Medical Tribunal New South Wales

• Medium Neutral Citation: Health Care Complaints Commission v Dr Saeid Saedlounia [2013] NSWMT 13
• Hearing dates: 29, 30 April and 1 May 2013
• Decision date: 21 June 2013
• Before: Levy SC DCJ; Dr JYF Ng; Dr J Davidson; Ms HH Kiel

Decision

See paragraphs 141 - 142 for orders.

• Catchwords: MEDICAL TRIBUNAL - breaches of practice and visa conditions by overseas medical graduate - whether unsatisfactory professional conduct - whether professional misconduct - protective orders to include deterrence - practice conditions
• Legislation Cited: Crimes (Sentencing Procedure) Act 1999, s 17; Health Practitioner Regulation National Law (NSW) 86a, s 139B, s 139E, s 146C; Medical Practice Act 1992, s 4, s 7
• Cases Cited: Briginshaw v Briginshaw [1938] HCA 34; (1938) 60 CLR 336; Chew v R [1992] HCA 18; (1992) 173 CLR 626; HCCC v Litchfield (1977) 41 NSWLR 630; HCCC v Maendel [2013] NSWMT 3; King v Health Care Complaints Commission [2011] NSWCA 353; Law Society of NSW v Foreman (1994) 34 NSWLR 408; Lee v HCCC [2012] NSWCA 80; Pillai v Messiter [No.2] (1989) 16 NSWLR 197; Prakash v HCCC [2006] NSWCA 153; Re Dr Than Le [2001] NSWMT, 20 September 2001; Saville v HCCC (2006) NSWCA 298
• Texts Cited: Corpus Juris Secundum, Vol 58, (1948)
• Category: Principal judgment
• Parties: Health Care Complaints Commission (Applicant); Dr Saeid Saedlounia (Respondent)
• Representation: Ms C Spruce (Applicant); Mr M Lynch (Respondent); Solicitor for Health Care Complaints Commission (Applicant); Mitry Lawyers (Respondent)
• File Number(s): 40019/12
• Publication restriction: No

REASONS FOR DECISION

Table of Contents

The proceedings	[1]
The practitioner	[2] - [5]
Framework for the complaints	[6] - [14]
Procedural course of the hearing	[15] - [17]
Facts	[18] - [24]
Dr Saedlounia's explanations	[25] - [40]
Legislation	[41] - [42]
Principles from decided cases	[43] - [50]
Principles relevant to consideration of the facts	[51] - [57]
Submissions of the parties	[58] - [60]
Determination of Complaint 1	[61] - [63]
Determination of Complaint 2	[64] - [89]
Determination of Complaint 3	[90] - [117]
Need for protective orders	[118] - [139]
Findings	[140]
Protective orders	[141]
Practice conditions	[142]
Appendix

The proceedings

1 This Tribunal has been convened to inquire into three inter-related disciplinary complaints brought by the Health Complaints Commission ["HCCC"l against Dr Saeid Saedlounia, now a fully registered general practitioner. The Further Amended Notice of Complaint relied upon by the HCCC was tendered as Exhibit "A". It alleged that at times when Dr Saedlounia, an overseas medical graduate, held conditional registration that enabled him to work in identified areas of need, pursuant to a visa granted to him for that purpose, he breached those conditions and engaged in unsatisfactory professional conduct and professional misconduct, within the respective meanings of s 139B and s 139E of the Health Practitioner Regulation National Law (NSW) 86a ["National Law"].

The practitioner

2 Dr Saedlounia was born in 1977, in Esfahan, Iran. He is 35 years of age. He arrived in Australia in 2005 from Iran, where he had obtained his primary qualifications in medicine in 2000. Before his conditional registration in NSW, and between 2005 and 2007, he had worked as an assistant in nursing, and as a pool attendant at an aged care facility, as was permitted by the tourist visa he held at that time. In 2011 he obtained full registration as a general practitioner. In that year he became a permanent resident in Australia. He became an Australian citizen in 2013.

3 The complaints before the Tribunal relate to conduct by Dr Saedlounia which he now acknowledges to have involved historical breaches of the conditions that had been placed on his practising rights between 2007 and 2009. At those times, he was registered conditionally, and he was restricted to working within defined levels of supervision in two identified areas of need in the community in accordance with his visa conditions, which was the customary basis upon which overseas medical graduates, whose overseas qualifications were not recognised in Australia, could obtain employment in this country pending a determination of full recognition of the their professional skills and qualifications.

4 Dr Saedlounia's registration history is as follows:

(1) Between 1 March 2007 and 31 March 2009, Dr Saedlounia was granted conditional registration to work as a general practitioner under supervision at the Wellington Aboriginal Corporation Health Service. In that time, between 15 November 2007 and 31 March 2008, as a consequence of a change in the availability of supervision, that conditional registration was varied to include the position of Visiting Medical Officer at Wellington District Hospital;

(2) Between 1 April 2008 and 23 May 2009, Dr Saedlounia's authorisation to work at the Wellington Aboriginal Corporation Health Service and the Wellington District Hospital, continued with some variation to his supervision arrangements;

(3) Between 23 May 2009 and 23 July 2009, Dr Saedlounia's registration was withdrawn. This appeared to have been due to difficulties in securing the required level of supervision in the area to which he had been assigned;

(4) Between 24 July 2009 and 23 November 2009, Dr Saedlounia was conditionally registered in the category Public Interest - Standard Pathway under s 7(1 )(G) of the now repealed Medical Practice Act 1992. This obliged him to work at both the Manly and the Royal North Shore Hospitals, in the field of addiction medicine;

(5) Between 23 November 2009 to 1 December 2009, Dr Saedlounia was not registered in NSW because he had resigned his employment as the work he had obtained at North Shore Hospital was not authorised by the terms of his visa;

(6) From 1 December 2009, Dr Saedlounia was granted limited registration until 22 December 2011, conditional upon him working in an area of need in Wodonga, in Victoria;

(7) After 1 July 2010, by operation of law, Dr Saedlounia became registered under the provisions of the new National Law governing health care practitioners;

(8) From 22 December 2011 until the present time, Dr Saedlounia has had full registration as a general practitioner.

