of Information and Data Protection Act Officer at Manchester Metropolitan University, dated 10 June 2018; Ms I, Business Manager at American Academy of Aesthetic Medicine, dated 16 April 2018; and Ms J, Office Manager at the State University of New York Downstate Medical Center College, dated 18 April 2018. Documentary Evidence 13. The Tribunal had regard to the documentary evidence provided by the parties. This evidence included, but was not limited to: Contract of Employment for Dr Samin at 4 Seasons Medical Centre, dated 17 November 2016; Various Payslips, dating between August 2016 and June 2017; Email correspondence between 4 Seasons Medical Centre and Mr B enclosing screenshots of website, dated 20 June 2017; Excerpts of Transcripts from day three of an MPT Hearing, dated 21 July 2017; Mr B s Investigation Report, dated 20 June 2017; Various letters from Dr E to Dr Samin, dated between 4 November 2016 to 16 May 2017; Record of interview of Dr Samin by Mr B, dated 12 June 2017; BAYT website public profile of Dr Samin; Email correspondence between Queen Mary University and Mr B, dated 5 June 2017; Yellow Pages listing for Derma Aesthetics Ltd, Llandudno; Companies House information Derma Aesthetics Ltd; 5
Email correspondence from Yell.com and Mr B, dated 13 June 2017; Public Facebook page for Dr Samin; Email correspondence between the State University of New York, Downstate Medical College of Medicine and Mr B, dated 9 June 2017; Letter from State University of New York, Downstate Medical College of Medicine to the GMC, dated 13 April 2018. The Tribunal s Approach 14. In reaching its decision on facts, the Tribunal has borne in mind that the burden of proof rests on the GMC and it is for the GMC to prove the Allegation. Dr Samin does not need to prove anything. The standard of proof is that applicable to civil proceedings, namely the balance of probabilities, i.e. whether it is more likely than not that the events occurred. 15. The Tribunal has considered all the evidence, both oral and documentary, together with the submissions made by Ms Duckworth, Counsel, on behalf of the GMC. 16. When considering matters of dishonesty, the tribunal took account of the principles in Ivey v Genting Casinos (UK) Ltd t/a Crockfords [2017] UKSC 67. It bore in mind that it should first ascertain, subjectively, the actual state of Dr Samin s knowledge or belief as to the facts and should then decide whether his conduct was honest or dishonest by applying the objective standards of ordinary decent people. The Tribunal s Analysis of the Evidence and Findings Findings 17. The Tribunal has considered each outstanding paragraph of the Allegation separately and has evaluated the evidence in order to make its findings on the facts. Paragraph 1(a) 18. The Tribunal had regard to excerpts from the transcript of day three of a, where Dr Samin states After what has happened and I have not been able to work, I have stayed at home with my family Despite I am not working, I still go and attend the departmental teaching. Further, the Tribunal notes that Dr Samin replied yes when asked the question You have not been working for some months now. 19. In reaching its decision, the Tribunal relies on the content of the transcript, specifically Dr Samin s sworn evidence, in that it contains the statements in Schedules 1, 2 and 3 of the Allegation. The Tribunal notes in relation to Schedule 3, it is not clear if the question was put by the GMC barrister or the Tribunal. However, 6
whilst Schedule 3 suggests that it is the GMC barrister posing the question this does not affect the position that Dr Samin s answer, which was given on oath, was factually incorrect and untrue. 20. In finding that the answers given were untrue, the Tribunal takes account of the contract of employment in place between Dr Samin and 4 Seasons Medical Centre Ltd, covering the period to which Dr Samin s answers relate. It also notes the Payslips given in GMC evidence showing that Dr Samin was in receipt of payment for that employment at the relevant time. It is apparent from this evidence that Dr Samin was employed and working during the period to which his answers under oath or affirmation relate. 21. Therefore, on the balance of probabilities, it finds Paragraph 1(a) of the Allegation, proved. Paragraph 3 22. The Tribunal next considered the application of Paragraph 3 to Paragraph 1(a) of the Allegation. 23. The Tribunal finds that Dr Samin was aware when he was asked in the 2017 Tribunal about his work status that he was employed by 4 Seasons Medical Centre Ltd and had been in receipt of salary payments for that employment for many preceding months. He was also aware, having sworn an oath, or given an affirmation, that he was under a legal obligation to answer questions truthfully. 24. It is inconceivable to the Tribunal that at the time he provided his answers to the 2017 Tribunal he did not know that they were untrue. 25. The Tribunal finds Paragraph 3 of the Allegation, proved, in relation to Paragraph 1(a). Paragraph 9 - Dishonesty 26. The Tribunal considered that giving truthful evidence is at the apex of witness credibility and by being dishonest shows a blatant disregard to the regulator. The Tribunal is satisfied, given Dr Samin s state of mind established above, that his conduct in providing untrue statements to the 2017 Tribunal was also dishonest by the objective standards of ordinary decent people. 27. The Tribunal finds Paragraph 9, of the Allegation, proved, in relation to Paragraph 1(a) of the Allegation. 7
