Tribunal confirms Medical Board decision to refuse registration

01 Jun 2016

A tribunal has confirmed a decision of the Medical Board of Australia to refuse an application for renewal of limited registration.

On 12 June 2012, the Board considered an application by Dr Rhandy Cabading to renew his limited registration. The Board refused his application on the basis that Dr Cabading had consistently failed the Royal Australian College of General Practitioners (RACGP) fellowship examination and the Australian Medical Council examinations and had failed to progress to general or specialist registration in the 10 years that he had held limited registration.

On 10 July 2012, Dr Cabading applied to the Queensland Civil and Administrative Tribunal (the tribunal) for a stay and review of the decision. The Board agree for the decision to be stayed.

Between July 2012 and when the matter was heard on 10 December 2013, Dr Cabading attempted the RACGP Key Feature Problems (KFP) Examination three times. Dr Cabading failed the KFP module on each attempt.

After the matter was heard by the tribunal, Dr Cabading continued to attempt to pass the required examinations, but was not successful. He attempted to pursue a different pathway by completing a Practice Based Assessment through the RACGP. At a directions hearing on 4 December 2015, the tribunal was informed that Dr Cabading had not passed the assessment.

On 24 March 2016, the tribunal issued its decision and made the following orders:

• The decision of the Board of 12 June 2012 refusing Dr Cabading’s application for limited registration is confirmed.
• The stay of the Board’s decision ordered on 19 July 2012 is removed.
• Dr Cabading is to pay the Board’s costs of and incidental to the review proceedings.

During proceedings, Dr Cabading had argued that he should be granted renewal of his registration, subject to a condition requiring supervision, for a number of reasons, including that:

• the examinations he had failed were not a fair and reasonable assessment of his competency,
• he was able to present expert opinion that supported that he was capable of practising under supervision, and
• the Board’s decision not to renew his limited registration was not the result of any patient suffering harm at his hands.

The tribunal stated that the question before it was not whether Dr Cabading was capable of practising under supervision, but whether the Board’s decision to refuse Dr Cabading’s renewal application was the correct and preferable decision.

The tribunal referred to the matter of Tabanas v Medical Board of Australia (No.3). Justice Horeman-Wren SC agreed with the observations by the Queensland tribunal in that matter as follows:

... having seen a large number of patients whilst practising under limited registration, without complaint and with the support of other medical practitioners, was not the most accurate means of assessing competence....if it were, there would be little if any utility in the examinations which set the measurable standards for admission into general or specialist practice.

The tribunal in Tabanas went on to state:

A non-injurious complaint free period of practice is not necessarily demonstrative of a sufficient level of competence. Examinations apply a uniformity to the measurement of competence. They also serve to set a measurable standard of competence, the attainment of which is considered a minimum necessary requirement to enter, or remain with, the profession.

Repeated failures to meet those standard requirements provide a sound basis for concluding that the person is unable to demonstrate a sufficient level of competence.

Requiring persons seeking registration to demonstrate their competence by passing such examinations is entirely consistent with the objectives of the National Registration and Accreditation Scheme established under the National Law to provide for the protection of the public by ensuring that only health practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered, and to facilitate the rigorous and responsive assessment of overseas-trained health practitioners .It also facilitates the guiding principle of the scheme that it operate in a transparent, accountable, efficient, effective and fair way.

The tribunal considered that these observations applied in Dr Cabading’s matter and his continuing failure to pass the relevant examinations required to attain general or specialist registration over 10 years supported the Board’s decision to refuse his renewal application for limited registration as the correct and preferable decision.

Dr Cabading’s name has been removed from the register of practitioners.

Reasons for the tribunal’s decision will be published on the AustLII website.