5 Between 4 January 2010 and 4 January 2012, Dr Saedlounia worked as a general practitioner at the Elmwood Medical Centre in Wodonga, in Victoria. Since 2 February 2012, he has been employed as a general practitioner at the Rouse Hill Medical Centre from Sundays to Thursdays, working shifts between 1.00pm and 10.00pm.

Framework of the complaints

6 Complaints 1 and 2 allege unsatisfactory professional conduct. Complaint 3 alleges that the effect of Complaints 1 and 2 amounts to professional misconduct.

7 The particulars of the complaints of unsatisfactory professional conduct and professional misconduct alleged against Dr Saedlounia must be viewed in light of the imposed obligatory practice conditions which limited the rights of Dr Saedlounia to practise medicine. Those conditions had their origin in the nature of successive issue of 457 Visas the Australian Government had granted to Dr Saedlounia over a period of time. Those visas were as follows:

(a) On 21 May 2007, a Temporary Business (Long Stay) Standard Business Sponsorship Visa (Subclass 457) was granted with an attached Condition 8107 identifying Dr Saedlounia's sponsor as the Wellington Aboriginal Health Service. That visa enabled him to work as a general practitioner and it prohibited him from ceasing to work with that sponsor as well as prohibiting him from taking up work elsewhere during the currency of the visa restrictions;

(b) On 8 October 2009, a Temporary Business (Long Stay) Standard Business Sponsorship Visa (Subclass 457) was granted with validity until 19 October 2010. That visa had an attached Condition 8107 identifying Dr Saedlounia's sponsor as the Northern Sydney and Central Coast Area Health Service. That visa enabled him to work in the category of a psychiatrist, which was a registrar's position.

8 In order for Dr Saedlounia to pursue work in the positions identified in his visas, he was required to, and in fact obtained from the regulatory authority, the Medical Board of NSW ["the Board"], conditional registration as a medical practitioner. From 1 July 2010, the regulatory successor of the Board has been the Medical Council of Australia ["the Council"], following the National Law coming into effect on that date.

9 A statement was tendered from the Medical Director of the Council confirming that Dr Saedlounia's qualifications from Iran were not recognised qualifications. To enable him to work in an area of need the former Board exercised its discretion to extend conditional registration to him. That statement of the Medical Director, which was not challenged, set out the basis, need and justification for a strictly applied and suitable supervisory, support and training regime for conditional registrants to provide assurance to the regulatory authority that conditional registrants practised safely, and did not place the public at risk: Exhibit "D".

10 The detail of the practice conditions the Board imposed on Dr Saedlounia are not the subject of any dispute. Those details are included in the Appendix to these reasons.

11 The unsatisfactory professional conduct alleged against Dr Saedlounia can be briefly summarised as comprising:

(a) Working as a locum general medical practitioner for Carrington Centennial Care providing services at Grassmere Terrace Aged Care Facility on 8 occasions between 26 September 2009 and 14 November 2009: (Part of Complaint 1);

(b) Working as a Visiting Medical Officer at Wellington District Hospital on some 62 identified occasions between 1 December 2007 and 2 April 2008, during which time he either practised or purported to practise medicine at Wellington District Hospital: (Part of Complaint 2);

(c) Failure to comply with his 457 Visa between 27 July and 7 August 2009, by working at the Herbert Street Clinic of the North Sydney Drug and Alcohol Service as a Senior Resident Medical Officer: (Part of Complaint 2);

(d) Providing a curriculum vitae or professional resume to YourWorld Recruitment agency that was false and misleading as to his work experience, by which he claimed he had worked for Worksafe Medics as an Occupational Medical Practitioner (Casual), when he had not been employed in that capacity: (Part of Complaint 2).

12 The particulars of the allegation levelled at Dr Saedlounia that he engaged in professional misconduct, which is the subject of Complaint 3, are the same as the allegations particularised for Complaints 1 and 2, but under this complaint, it was alleged that the pattern of conduct in question was of a sufficiently serious nature to justify suspension or cancellation of Dr Saedlounia's registration as a medical practitioner.

13 The factual substance of the complaints relied upon by the HCCC came to light in November 2009 when the supervising psychiatrist, in charge of the Herbert Street Clinic of the North Sydney Drug and Alcohol Service, Dr Dore, became aware that Dr Saedlounia had been working in breach of his visa conditions, following which, the authorities were necessarily notified of that fact.

14 In those events, and in accordance with the duty required of her as Dr Saedlounia's nominated supervisor, Dr Dore wrote to the Board enclosing an 8 page summary of her concerns that had arisen during Dr Saedlounia's employment at the Herbert Street Clinic. That summary includes a description of the sequence of events by which Dr Saedlounia's unauthorised employment came to light. In October 2009, some results of blood tests that had been ordered in his name had arrived at the Herbert Street Clinic relating to persons who were not patients of that Clinic. This led to Dr Dore investigating Dr Saedlounia's terms and conditions, including his visa status. In her letter of 20 November 2009, Dr Dore also notified the Board of Dr Saedlounia's resignation from the Northern Sydney Drug and Alcohol Service. In view of the way the HCCC has framed its complaints, it is not necessary to analyse or consider the details that are set out in Dr Dore's letter and her attached summary.

Procedural course of the hearing

15 As the underlying facts were ultimately not in dispute, the parties agreed that in this case, it was convenient for them to proceed without the need for a two-stage hearing: King v Health Care Complaints Commission [2011] NSWCA 353, at [202] to [205].

16 That agreement also had the expedient effect of avoiding the need to delve deeply into the voluminous and complicated Commonwealth regulatory regime that surrounds the granting of 457 Visas that enabled overseas trained medical graduates to work under supervision in a declared area of need.

17 The substance of the three complaints raised by the HCCC will be considered after the agreed facts, the relevant legislation and the principles applicable to those facts have been identified.

Facts

18 The statement of agreed facts replicated in the Appendix to these reasons includes an outline of the regulatory framework for the conditional registration of overseas trained medical graduates who have been granted 457 Visas. Also set out in the Apppendix is the undisputed sequence of events that Dr Saedlounia now concedes justifies findings of unsatisfactory professional conduct on his part. In essence, that conduct comprised three elements.