Paragraph 1(b) 28. The Tribunal had regard to the transcript of day three of a Medical Practitioners Tribunal, where Dr Samin states The only payment I am currently getting is 500 a month for one day of work that I am expected to do in the hospital. 29. In a letter to Dr Samin from Dr E, Deputy Medical Director at BCUHB, dated 29 November 2016, it states that Dr Samin is restricted from clinical duties. It makes clear that he is not permitted to treat patients but is entitled to payment and to attend for Supporting Professional Activities. 30. The Tribunal relies on the exerts of the Transcript of the 2017 Tribunal. However, in the way the Allegation against Dr Samin has been framed in your submissions to the Tribunal that you currently worked for one day per month, the Tribunal is not satisfied that Dr Samin told the Tribunal he was currently working one day per month. In the submissions, Dr Samin states that he is suspended from the the hospital position as well as the Medical Performers List. He has an ongoing entitlement to salary during this suspension but is only permitted to attend work for Supporting Professional Activities. 31. The Tribunal therefore finds Paragraph 1(b) of the Allegation, not proved. Paragraph 3 32. Accordingly, the Tribunal finds Paragraph 3 of the Allegation, not proved, in relation to Paragraph 1(b) of the Allegation. Paragraph 9 Dishonesty 33. Accordingly, the Tribunal finds Paragraph 9 of the Allegation, not proved, in relation to Paragraph 1(b) of the Allegation. Paragraph 2 34. The Tribunal had regard to Dr Samin s offer letter of employment as a Salaried GP at 4 Seasons Medical Centre Ltd, Warrington. In this letter, it states that Dr Samin would undertake four sessions per week (Wednesday/ Thursday) with effect from 21 July 2016 35. The Tribunal accepts the Salaried GP contract as clear evidence. It also considers the Payslips it has seen as supportive evidence to the employment contract. Therefore, on the balance of probabilities, the Tribunal finds Paragraph 2 of the Allegation, proved, in its entirety. 8
Allegation 9 - Dishonesty 36. The Tribunal next went on to consider if the Facts found proved in relation to Paragraph 2 of the Allegation were dishonest. In the way that Paragraph 2 is framed it is merely a statement of a series of facts, which are found by the Tribunal to be correct and proved. There is no conduct or assertion contained in Paragraph 2 on which the Tribunal must determine Dr Samin s honesty or dishonesty. 37. The Tribunal therefore finds Paragraph 9 of the Allegation, not proved, in relation to Paragraph 2(a), (b) and (c) of the Allegation. Paragraph 3 38. The Tribunal finds Paragraph 3 of the Allegation, proved, in relation to Paragraph 1(a) of the Allegation. 39. The Tribunal finds Paragraph 3 of the Allegation, not proved, in relation to Paragraph 1(b) of the Allegation. 40. The Tribunal determined that Paragraph 9 of the Allegation has no application to Paragraph 3 of the Allegation. Paragraph 4 41. The Tribunal had regard to Dr Samin s CV on the BAYT.com website, where it is detailed that he had 46 years, 3 months experience, a Journal of Gastroenterology- " Primary Crohns disease of the appendix and had a Master s degree, Aesthetic Medicine/ Dermatology at Queen Mary University, London. 42. In an interview with Mr B, Investigating Officer Betsi Cadwaladr University Local Health Board, Dr Samin admitted that the information entered onto the BAYT.com website was factually incorrect, and said that the information was uploaded without his knowledge. 43. The Tribunal has no reason to doubt the evidence given to it by Mr B. It was impressed by the thoroughness of his investigation and the logical way he presented both his documentary and oral evidence to the Tribunal. In his statement, Mr B states From the information I received from the BAYT website it appears that job seekers register with BAYT.com and create a free account and then upload, or build, CVs themselves. 44. Based on the evidence before it, the Tribunal is content that BAYT.com is a self-selected CV portal and that, on balance, it is far more likely than not that Dr Samin entered the information on it himself, rather than someone else having been 9
able to collate and upload such detailed information about Dr Samin, his employment history and experience. The Tribunal was of the view that the level of detail quoted on the BAYT.com would not be available to anyone other than Dr Samin himself. 45. The Tribunal finds on the balance of probabilities, Paragraphs 4(a), (b) and (c) of the Allegation, proved. Paragraph 8 - Untrue 46. The Tribunal next considered whether Dr Samin knew that his claims about his qualifications and experience were untrue. In his interview with Mr B, Dr Samin admitted that the statements were untrue. The Tribunal has found that Dr Samin posted those statements. However, it distinguishes the statement in Paragraph 4(a) from those in Paragraphs 4(b) and (c). It is not persuaded that, given Dr Samin s age and the absurdity of someone of that age stating they had 46 years experience is anything more than a typographical error, given that in the same document he had stated his graduation year as 2001. 47. The Tribunal therefore finds: Paragraph 8 of the Allegation, not proved, in relation to Paragraph 4(a) of the Allegation; and proved, in relation to Paragraphs 4(b) and (c) of the Allegation. Paragraph 9 Dishonesty 48. Having found that Dr Samin s claims about his qualifications and experience were untrue, it next went on to consider if his actions were dishonest. 49. The Tribunal was of the view that Dr Samin was not being dishonest when stating that he had 46 years, 3 months experience as it determined that likely to have been an error. Given that finding, it determines that this would not be considered dishonest by the standards of ordinary decent people. 50. In relation to Paragraphs 4(b) and (c), the Tribunal determines that Dr Samin knew these to be untrue and considers that he created the entries to bolster his CV. Such conduct would be considered dishonest by ordinary decent people. 51. The Tribunal therefore finds: Paragraph 9, of the Allegation, not proved, in relation to Paragraph 4(a) of the Allegation; and proved, in relation to Paragraphs 4(b) and (c) of the Allegation. Paragraph 5 52. The Tribunal had regard to the Companys House record provided in evidence which details DERMA AESTHETICS LTD as the company name in full, the company 10
