Satisfied requirements set out in Medicine Act to obtain new certificate of registration
The Ontario Physicians and Surgeons Discipline Tribunal (OPSDT) has reinstated a doctor whose licence got revoked for sexually abusing a female patient.
In Margaliot v. College of Physicians and Surgeons of Ontario, 2022 ONPSDT 20, the applicant Zvi Margaliot is a plastic surgery specialist licensed to practise in Ontario as a hand surgeon. Between 2009 and 2011, he treated patient A for wrist complaints and performed two surgical procedures on her. After patient A contacted the applicant through Facebook, they began exchanging emails and texts and eventually started a sexual relationship in March 2011.
During the hearing before the College of Physicians and Surgeons of Ontario (CPSO), the applicant did not contest that he engaged in the sexual abuse of a patient that “would reasonably be regarded by members of the profession as disgraceful, dishonourable, or unprofessional.” The CPSO found him guilty of professional misconduct and revoked his certificate of registration in September 2016.
After six years, the applicant applied for reinstatement with the OPSDT under s. 72 of the Regulated Health Professions Act. Section 72 provides that a person whose certificate of registration has been revoked may apply for a new certificate. Moreover, an application concerning a revocation for sexual abuse of a patient cannot be made earlier than five years from the time the certificate was revoked.
While it did not oppose the application, the CPSO argued that the applicant must satisfy the following requirements set out in the Medicine Act to obtain a new certificate:
- The applicant is mentally competent to practise medicine;
- The applicant will practise medicine with decency, integrity and honesty, and in accordance with the law;
- The applicant can communicate effectively and will display an appropriately professional attitude.
- The applicant has sufficient knowledge, skill and judgment to engage in the kind of medical practice authorized by the certificate.
The OPSDT held that the applicant was entitled to obtain a new certificate of registration since he satisfied all the requirements set out in the Medicine Act.
According to the OPSDT, the applicant was mentally competent to practise medicine based on the separate reports of the Ontario Medical Association’s Physician Health Program (PHP) and the applicant’s family physician.
The first report provided that the applicant “had made gains with his therapy,” such that a return to clinical work could be considered, and he did not meet the criteria for the PHP’s mental health or substance use monitoring programs. Meanwhile, the family physician’s report showed that the applicant did not have any physical or mental ailment that could affect his ability to practise medicine safely.
In addition, the OPSDT found that the applicant’s testimony regarding insight and change into his behaviour supported the premise that he would practise medicine with decency, integrity and honesty and in accordance with the law.
“He testified that he accepted that his conduct was an egregious breach of his ethics and his duty to his patient,” the OPSDT wrote. “He understood the privilege of the CPSO’s regulation of the profession in the public interest and that he had violated the trust society puts in physicians to monitor themselves and behave ethically.”
The OPSDT also ruled that the applicant could communicate effectively and would display an appropriately professional attitude based on letters of support from his past colleagues, attesting to his surgical and communication skills.
“Moreover, since the revocation of his certificate of registration, the applicant has continued to participate in continuing medical education (CME) and filed a record of his CME with the Royal College of Physicians,” the OPSDT wrote.
The applicant argued that the individualized education plan (IEP) he prepared in support of his application proved that he had sufficient knowledge, skill, and judgment to engage in medical practice authorized by the certificate. The OPSDT agreed.
The applicant’s IEP consists of a weekly schedule to review the most important topics from a structured hand surgery course published by the American Society for Surgery of the Hand.
“Dr. Hay, a CPSO medical advisor, and Lisa Wilson, a CPSO employee who works with physicians who are either changing their scope of practice or who are re-entering practice after an extended absence, reviewed the IEP and provided their comments and opinions,” the OPSDT wrote. “They are of the view that six months of moderate-level supervision would be appropriate to the applicant, subject to positive reports from a supervisor acceptable to the CPSO.”