19 The first element is the breach by Dr Saedlounia of the original 457 Visa granted to him on 21 May 2007, which was stated to be in force until 8 October 2009. Those breaches occurred when Dr Saedlounia carried out professional work in a number of different unauthorised establishments, notwithstanding that the visa that had been granted to him required that he restrict his work solely to the Wellington Aboriginal Corporation Health Service.

20 The unauthorised establishments concerning that first element were the Wellington District Hospital, where Dr Saedlounia carried out professional medical work, Worksafe Medics, where his work was described as a "casual clinical support person" performing the duties described at paragraph [23] of the statement of agreed facts, the Herbert St Clinic of the Northern Sydney Drug and Alcohol Service, where he worked as a Senior Resident Medical Officer, and with an agency called Carrington Centennial Care, through which his services were provided as a locum general practitioner to the Grassmere Terrace Aged Care Facility.

21 The second element is the breach of the second 457 Visa granted to Dr Saedlounia on 8 October 2009. The effect of that second visa was to provide Dr Saedlounia with the required authorisation to work as a psychiatry registrar with the Northern Sydney and Central Coast Area Health Service. The conditions of that visa were breached by Dr Saedlounia in that he undertook further work as a locum general practitioner at the Grassmere Terrace Aged Care Facility in contravention of his visa.

22 The third element concerned inaccuracies in the representations made by Dr Saedlounia in a curriculum vitae or professional resume that he had provided to YourWorld Recruitment, a medical employment agency. The inaccurate representation within that document was in the form of a statement that he had worked for Worksafe Medics as an "Occupational Medical Practitioner (Casual)" when in fact this was not so, as he had only been enlisted to work as a support person to the medical practitioner who operated that company.

23 Although Dr Saedlounia has conceded that the particulars of his visa breaches are factually correct, he disputes that those breaches amount to improper or unethical conduct in the practise of medicine, for example, when he was working in the capacity of a clinical support person. He has also raised a question as to whether the inclusion of misleading information in his curriculum vitae could be properly characterised as unethical, even though it does relate to the practise of medicine.

24 Apart from raising arguments on those matters, Dr Saedlounia concedes that the other agreed facts amount to unsatisfactory professional conduct on his part. The Tribunal is required to consider whether these factual matters also amount to professional misconduct on the part of Dr Saedlounia, who has denied that characterisation, and has sought to portray those breaches as being of a more benign character, due to claimed inadvertence on his part.

Dr Saedlounia's explanations

25 In response to the complaints, Dr Saedlounia provided a statement dated 31 January 2013, as well as a supplementary statement dated 23 April 2013. In the course of his oral evidence, he also gave some explanations for the conduct in question. Those matters are reviewed in the paragraphs that follow.

26 In his statement dated 31 January 2013, Dr Saedlounia admitted the particulars of Complaint 1, and admitted that he had contravened the conditions of his registration by working as a locum general practitioner for Carrington Centennial Care at the Grassmere Aged Care Facility on the dates alleged in that complaint. His explanation for that breach was that he was under the impression that his visa at the time allowed him to work for that establishment, and he said he did not realise he was in breach of his visa: statement paragraphs [17] - [18], [23]. In his supplementary statement dated 23 April 2013, Dr Saedlounia reiterated his earlier concession concerning Complaint 1 and provided the further explanation that at the time, he had relied upon the proprietor of YourWorld Recruitment to satisfy himself that the job in which he had been placed, was appropriate in light of the Board's conditions. Dr Saedlounia now acknowledges that it was in fact his own responsibility to ensure the Board's requirements were satisfied in that regard.

27 In his statement dated 31 January 2013, Dr Saedlounia also admitted the terms and conditions of the visas that had been issued to him on 21 May 2007, 8 August 2009 and 8 October 2009. It was implicit within that statement, that Dr Saedlounia conceded that he was in breach of his visa conditions prior to 14 September 2009, at which time the conditions applying to 457 Visas became more flexible in allowing the holders of such visas to work for multiple employers.

28 In his statement dated 31 January 2013, Dr Saedlounia claimed that he had interpreted his registration conditions that stated that he "may not" work in any other employment than the employment specified in his conditions of registration as not amounting to a prohibition at that time: statement paragraph [25]. That explanation was the subject of challenge in cross-examination.

29 Dr Saedlounia's statement dated 31 January 2013 went on to address the 5 particulars that comprised Complaint 2: statement paragraphs [27] - [39].

30 As to Particular 1 of Complaint 2, Dr Saedlounia conceded that whilst employed at the Wellington Aboriginal Corporation Health Service he had carried out on-call sessional work at the Wellington District Hospital. He claimed that he assumed the Medical Director of the Hospital would have checked his visa before approaching him to do that work. In his supplementary statement dated 23 April 2013, Dr Saedlounia reiterated his earlier concession on this particular, and that the breach amounted to improper or unethical conduct in the practise of medicine. By way of further explanation, Dr Saedlounia stated that he had been encouraged by the CEO of the Corporation to work at the Wellington District Hospital so that he could continue his care of Aboriginal patients who may be admitted to that Hospital. He said he now accepted that at the time it would have been wiser for him to have first sought the approval of the Department of Immigration before commencing to work at that Hospital.

31 As to Particular 2 of Complaint 2, Dr Saedlounia conceded that he had worked for Worksafe Medics on the dates set out in the complaint, but he claimed his role was to accompany a nurse employed by that company to different worksites to "conduct simple assessments, such as audiometry, spirometry, and other haemodynamic observations which did not necessarily need to be performed by a registered health practitioner". In his supplementary statement dated 23 April 2013, Dr Saedlounia admitted the facts alleged against him, but argued that the work that he had undertaken for Worksafe Medics was only as a clinical support person, and not as a medical practitioner. Dr Saedlounia stated that whilst in that employment he had not held himself out as being a medical practitioner.