type, situation of registered office and the proposed register office address. It notes that Dr Samin is the sole shareholder and the officer. Dr Samin confirmed that he was the only director in his interview with Mr B. 53. The Tribunal had sight of a Derma Aesthetics advert placed on Yell.com which states that treatments were provided by Dr Samin who is a Fellow of the American Association of Aesthetic Surgeons. 54. The Tribunal heard oral evidence from Ms C, UK Compliance and Legal Manager at Yell Limited, who came across as clear and professional during the course of her evidence. She confirmed in her evidence that the posting on Yell.com would be initiated by the advertiser or would have to have been confirmed by the advertiser before posting on the website. Ms C also confirmed that the Derma Aesthetics advert was updated in August 2015 with the customer. Ms C in her evidence stated that the adverts are checked every two years with the customer for confirmation of accuracy. 55. Based on the evidence before it, the Tribunal accepted Ms C s evidence and is content that on, the balance of probabilities, Dr Samin was in control of advertisements placed on Yell.com and placed the advert containing the statement. 56. The Tribunal therefore finds Paragraph 5 of the Allegation, proved. Paragraph 8 - Untrue 57. The Tribunal considers that Dr Samin knew that he was not a Fellow of the American Association of Aesthetic Surgeons. He confirmed to Mr B that this organisation does not exist. The Tribunal has found that Dr Samin was responsible for the advertisement. It is satisfied that Dr Samin knew it was untrue when he posted the statement and was bolstering this advertisement. 58. The Tribunal therefore finds Paragraph 8 in relation to Paragraph 5 of the Allegation, proved. Paragraph 9 Dishonesty 59. The Tribunal was of the view that Dr Samin deliberately falsifying information that he was a Fellow of the American Association of Aesthetic Surgeons, on a publicly-available advertisement, for personal gain would be considered dishonest by ordinary decent people. 60. The Tribunal therefore finds Paragraph 9 in relation to Paragraph 5 of the Allegation, proved. 11
Paragraph 6 61. The Tribunal had regard to screenshots of Dr Samin s Facebook profile which states that Dr Samin studied: for a MSc in Anti-aging, Regenerative Medicine and Medical Aesthetics at Queen Mary University ; Aesthetics at the State University of New York Downstate Medical Center College of Medicine ; and Medical Aesthetics at the American Academy of Aesthetic Medicine. 62. The Tribunal is satisfied that a Facebook profile is created and controlled by the profile owner. Dr Samin admitted to Mr B that it was his profile. Further, Dr Samin refers in his interview with Mr B regarding the Facebook sections available to him. He stated that the correct course option was not available for him and therefore he had selected an MSc. 63. The Tribunal accepts Mr B s evidence and finds that, on the balance of probabilities, Dr Samin created the Facebook profile and made the statements set out in Paragraphs 6(a), (b) and (c) of the Allegation. 64. The Tribunal therefore finds Paragraph 6 of the Allegation, proved in its entirety. Allegation 8 Untrue 65. Mr B s Investigation Report, he states in relation to Paragraph 6(a) and (b) of the Allegation: Again, in relation to his Facebook profile, it was pointed out to Dr Samin that it stated that he had studied Aesthetics at the State University of New York, Downstate Medical College of Medicine and he was asked when he studied there, what he studied and what type of course was it i.e. distance learning or if he physically attended there, and to provide evidence of the qualifications he obtained and Dr Samin replied that he went to the library there to study for his MSc Course at Queen Mary University, London In relation to Paragraph (6)(c) of the Allegation: He added that he never attended there as it was just a Facebook group. Dr Samin again said that he has qualifications from the American Association of Aesthetic Medicine and Surgery. 66. Mr B s witness statement, he states in relation to the MSc from Queen Mary University: 12