32 As to Particular 3 of Complaint 2, Dr Saedlounia conceded that between 27 July 2009 and 7 August 2009, he failed to comply with his visa conditions by working at the Herbert St Clinic of the North Sydney Drug and Alcohol Service as a Senior Resident Medical Officer until there was a visa problem. He claimed he "was not previously aware that there was any problem" with his visa. He claimed that as he had not been paid for that work (as a result of the discovery that his visa did not authorise that work) this did not constitute work that amounted to a breach of any relevant condition. That evidence has to be read in conjunction with his oral evidence, where he conceded that during that time at the Herbert St Clinic, he had provided his services at that Clinic in the expectation that he would be paid accordingly. In his supplementary statement dated 23 April 2013, Dr Saedlounia contested the proposition that during his 11 days working at the Herbert St Clinic, that employment amounted to unsatisfactory professional conduct in breach of his visa. That contest was based upon the proposition that he had worked without being paid.

33 As to Particular 4 of Complaint 2, Dr Saedlounia conceded that between 26 September 2009 and 14 November 2009, on the dates set out in the complaint, he failed to comply with the conditions of his visa in that he worked for Carrington Centennial Care as a locum general practitioner providing services at the Grassmere Terrace Aged Care Facility. By way of explanation, he reiterated his interpretation of the employment restrictions on his visa, namely "may not", as not constituting a prohibition from pursuing that employment. He expressed embarrassment and remorse over that conduct. In his supplementary statement dated 23 April 2013, Dr Saedlounia clarified this earlier admission, but he excluded from that admission the dates 26 September and 3 October 2009. He did so on the basis of his understanding, that after 14 September 2009, his visa conditions became more flexible, and allowed for multiple employers, including at Carrington Centennial Care. He subsequently conceded that he should have read his visa conditions more carefully, and did not believe his conduct was unethical or improper, or to be unsatisfactory professional conduct.

34 As to Particular 5 of Complaint 2, Dr Saedlounia conceded that although he had provided a curriculum vitae to YourWorld Recruitment in September 2009, in which he represented that he had been employed by Worksafe Medics as an "Occupational Medical Practitioner (Casual)" when he had not been so employed, and had represented that he had held the position of "Psychiatry Registrar" at Royal North Shore Hospital from July 2009 when he had not been so employed, he admitted the factual basis of the allegations in the complaint. With regard to those Worksafe representations he stated "I deeply regret the misunderstanding that this description would cause". He also stated that the representation was inappropriate, and did not accurately describe his position at that establishment. In his oral evidence on this subject, Dr Saedlounia characterised the misleading inclusion of Occupational Medical Practitioner (Casual) in his curriculum vitae as simply being a typographic error, and he claimed the prefatory word "Assistant" had been omitted: T32.35 - T32.46.

35 At the time he prepared his 31 January 2013 statement, he deferred making any comment about the representation in his curriculum vitae that he was a Psychiatry Registrar at the Royal North Shore Hospital from July 2009 until he saw documents from that Hospital.

36 In his supplementary statement dated 23 April 2013, at paragraph [11], Dr Saedlounia stated:

"11. In answer to particular 5,1 admit the facts alleged but did not intend to deliberately mislead anyone by the references to "Occupational Medical Practitioner" and "Psychiatric Registrar". The first entry should have stated "Occupational Medical Practitioner Assistant". The advertisement that I saw on Seek.com to the Herbert Street Clinic position was, as I recall, described as "Registrar/Senior Resident Medical Officer" in ether Addiction Medicine or Psychiatry even though I was only employed under the supervision of Dr Dore, a Psychiatrist. I believed that my sponsor, the NSCCAHS, had communicated with the Immigration authorities which led to that description. I note that in tab 57 the Immigration Department referred to my job as a Psychiatry Officer/Medical Officer" "

37 In summary, in his statements, Dr Saedlounia conceded that the conduct he has admitted in relation to Complaint 1 is capable of amounting to unsatisfactory professional conduct. He made the same concession with respect to Complaint 2, except for Particulars 2 and 3, which concerned whether he worked or had purported to have worked as a medical practitioner for Worksafe Medics, and whether he had "worked" at the Herbert St Clinic because he had not been paid for his attendance there.

38 In his oral evidence concerning the breaches of his visa and practice conditions, Dr Saedlounia stated that he was sorry for such breaches, which he maintained were not deliberate breaches. He sought to explain those matters by asserting his failure to pay proper attention to those conditions, and his failure to read them and check them: T32.7; T41.14. He also agreed that in the circumstances, a responsible person acting responsibly would not have made the assumptions he had made about his visa conditions, and instead would have taken steps to check whether the conditions covered the employment he was contemplating: T91.42 - T91.50.

39 In his oral evidence, on numerous occasions, when his practice conditions were drawn to his attention in context, he reiterated that he was sorry for those breaches of the conditions that had been imposed upon him by the Board. When questioned about a possible interpretation of his evidence that his expressions of remorse could be seen as glib, superficial or insincere, at T95.22 - T95.27, he stated

"A. Firstly, all doctors believe in honesty. When we say that we are sorry, that means really we are. So being in the position of treating patients and taking the responsibility of having their problems confidential. I've been in many tested occasions. When I say sorry, I really mean that, and my future actions will prove that I am really sorry about that. I am really sorry. I really feel embarrassed of being in this position whilst I could treat patients."

40 Those explanations by Dr Saedlounia will be considered in the course of determining the outcome of the respective complaints.

Legislation

41 The term unsatisfactory professional conduct is broadly defined in the legislation and it is not only confined to clinical conduct: s 139B of the National Law. Relevant to the context of these proceedings, it also includes contravention of a condition to which a practitioner's registration is subject: s 139B(1)(c), and other improper or unethical conduct relating to the practice or purported practice of medicine: s 139B(1)(l) of the National Law.

42 The term professional misconduct is defined as comprising unsatisfactory professional conduct that is of a sufficiently serious nature to justify suspension of the practitioner's registration, or one or more instances of unsatisfactory professional conduct, when considered together, amount to conduct of a sufficiently serious nature to justify suspension or cancellation of the practitioner's registration: s 139E of the National Law.

Principles from decided cases

43 In considering whether or not the complaints of unsatisfactory professional conduct or professional misconduct have been made out, the Tribunal has been mindful of the gravity of such allegations, and has therefore approached the evaluation of the evidence on the basis that for proof of such allegations, persuasion to a high degree of comfortable satisfaction is required on the balance of probabilities: Briginshaw v Briginshaw [1938] HCA 34; (1938) 60 CLR 336. A reference in these reasons to the Tribunal being satisfied on a particular matter of fact or conclusion, should be read as being a state of satisfaction or proof to that standard.

44 Impropriety of conduct should be interpreted as meaning that the conduct in question must be objectively shown to have been in breach of the standards that would be expected of a person in the position of reasonable persons with the knowledge and duties, power and authority of, in the context of these proceedings, a medical practitioner in the circumstances: Chew v R [1992] HCA 18; (1992) 173 CLR 626.

45 Whilst there is no comprehensive exploration within the caselaw as to when unsatisfactory professional conduct can amount to professional misconduct, the concept is provided for within the terms of s 139E of the National Law, which must be given a purposive interpretation.

46 In determining whether the conduct in question amounts to professional misconduct, a deliberate departure from, or indifference to, accepted standards of practice can qualify as professional misconduct: Pillai v Messiter [No.2] (1989) 16 NSWLR 197, at page 200.

47 In determining whether or not the unsatisfactory professional conduct in question can amount to professional misconduct, there is no prohibition within s 139E for considering whether a pattern of unsatisfactory professional conduct can amount to professional misconduct, as was submitted by the HCCC in this case. Such an approach would be consistent with a purposive approach to the legislation.

48 It is a well-established principle that conditions of medical registration must be scrupulously observed: Prakash v HCCC [2006] NSWCA 153, at [74], following Re Dr Than Le [2001] NSWMT, 20 September 2001, at [95].

49 In formulating protective orders, the Tribunal is required to not only consider the object of protection of the public, but to recognise that object also includes deterring the practitioner, and other practitioners, from either repeating the misconduct or leaving it open to temptation to act in a manner that falls short of the required high standards of professional persons in positions of trust and confidence: Law Society of NSW v Foreman (1994) 34 NSWLR 408, per Giles JA, at page 471B.

50 The application of the foregoing principles does not first require a finding of dishonesty on the part of the practitioner. Recklessness is a sufficiently serious consideration to justify invoking sanctions to protect the public: Lee v HCCC [2012] NSWCA 80, at [67].

Principles relevant to consideration of the facts

51 The HCCC submitted that the subject matter of the complaints involve an important matter of principle, identified as being the necessity for overseas trained medical practitioners, whose qualifications are not recognised in Australia, to strictly comply with the regulatory regime that permits them to undertake professional work in Australia whilst going through the process of further supervision, training and qualification that will ultimately permit practice unconditionally with full registration. That principle is indisputable. The HCCC identified two relevant aspects of that regulatory regime.

52 First, an overseas trained medical practitioner has to obtain a visa that permits work as a medical practitioner. The general pathway by which this occurs is to obtain what is known as a 457 Visa issued by the Australian Government. The mechanism for obtaining such a visa is for an employer willing to employ the practitioner to agree to be a sponsor and offer the visa applicant a position as a medical practitioner. A 457 Visa is then granted specific to that employer who then agrees to supervise the practitioner whilst performing work in the approved position. Secondly, a person wishing to practise medicine in those circumstances must also obtain registration from the authority responsible for the registration of medical practitioners, in this instance, the Board, or its successor in title, the Council.

53 When Dr Saedlounia arrived in Australia in 2005, he was not entitled to full registration because the Board did not recognise his qualifications from Iran. However, in 2007, the Board determined that he was entitled to limited registration subject to specified conditions. The purpose of imposing those conditions was to ensure that Dr Saedlounia was appropriately supervised at all times whilst working in a medical capacity.

54 When a medical practitioner applies for the right to undertake professional work in a particular position at a particular institution, the Board undertakes a process of carefully formulating its requirements for conditions to ensure that the necessary level of supervision is identified and imposed in the interest of safety of the public.

55 In Dr Saedlounia's situation, as in any other similar situation, the Board did so by taking into account the situation of the proposed employers, the supervision available at the particular establishments where the employment would be available, who would actually provide the supervision, the nature of the work that was intended to be performed by the conditional registrant, and the level of risk involved in those circumstances. Only then is conditional registration, on identified terms, offered to an overseas trained medical practitioner, as was the case with Dr Saedlounia.

56 It is self-evident that if a conditional registrant commences to work in a professional environment other than the one that was assessed for suitability and made the subject of conditions, an hiatus occurs in the devised mechanism for safeguarding the protection of the public. The hiatus is constituted by the unauthorised employment situation where the Board's conditions and supervision requirements are absent. That is a matter of critical importance to the protection of the public.

57 It is also of critical importance that conditional registrants in the position of Dr Saedlounia at all relevant times, comply with all aspects of the regulatory regime that governs the right to work as a medical practitioner in Australia. Questions concerning the extent, if any, of harm that might have been caused by breaches of these conditions of governance are irrelevant, or at best, secondary to the paramount need to protect the health and safety of the public: s 3A of the National Law.

Submissions of the parties

58 Against the background of the above principles, none of which involved controversy, the HCCC submitted that whilst Dr Saedlounia's breach of his visa conditions might, on a superficial analysis, seem to be minor when viewed in isolation, however, when viewed in an overall context, they indicate a pattern of conduct in which Dr Saedlounia has shown disregard for the rules and regulations that governed his right to work as a medical practitioner in Australia. It was submitted that this pattern of conduct amounted to professional misconduct in this case. The HCCC submitted that this is a matter of critical importance and that such conduct ought not be condoned by the Tribunal in its deliberation on the matter.

59 The HCCC also submitted that in this case, a very important issue of deterrence arises for consideration in the framing of the protective orders.

60 Although Dr Saedlounia conceded that the conduct in question amounted to unsatisfactory professional conduct, he contested the submitted conclusion that his conduct amounted to professional misconduct. In the paragraphs that follow, the above submissions and the latter contention will be considered in relation to the respective complaints, and in the light of the explanations that Dr Saedlounia provided in respect of his actions.