I asked Dr Samin if this was true and he said that it was not, but that there was no option on Facebook to select what course he was actually undertaking In relation to studying Aesthetics at the State University of New York Downstate Medical Center College of Medicine: Dr Samin replied that he went to the library there to study for his Master s course at Queen Mary University. He had not actually enrolled on a course there In relation to studying Medical Aesthetics at American Academy of Aesthetic Medicine: I asked Dr Samin where this institute was located and he replied that he had never attended there and that it did not exist I discovered that the American Academy of Aesthetic Medicine does exist, however, the Academy confirmed by way of email that there was no record of any membership or participation by Dr Samin 67. The Tribunal noted Dr Samin s admissions to Mr B, that the information entered onto his Facebook profile was untrue. It is satisfied that at the time he made the statements Dr Samin knew them to be untrue and was bolstering his Facebook profile. 68. The Tribunal therefore find Paragraph 8 of the Allegation, proved, in relation to Paragraphs 6(a), (b) and (c) of the Allegation. Allegation 9 Dishonesty 69. The Tribunal considers that Dr Samin knowingly posted untrue statements about his qualifications and experience and this would be considered dishonest by ordinary decent people. 70. The Tribunal therefore find Paragraph 9 of the Allegation, proved, in relation to Paragraphs 6(a), (b) and (c) of the Allegation. Paragraph 7 71. The Tribunal noted an NHS Jobs submitted application form detailing the applicants name as Kashif Samin for the position of Speciality Doctor at Betsi 13
Cadwaladr University Local Health Board which was submitted in July 2013. Dr Samin was successful in his application. 72. In the submitted application form, the Tribunal noted that Dr Samin entered in the Desirable Qualifications section of his application for employment, that he obtained an MSc in Emergency Medicine from Manchester Metropolitan University in 2015 and that in the research work and publications section, that he had an article entitled Primary Crohns Disease of the Appendix published in the Journal of Gastroenterology. 73. The Tribunal noted in Mr B s Investigation Report, he states Dr Samin was then shown an NHS application form which was in relation to his application for a role as a Speciality Doctor within BCUHB and he was asked if he was successful in obtaining the position the form related to and he confirmed that it was his application and that he was successful. It was pointed out to Dr Samin that this was not a CV but a job application for a specific role and he was asked if he had ever studied at Manchester Metropolitan University and he replied that he started a Master s in Emergency Medicine in November 2012 and he was supposed to complete in 2015 but because of his divorce he dropped out but then enrolled again later in 2015 but he couldn t complete and dropped out again. 74. In Mr B s witness statement, he states: In the Publications section on the CV, it stated that Dr Samin had published an article in the Journal of Gastroentology entitled Primary Crohns disease of the appendix. I could not find any evidence that this article existed. During the interview, Dr Samin confirmed that he could not provide evidence of the article and stated that it was not a publication, it had been copied from his experience of presenting in Journal club in hospital when he was employed at Morriston Hospital, Swansea, and that it was a BAYT misprint. 75. The Tribunal accepts Mr B s evidence and the application form and therefore finds, on the balance of probabilities, Paragraph 7 of the Allegation, proved in its entirety. Paragraph 8 - Untrue 76. In relation to Paragraph 7(a) of the Allegation, the Tribunal considers that Dr Samin entered 2015 in the context of intending to achieve the qualification in 2015 and is not persuaded that he understood what that particular section of the 14
application form was asking for. It is not persuaded by the evidence that in 2013 Dr Samin intended to state that he had achieved the MSc in 2015. 77. In relation to Paragraph 7(b) of the Allegation, the Tribunal noted that Dr Samin admitted to Mr B that the article does not exist. It was of the view that Dr Samin knowingly submitted the application form knowing this information was untrue. The article was entirely fictitious. 78. The Tribunal therefore finds: Paragraph 8 of the Allegation, not proved, in relation to Paragraph 7(a) of the Allegation; Paragraph 8 of the Allegation, proved, in relation to Paragraph 7(b). Paragraph 9 Dishonesty 79. In relation to Paragraph 7(a) of the Allegation, the Tribunal considered that Dr Samin was not being dishonest in mistakenly entering the intended 2015 qualification on the application form, by the standards of ordinary decent people. 80. In relation to Paragraph 7(b) of the Allegation, the Tribunal notes that Dr Samin submitted the application form knowing that the article did not exist, which was dishonest by the standards of ordinary decent people. 81. The Tribunal therefore finds: Paragraph 9 of the Allegation, not proved, in relation to Paragraph 7(a) of the Allegation; and proved, in relation to Paragraph 7(b) of the Allegation. Paragraph 8 82. The Tribunal has outlined its reasoning in the relevant paragraphs of the Allegation throughout this determination. 83. The Tribunal finds Paragraph 8 of the Allegation; Not Proved in relation to Paragraphs 4(a) and 7(a) of the Allegation; and Proved in relation to Paragraphs 4(b)(c), 5, 6(a)(b)(c) and 7(b) of the Allegation. Paragraph 9 84. The Tribunal has outlined its reasoning in each Allegation throughout this determination in relation to this Allegation. 85. The Tribunal finds Paragraph 9 of the Allegation; 15
Not Proved in relation to Paragraphs 1(b), 2(a)(b)(c), 4(a) and 7(a) of the Allegation; and Proved in relation to Paragraphs 1(a), 4(b)(c), 5, 6(a)(b)(c) and 7(b) of the Allegation. Not applicable in relation to Paragraph 3 of the Allegation. The Tribunal s Overall Determination on the Facts 1. On 21 July 2017, you informed the (the Tribunal ): a. in your sworn evidence that you were not working in the terms set out in Schedules 1-3; Found Proved b. in your submissions to the Tribunal that you currently worked for one day per month. Not Proved 2. You were contracted to work as a General Practitioner at 4 Seasons Medical Centre Ltd: a. from 21 July 2016; Found Proved b. at the time when you made the statements to the Medical Practitioners Tribunal referred to in paragraph 1; Found Proved c. for four sessions (16 hours) per week (Wednesday and Thursday). Found Proved 3. Your statements referred to in paragraph 1 contained information which you knew to be untrue. Not Proved in relation to Allegation 1(b) Found Proved in relation to Allegation 1(a) 4. You created a publicly available CV on a recruitment website (BAYT.com) which stated that you: a. had 46 years, 3 months experience; Found Proved b. had an article entitled Primary Crohns Disease of the Appendix published in the Journal of Gastroenterology; Found Proved 16
c. had a Masters degree in Aesthetic Medicine/Dermatology from Queen Mary University, London. Found Proved 5. You placed an advert on the Yell.com website for the company Derma Aesthetics Ltd which stated that you were a Fellow of the American Association of Aesthetic Surgeons. Found Proved 6. You created a Facebook profile and stated that you studied: a. for a MSc in Anti-aging, Regenerative Medicine and Medical Aesthetics at Queen Mary University, London; Found Proved b. Aesthetics at the State University of New York Downstate Medical Center College of Medicine; Found Proved c. Medical Aesthetics at the American Academy of Aesthetic Medicine. Found Proved 7. In July 2013, you submitted a job application form, to Betsi Cadwaladr University Local Health Board for the position of Speciality Doctor, in which you stated that you: a. obtained an MSc in Emergency Medicine from Manchester Metropolitan University in 2015; Found Proved b. had an article entitled Primary Crohns Disease of the Appendix published in the Journal of Gastroenterology. Found Proved 8. You knew that the claims about your qualifications and experience as referred to in paragraphs 4-7 were untrue. Not Proved in relation to Allegation 4(a), 7(a) Found Proved in relation to Allegation 4(b)(c), 5, 6(a)(b)(c) and 7(b) 9. Your actions described at paragraphs 1 to 8 were dishonest Not Proved in relation to Allegation 1(b), 2(a)(b)(c), 4(a) and 7(a) Found Proved in relation to Allegation 1(a), 4(b)(c), 5, 6(a)(b)(c) and 7(b) Not applicable in relation to Paragraph 3 of the Allegation 17
Determination on Impairment - 29/06/2018 1. Having given its determination on the Facts in this case, in accordance with Rule 17(2)(k) of the Rules, the Tribunal has considered whether, on the basis of the facts which it has found proved, Dr Samin s fitness to practise is impaired by reason of misconduct. 2. The Tribunal has separately considered both the new and review matters in Dr Samin s case, in accordance with Rule 21A and considered, under Rule 22(1)(f), whether Dr Samin s fitness to practise is currently impaired by reason of his misconduct and remains impaired by reason of his conviction. Background to the Review Elements of the Case 3. After handing down its Determination on Facts, the Tribunal has been informed of the background to Dr Samin s case and of his fitness to practise history. The details of Dr Samin s previous hearings remain a matter of record and the Tribunal does not propose to rehearse them here, beyond the following summary. 4. On 14 January 2015, North Wales Police received a complaint of fraud from Dr Samin s ex-wife, Dr R. Dr R alleged that Dr Samin had sold their former matrimonial home by fraudulently signing her signature on documents related to the sale of the house. On 20 January 2016 Dr Samin accepted that he had falsified Dr R s signature on a banking transfer document and on a land registry document, and on 3 August 2016 Dr Samin pleaded guilty to two offences of making a false instrument at Mold Crown Court. The 2017 Tribunal 5. Dr Samin s case was first considered by a in July 2017 ( the 2017 Tribunal ). Dr Samin was present at that hearing but was not represented. 6. At the 2017 Tribunal, Dr Samin admitted the entirety of the allegations against him and, accordingly, it found them proved. Further, Dr Samin made admissions that his fitness to practice was impaired and the 2017 Tribunal went on to determine that he was impaired by reason of his conviction. 7. The 2017 Tribunal determined to impose an order of suspension on Dr Samin s registration for a period of 4 months and imposed an immediate order of suspension. It accepted Dr Samin s evidence that his dishonesty was not persistent, it was a one-off incident, and no evidence of other dishonest action had been adduced. Further, it was satisfied that Dr Samin showed insight and did not pose a significant risk of repeating his actions. The 2017 Tribunal was satisfied that the behaviour leading to Dr Samin s conviction was not fundamentally incompatible with 18