Determination of Complaint 1 - unsatisfactory professional conduct

61 Complaint 1 particularised a single element of alleged unsatisfactory conduct concerning Dr Saedlounia's practise of medicine. This concerned his conduct, on 8 occasions between 26 September and 14 November 2009, when he provided locum general practitioner services for Carrington Centennial Care at the Grassmere Terrace Aged Care Facility. This activity was in contravention of the conditions of his registration, which required that he work as a Senior Resident Medical Officer in the field of Addiction Medicine at two specified clinics at Manly Hospital and at Royal North Shore Hospital.

62 In his supplementary statement dated 23 April 2013, at paragraph [3], Dr Saedlounia has admitted the conduct in question, and he has admitted that conduct amounts to unsatisfactory professional conduct. The Tribunal is satisfied to the required standard of proof that those admissions were appropriately made, and finds that Dr Saedlounia engaged in unsatisfactory professional conduct as particularised in Complaint 1.

63 The Tribunal is also satisfied that the conduct concerning Complaint 1 merits the making of protective orders. Those orders will be considered in light of the overall findings of the Tribunal concerning Complaint 2 and Complaint 3.

Determination of Complaint 2 - unsatisfactory professional conduct

64 Complaint 2 particularised five elements of alleged unsatisfactory professional conduct on the part of Dr Saedlounia whilst engaging in the practise, or the purported practise, of medicine. Those elements comprised:

(a) Dr Saedlounia's work at the Wellington District Hospital;

(b) Dr Saedlounia's work at Worksafe Medics;

(c) Dr Saedlounia's work at the Herbert Street Clinic for the Northern Sydney Drug and Alcohol Service;

(d) Dr Saedlounia's work for Carrington Centennial Services at the Grassmere Terrace Aged Care Facility;

(e) Dr Saedlounia's provision of a false and misleading curriculum vitae to Your World Recruitment agency.

65 Dr Saedlounia has admitted the particularised conduct occurred as alleged in the particulars of Complaint 2, but he has sought to downplay the significance of some of that conduct insofar as alleged unsatisfactory professional conduct is concerned. It is therefore necessary for the Tribunal to record its findings on each of the five identified elements.

Work at the Wellington Hospital

66 As to element (a) above, or Particular 1 of Complaint 2, and as summarised at paragraph [30] above, Dr Saedlounia ultimately conceded that by working at Wellington District Hospital as a General Practitioner/Visiting Medical Officer on the 62 particularised occasions between 1 December 2007 and 26 March 2008, when the conditions of his registration required him to work for his sponsor, the Wellington Corporation Aboriginal Health Service, in contravention of his 457 Visa, and his practice conditions. Dr Saedlounia conceded that these breaches amounted to improper or unethical conduct by him in the practise of medicine.

67 It is not a relevant answer to such breaches, for Dr Saedlounia to say that he had been encouraged to work at Wellington Hospital by the CEO of the Wellington Corporation Aboriginal Health Service. In this regard, of predominant relevance, is Dr Saedlounia's concession that it would have been wiser for him to check with the authorities before embarking on his sessional work at the Wellington District Hospital.

68 The Tribunal is of the view that such a course ought to have been obvious to Dr Saedlounia at all relevant times on a plain understanding of the terms of his visa and his conditional registration. In oral evidence Dr Saedlounia acknowledged that his approach to his visa and practice conditions was that he had not read them or checked them, as a responsible person acting responsibly should have done in the circumstances. In that regard the Tribunal is satisfied to the required standard of proof, based on Dr Saedlounia's own admission, that he wilfully allowed himself to be blinded to the details of his visa and practice conditions. This is a recognised phenomenon that sometimes occurs in the case of persons otherwise of capacity, who act irrationally, and contrary to their normal standards: Law Society of NSW v Foreman (1994) 34 NSWLR 408, at p 469F, per Giles JA.

69 Instead of checking his visa and practice conditions, Dr Saedlounia failed to do so, and made incorrect and unwarranted assumptions about the extent of his conditional practising rights.

70 In those circumstances, the Tribunal is of the view that such conduct involved a degree of carelessness on the part of Dr Saedlounia that amounts to recklessness: Lee v HCCC, at [67]. As a result, the Board's devised mechanism for the protection of the public was placed at risk, because Dr Saedlounia was practising without the level of supervision the Board had required in his circumstances on grounds of public safety.

71 The Tribunal regards these breaches as being of a serious character, and accordingly finds that the element of the particulars of Complaint 2 concerning unauthorised practice at the Wellington District Hospital demonstrate proof to the required standard, of unsatisfactory professional conduct on the part of Dr Saedlounia.

Work at Worksafe Medics

72 As to element (b) above, or Particular 2 of Complaint 2, as summarised at paragraph [31] above, Dr Saedlounia sought to downplay the significance of the work he had carried out at Worksafe Medics between 26 May 2008 and 28 January 2009. Whilst that work was characterised both by him and by the proprietor of that company, Dr Michael Shenouda, as comprising the position of a "clinical support person", the evidence, including the evidence of Dr Shenouda, did not entirely support Dr Saedlounia's claim of having been a clinical support person in the described circumstances.

73 Dr Shenouda described the work as comprising carrying out spirometry and audiology tests, assisting patients to fill out questionnaires and consent forms. Dr Shenouda also stated that there had been "a few occasions where [Dr Saedlounia] did work that could be interpreted as the work of a Medical Practitioner, but this was done under my supervision and for training purposes": Exhibit "F".

74 Dr Shenouda further explained that Dr Saedlounia "was certainly not permitted to perform any skin checks, but perhaps for training purposes": Exhibit "F".

75 The Tribunal is of the firm view that the above tasks as described by Dr Shenouda were tasks that should ordinarily be seen to be tasks carried out in the practise, or the purported practise, of medicine. It is difficult to see how inspecting the skin of workers for bruising and needle marks did not constitute the use or exercise of knowledge, skill, judgment and experience in the course of medical practice, so as to constitute the practise or purported practise of medicine. Furthermore, it is difficult to see how Dr Saedlounia accompanying a practice nurse to work sites to assess employees at those sites in the manner described, properly constituted supervision and training under Dr Shenouda, as has been asserted.