continued registration and that erasing his name from the Medical Register would be disproportionate, punitive and not in the public interest 8. The 2017 Tribunal determined that a review into Dr Samin s case was not necessary. Assistant Registrar Decision 9. Following information provided to the GMC, the Assistant Registrar requested that Dr Samin provide the following objective evidence at any review hearing: Evidence to show that he has reflected upon, and gained further insight into, his dishonesty and misconduct, and of his remediation; Evidence that he has kept his knowledge and skills up to date; and Evidence that a return to unrestricted practice will not put patient safety at risk. 10. On 20 September 2017 the GMC wrote to Dr Samin and informed him that an Assistant Registrar had considered his case and had decided that a review hearing was necessary. The 2017 Review Tribunal 11. On 27 November 2017, a Tribunal ( the 2017 Review Tribunal ) met to review Dr Samin s case. It was provided with email correspondence from Dr Samin indicating that he wished to participate in the hearing via Telephone Link. However, attempts were made to contact Dr Samin by Telephone Link and by email correspondence, but no reply was forthcoming. 12. The 2017 Review Tribunal determined that an adjournment would be the fairest course of action considering the short time given to Dr Samin to prepare his case. It therefore adjourned Dr Samin s case and extended the order of suspension on his registration for a further period of two months. The 2018 Review Tribunal 13. On 16 February 2018, a Tribunal ( The 2018 Review Tribunal ) met to review Dr Samin s case. 14. Dr Samin indicated to the GMC prior to the 2017 Review Tribunal, that he would provide the evidence requested. However, Dr Samin had not done so and had not engaged with the GMC for over a month leading up to the 2018 Review Hearing. The 2018 Reviewing Tribunal had serious concerns about whether reflective and continuing professional development work had in fact been undertaken by Dr Samin. It had also borne in mind that the longer Dr Samin was suspended, the risk of him 19
becoming deskilled continued to increase. The 2018 Review Tribunal determined that Dr Samin s fitness to practise remained impaired by reason of his conviction. 15. The 2018 Review Tribunal took into account that Dr Samin had not provided any evidence of reflection or development of insight, and no evidence of any measures Dr Samin had taken to ensure that his medical knowledge and skills were up to date. It concluded that a further period of suspension would allow Dr Samin time to reflect on his dishonest behaviour and to prepare evidence that he had kept up with his professional development. The 2018 Review Tribunal determined that Dr Samin's period of suspended registration should be extended for a further period of 6 months. 16. Having had regard to paragraph 164 of the Sanctions Guidance (February 2018 edition)( SG ), the 2018 Review Tribunal directed that, shortly before the end of the period of Dr Samin s suspended registration, his case will be reviewed by a. It considered that a future Tribunal reviewing this matter would be assisted by receiving: Evidence to show that Dr Samin has reflected on, and remediated, the dishonesty which led to his conviction; Evidence to show that he has kept his medical knowledge and skills up to date; Evidence that a return to unrestricted practice would not put patients at risk; and Evidence to explain his lack of engagement with the review hearing process. The Evidence 17. In considering whether or not Dr Samin s fitness to practise is impaired by either the new and/or review matters in this case, the Tribunal carefully considered all the documentary evidence adduced at this hearing including, but not limited to: Email correspondence from Dr Samin to the GMC, dated 27 June 2018; Determinations from MPT hearing between 19 to 21 July 2017; Assistant Registrar decision for early review, dated 6 September 2017; Determination on service and proceeding in absence, dated 27 November 2017; Determination on adjournment and extension of order, dated 27 November 2017; Determinations from Review hearing on 16 February 2018. 20
Submissions on behalf of the GMC 18. Ms Duckworth, Counsel, submitted that Dr Samin s fitness to practise is currently impaired by reason of his misconduct and conviction. Ms Duckworth directed the Tribunal s attention to paragraphs 17, 123, and 125(d) the SG, and paragraphs 1, 14, 65, 66, 70, 71 and 72 of Good Medical Practice (2013 edition)( GMP ). 19. In relation to the misconduct aspect of this case, Ms Duckworth directed the Tribunal s attention to Roylance v GMC [2000] 1 AC 311 and Meadow v GMC [2006] EWCA CIV 1390. Further, she directed the Tribunal s attention to CHRE v NMC and Paula Grant when considering Dr Samin s current impairment. 20. Ms Duckworth submitted that the Tribunal has found that Dr Samin acted dishonestly in its findings regarding his conduct towards his regulatory body, in the entries on BAYT.com, Yell.com, Facebook and in his application to Betsi Cadwaladr University Local Health Board. Further, she submitted that Dr Samin s lack of honesty is in breach of GMP and in doing so he has made securing employment more of a priority than his concern for patients. Ms Duckworth submitted that Dr Samin s persistent dishonesty breaches the fundamental tenets of the medical profession. She submitted in relation to the new aspect of this case, Dr Samin s dishonest actions constitute misconduct that was serious. 21. Ms Duckworth submitted that Dr Samin s medical registration is currently suspended. She submitted that Dr Samin has acted dishonestly in the past when he was convicted in 2016 of two instances of the offence of Making a False Instrument in relation to 2013 documents. Further, Ms Duckworth submitted that Dr Samin acted dishonestly in his NHS Jobs application in 2013, and in 2017 when he gave misleading and false information to the 2017 Tribunal. She submitted that in this regard, his dishonesty had been persistent, repeated and over a long period of time. 22. Ms Duckworth directed the Tribunal s attention to the 2018 Review Tribunal s recommendations of evidence Dr Samin should submit to a reviewing Tribunal. She submitted that Dr Samin has not provided any of the evidence the 2018 Review Tribunal requested in relation to his ongoing professional development, insight and reflection into his conviction, and demonstrating remediation. Ms Duckworth submitted that Dr Samin has in the past, and is likely to in the future to bring the profession into disrepute. 23. Ms Duckworth acknowledged that the Tribunal had been told that Dr Samin is caring for his mother. However, she submitted that Dr Samin has not provided any evidence in how he is caring for his mother or if he is undertaking any professional development in this regard. 21