76 The Tribunal considers Dr Saedlounia's evidence that he had not introduced himself as a medical practitioner when carrying out the work required of him by Worksafe Medics was a misguided explanation, and lacked insight into the real question of how his involvement in those activities may have appeared to the lay persons or patients whom he was assessing on behalf of his employer. The Tribunal considers this to be a matter of some significance.

77 In light of Dr Shenouda's unchallenged evidence on the subject matter and content of Dr Saedlounia's work at Worksafe Medics, the Tribunal does not accept Dr Saedlounia's evidence that he did not carry out tasks in the practise or purported practise of medicine for Worksafe Medics. Instead the Tribunal accepts Dr Shenouda's account cited in Exhibit "F", as cited above, as being more likely to be correct, save for uncertainties over the level of supervision, which was in any event, not authorised by the Board.

78 That conclusion is a matter of some significance, as Dr Shenouda's company was not a designated area of need for the purposes of Dr Saedlounia's visa conditions, and neither the Australian Government nor the Board had authorised Dr Shenouda to provide Dr Saedlounia with supervision or training of any kind, nor did the Board authorise Dr Saedlounia to carry out the described activities and assessments involving patients who were being examined or assessed by Worksafe Medics.

79 The Tribunal therefore concludes and finds that Dr Saedlounia's work at Worksafe Medics was in contravention of the requirements of his visa and also in contravention of his conditional registration with the Board. As such, the Tribunal is satisfied to the required standard, that these events demonstrate unsatisfactory professional conduct on the part of Dr Saedlounia. In that regard, the Tribunal notes with concern that whilst Dr Saedlounia was working for Worksafe Medics, the protection of the public, which is usually an assumed matter that is provided for through the normal processes of accreditation and registration, was absent insofar as his contact with patients was concerned.

Work at the Herbert Street Clinic

80 As to element (c) above, or Particular 3 of Complaint 2, as summarised at paragraph [32] above, Dr Saedlounia admitted to being in breach of his visa conditions between 27 July and 7 August 2009, by working as a Senior Resident Medical Officer at the Herbert Street Clinic of the North Sydney Drug and Alcohol Service, notwithstanding that his visa conditions did not permit this employment.

81 The Tribunal has considered Dr Saedlounia's contention that those circumstances did not constitute a relevant breach of conditions because he had not been paid for the work in question. The Tribunal rejects that argument in view of Dr Saedlounia's concession that he performed the work in question with the expectation that he would be paid. It is not to the point that the reason he was not paid for that work was because the nominated employer had discovered it was not permitted by law to pay him as his visa did not allow that work to be undertaken by him. In the view of the Tribunal, because of Dr Saedlounia's expectation of payment, the distinction sought to be made by him is artificial, and does not operate as an exceptional circumstance.

82 In those circumstances, the Tribunal finds that it is satisfied to the required standard of proof, that in pursuing the particularised employment at the Herbert Street Clinic of the North Sydney Drug and Alcohol Service, Dr Saedlounia engaged in unsatisfactory professional conduct.

Work with Carrington / Grassmere Aged Care Facility

83 As to element (d) above, or Particular 4 of Complaint 2, as summarised at paragraph [33] above, although Dr Saedlounia conceded that he had worked with Carrington Centennial Care as a locum providing general practitioner services to the Grassmere Terrace Aged Care Facility, and that this work was in breach of visa conditions until 14 September 2009, he seeks to avoid a conclusion that such work constituted unethical, improper or unsatisfactory professional conduct because at the time he interpreted the words "may not", as included in his visa, as not constituting a prohibition on him carrying out work in addition to the work that he was conditionally authorised to pursue.

84 The Tribunal does not accept the submission to that effect made on behalf of Dr Saedlounia. The Tribunal sees this element of Dr Saedlounia's conduct as being in a similar category to element (a) or Particular 1 of Complaint 2 above, in that Dr Saedlounia had been careless or reckless concerning his obligation to ensure that he scrupulously complied with any applicable conditions placed on his practice.

85 In those circumstances, the Tribunal is satisfied to the required standard, that in respect of his employment which provided services at the Grassmere Terrace Aged Care Facility, Dr Saedlounia had engaged in unsatisfactory professional conduct.

Misleading Curriculum Vitae

86 As to element (e) above, or Particular 5 of Complaint 2, as summarised at paragraphs [34] - [36] above, the curriculum vitae that Dr Saedlounia provided to the YourWorld medical employment agency was plainly misleading in its content. That conclusion is compelling because, as he must have known, he had not worked in the position of an Occupational Medicine Physician (Casual) for Worksafe Medics, as was represented in the document.

87 The Tribunal does not accept Dr Saedlounia's explanation that this was a simple typographical error that had left out the prefatory description of Assistant in describing that position. That explanation was not included in any of Dr Saedlounia's statements prepared for these proceedings. It appeared for the first time in his oral evidence at the hearing. The Tribunal considers the answer to be glib and opportunistic. Similarly, the Tribunal does not accept Dr Saedlounia's portrayal of the circumstances of the misleading and incorrect description of his work experience with Worksafe Medics as a "misunderstanding".

88 The curriculum vitae in question was very obviously framed in order to enhance Dr Saedlounia's prospects of obtaining employment. It contained false and misleading particulars of his experience in medical practice, and this was known to Dr Saedlounia. The Tribunal is satisfied to the required standard, that in proffering his curriculum vitae with such misleading content, Dr Saedlounia's conduct amounted to improper and unethical conduct related to the practise or purported practise of medicine. The Tribunal therefore finds it is satisfied to the required standard of proof in respect of this fifth element of Complaint 2, that Dr Saedlounia engaged in unsatisfactory professional conduct.

Conclusion on Complaint 2

89 The Tribunal has found all elements of the unsatisfactory professional conduct in the practise or purported practise of medicine, as alleged against Dr Saedlounia, to have been proven to the required standard of proof. The question then arises as to whether the identified conduct should be seen as a pattern of unsatisfactory professional conduct. This is a matter to be determined in respect of Complaint 3.