24. Ms Duckworth submitted that Dr Samin has not provided any information on what his intentions would be in relation to returning to practise in the United Kingdom. The Relevant Legal Principles 25. The Legally Qualified Chair reminded the Tribunal that at this stage of proceedings, there is no formal burden or standard of proof and the decision on impairment is a matter for the Tribunal s judgment alone. 26. In approaching its decision, the Tribunal was mindful of the two stage process to be adopted: first whether the Facts as found proved amount to misconduct which is sufficiently serious to call the doctor s fitness to practise into question. If so it must then consider whether the doctor s fitness to practice is currently impaired by reason of such misconduct. 27. The Tribunal has been mindful of the overarching objective of the GMC set out in section 1 of the Medical Act 1983 (as amended) to: a. Protect, promote and maintain the health, safety and well-being of the public, b. Promote and maintain public confidence in the medical profession, and c. Promote and maintain proper professional standards and conduct for members of that profession. 28. Whilst there is no statutory definition of impairment, the Tribunal is assisted by the guidance set down by Dame Janet Smith in the Fifth Shipman Report and the more recent approach in CHRE v NMC and Paula Grant both of which recognise that as part of the process in determining whether a doctor is fit to practise today it must take account of past actions or failures to act. In particular, the relevant considerations as to whether Dr Samin s Fitness to Practise is impaired in the sense that he: a. Has in the past acted and/or is liable in the future to act so as to put a patient or patients at unwarranted risk of harm; and/or b. Has in the past or is liable in the future to bring the medical profession into disrepute; and/or c. Has in the past breached or is liable to breach in the future one of the fundamental tenets of the medical profession; and/or 22
d. Has in the past acted dishonestly and/or is liable to act dishonestly in the future. 29. In relation to the issue of what constitutes misconduct, the Tribunal was guided by the cases of: Roylance v GMC [2000] 1 AC 311; and Meadow v GMC [2006] EWCA CIV 1390. 30. The Tribunal must determine whether Dr Samin s fitness to practise is currently impaired by reason of misconduct and conviction, taking into account Dr Samin s conduct at the time of the events and any relevant factors such as whether the matters are remediable, have been remedied, any development of insight and the likelihood of repetition. The Tribunal s Determination 31. In considering the question of impairment, the Tribunal has taken account of all of the evidence, and the submissions of Ms Duckworth, Counsel, on behalf of the GMC. Misconduct 32. In determining whether Dr Samin s fitness to practise is currently impaired by reason of misconduct, the Tribunal has first of all considered whether the Facts found proved amount to professional misconduct by reference to the rules and standards ordinarily required to be followed by a medical practitioner. It has gone on to consider whether that misconduct constitutes a serious departure from those standards and is therefore misconduct likely to impair Dr Samin s fitness to practise. 33. The Tribunal had regard to introductory page to GMP that states: The duties of a doctor registered with the General Medical Council Patients must be able to trust doctors with their lives and health. To justify that trust you must show respect for human life and make sure your practice meets the standards expected of you in four domains. Maintaining trust - Be honest and open and act with integrity. - Never abuse your patients trust in you or the public s trust in the profession. 23
It also had regard to paragraph 1 of GMP: 1 Patients need good doctors. Good doctors make the care of their patients their first concern: they are competent, keep their knowledge and skills up to date, establish and maintain good relationships with patients and colleagues, are honest and trustworthy, and act with integrity and within the law. 34. Further, the Tribunal had regard to paragraphs 65, 66, 68, 70, 71(a) and 72(a)(b) of GMP, which is the standard in which a doctor should practise. It states: 65 You must make sure that your conduct justifies your patients trust in you and the public s trust in the profession. 66 You must always be honest about your experience, qualifications and current role. 68 You must be honest and trustworthy in all your communication with patients and colleagues. This means you must make clear the limits of your knowledge and make reasonable checks to make sure any information you give is accurate. 70 When advertising your services, you must make sure the information you publish is factual and can be checked, and does not exploit patients vulnerability or lack of medical knowledge. 71(a) You must be honest and trustworthy when writing reports, and when completing or signing forms, reports and other documents. You must make sure that any documents you write or sign are not false or misleading. a. You must take reasonable steps to check the information is correct. 72(a)(b) You must be honest and trustworthy when giving evidence to courts or tribunals. You must make sure that any evidence you give or documents you write or sign are not false or misleading. a. You must take reasonable steps to check the information. b. You must not deliberately leave out relevant information. 35. The Tribunal is of the view that those sections of GMP clearly establish the requirement for a doctor to be honest and trustworthy, in order to ensure that the trust placed in them is justified. Further, the Tribunal was of the view that honesty is a fundamental tenet of the medical profession. 24
36. Turning to the matters found proved in the Allegation, it concludes as follows: Allegation 1 (in conjunction with Allegations 3 and 9) 37. In relation to Allegation 1(a), the Tribunal considers the provision of untrue information, under oath or affirmation, to the 2017 Tribunal to be an extremely serious breach of Dr Samin s professional obligations and the law. It considers that Dr Samin s actions fall seriously below the standards set out in GMP but particularly paragraphs 1, 65 and 72(a) and (b). The Tribunal considers that Dr Samin s conduct in this regard undermines patients trust in doctors and brings the medical profession into disrepute. 38. The Tribunal determined that Dr Samin s conduct is a serious breach of the fundamental tenets of the profession and his actions fall far short of the standards expected of medical practitioner. 39. The Tribunal determined that Dr Samin s actions in Allegation 1 (in conjunction with Allegations 3 and 9) amounted to misconduct. Allegation 2 (in conjunction with Allegation 9) 40. Allegation 2, as framed, is merely a statement of a series of facts, as the Tribunal has previously determined. There is no conduct on which the Tribunal can undertake an analysis of Dr Samin s misconduct. 41. Accordingly, the Tribunal determines that Dr Samin s actions in Allegation 2 (in conjunction with Allegation 9) do not amount to misconduct. Allegation 3 42. The Tribunal has considered this Allegation in conjunction with Allegation 1(a) above. Allegation 4 (in conjunction with Allegations 8 and 9) 43. In relation to Allegation 4 (in conjunction with Allegations 8 and 9), the Tribunal considers that paragraphs 66, 68, 70, 71(a) of GMP are engaged. The Tribunal makes the following finding in relation to each aspect of this Allegation: Allegation 4(a) The Tribunal found that Dr Samin did not know the statement to be untrue when he stated that he had 46 years and 3 months experience on BAYT.com, and determined that it was more likely than not a typographical error. It considers, whilst his actions are a breach of GMP, in that he had not taken sufficient care to ensure the accuracy of the statement, it is not sufficiently serious to constitute misconduct. 25
Allegation 4(b) The Tribunal is of the view that Dr Samin s actions in dishonestly specifying that he had published this article on BAYT.com, was a clear departure from the standards outlined in GMP. He fabricated this article to enhance his CV. The Tribunal considers this to be a serious departure from the expected professional standard and to be misconduct. Allegation 4(c) The Tribunal was of the view that Dr Samin s actions in dishonestly stating that he had an MSc in Aesthetic Medicine/ Dermatology from Queen Mary University, which he knew to be untrue, a clear departure from the standards outlined in GMP above. The Tribunal considers that giving misleading and incorrect information for personal gain is a fundamental breach of the tenets of the medical profession and this misconduct brings the profession into disrepute. Allegation 5 (in conjunction with Allegations 8 and 9) 44. In relation to Allegation 5 (in conjunction with Allegations 8 and 9), the Tribunal considered that paragraphs 65, 66, 68, 70 and 71(a) of GMP are engaged. 45. The Tribunal is concerned that the Yell.com website is public-facing and is targeted at the general public and not predominantly at employing organisations. The Tribunal is of the view that dishonestly claiming to be a Fellow of an organisation that does not exist creates a falsely inflated impression of the organisation and its practitioner in the eyes of patients and the wider public. It is a clear breach of the fundamental tenets of the profession and falls seriously short of the standards expected of a medical practitioner. 46. The Tribunal determines that Dr Samin s actions in this regard amount to misconduct. Allegation 6 (in conjunction with Allegations 8 and 9) 47. In relation to Allegation 6 (in conjunction with Allegations 8 and 9), the Tribunal considers that paragraphs 65, 66, 68, 70 and 71(a) of GMP are engaged. The Tribunal considers that Dr Samin dishonestly stating on his Facebook profile that he studied for the courses and at the institutions specified was done in order to present more impressive credentials to the public than those he actually possessed. This conduct is a serious breach of the standards outlined in GMP, breaches the fundamental tenets of the profession, and brings the medical profession into disrepute. 48. The Tribunal determines that Dr Samin s actions in Allegation 6 amount to misconduct. 26