Determination of Complaint 3 - Whether professional misconduct

90 Complaint 3 alleges that Dr Saedlounia had engaged in professional misconduct by reason of his admitted conduct that is the subject matter of Complaints 1 and 2.

91 The HCCC submitted that those matters, and the required findings of unsatisfactory professional conduct concerning those matters, which the Tribunal has in fact made in the preceding paragraphs, demonstrated a pattern of unsatisfactory conduct which justifies the conclusion that Dr Saedlounia had engaged in professional misconduct within the meaning of the test propounded within s 139E of the National Law.

92 In contrast, on behalf of Dr Saedlounia it was submitted that in the circumstances none of the conduct amounted to justification for a finding of professional misconduct. For support, that submission drew upon reasoning within a recent and differently constituted Medical Tribunal in which a finding of professional misconduct was not made: HCCC v Maendel [2013] NSWMT 3. That decision will therefore be considered for applicability to the present case.

93 In assessing whether professional misconduct has been demonstrated, the two limbs of the test propounded in s 139E must be analysed and applied to the circumstances under consideration. In this case, the focus for the analysis is whether a relevant pattern of unsatisfactory conduct has been demonstrated. That analysis must be guided by applicable authority, as well as observing appropriate and respectful comity with the approach taken in other Medical Tribunal decisions in analogous cases.

First limb - s 139E(a) of the National Law

94 In the circumstances of this case, the Tribunal is of the opinion that of themselves, the individual findings of unsatisfactory professional conduct concerning Complaints 1 and 2, when viewed alone, are not of a sufficiently serious nature to justify suspension or cancellation of Dr Saedlounia's practising rights: s 139E(a) of the National Law.

95 That conclusion does not end the consideration of the matter because these matters cannot be viewed in isolation from each other.

Second limb - s 139E(b) of the National Law

96 The HCCC submitted, in accordance with the second limb of s 139E, that when all of the instances of unsatisfactory professional conduct (which the Tribunal has found to have been the case in its consideration of Complaints 1 and 2) are considered together, in aggregate, they amount to conduct of a sufficiently serious nature that justifies suspension or cancellation of Dr Saedlounia's registration: s 139E(b) of the National Law.

97 On behalf of Dr Saedlounia it was argued that there should be no such finding in this case because the subject matter of the complaints were of an insufficiently serious nature to justify a finding of professional misconduct.

98 The pivotal foci of the consideration under s 139E(b) are first, the aggregation of the instances of unsatisfactory professional conduct, and secondly, the seriousness of the nature of those instances.

99 In undertaking the required analysis, the Tribunal has taken care to keep separate from the threshold consideration, matters that may serve to mitigate the consequences of Dr Saedlounia's conduct. Those matters of mitigation are more relevant to the separate consideration of the need for, and the nature and extent of, any required consequential protective orders.

100 At the centre of the findings concerning the instances of Dr Saedlounia's unsatisfactory professional conduct, is his admitted failure to take the necessary time and care to read and consider the implications of his visa and practice conditions to ensure that he would scrupulously comply with those conditions. The Tribunal has concluded that this was to the point of wilfully blinding himself to that knowledge, not on just one occasion, but serially.

101 These failures occurred on each of the occasions on which there was a potential for a conflict to arise between Dr Saedlounia's own interests in securing employment, and the public interest, being the need to protect the public by strictly and scrupulously complying with the requirements of his visa, and the practice conditions imposed upon him by the Board.

102 The Tribunal is of the opinion that these failures, when taken together, are of a very serious nature, and demonstrate that Dr Saedlounia had a lack of insight into the need for him to act scrupulously with regard to his conditions of practice in order to ensure that the public was protected. The Tribunal considers that, prima facie, and subject to analysing Dr Saedlounia's responses and submissions, these failures appear to be of a sufficiently serious nature to justify suspension or cancellation of Dr Saedlounia's registration.

103 In addition to the foregoing prima facie conclusions, Dr Saedlounia's actions in taking up unauthorised employment outside the terms of his visa and practising conditions, on more than just one or two occasions, namely, with Wellington District Hospital, the Grassmere Terrace Aged Care Facility, Worksafe Medics and The Herbert St Clinic, add confirmatory weight to that prima facie impression of seriousness. Even more weight is added to that prima facie impression from the circumstances in which Dr Saedlounia misrepresented the nature of his medical work experience in a misleading description of his employment history in his curriculum vitae.

104 In the opinion of the Tribunal, at a prima facie level, these matters, when aggregated, represent compelling reasons for concluding that Dr Saedlounia has engaged in a pattern of unsatisfactory professional conduct that is of a sufficiently serious nature to justify the suspension or cancellation of his practising rights: s 139E(b) of the National Law.

105 In view of that compelling prima facie analysis, it is necessary to examine the reasons in support of a contrary view, as was submitted on behalf of Dr Saedlounia. In addition to the matters raised by Dr Saedlounia and considered in the course of addressing the subject matter of Complaints 1 and 2, the following factors were said to contra-indicate a finding of professional misconduct in this case.

106 First, it was submitted that Dr Saedlounia's conduct should not be seen as involving recklessness, given his relative inexperience of the legal and medical systems in Australia, also considering the issue of language. That submission sought to categorise the conduct of Dr Saedlounia as involving repeated acts of carelessness rather than recklessness. The Tribunal does not accept that submission. In the context of this case such a distinction amounts to nothing more than semantics. Dr Saedlounia had a good grasp of the language. He had undertaken courses in English. The overarching consideration was his obligation to acquire an understanding of the conditions that applied to his practice and to scrupulously observe them. He did not do so. The Tribunal considers that degree of repeated carelessness over time involved a reckless attitude towards his responsibility to scrupulously comply with the conditions to which he was subject: Lee v HCCC, at [67]; Prakash v HCCC, at [74]; Re Dr Than Le, at [95].

107 Secondly, it was submitted that the lack of caution in Dr Saedlounia's conduct was not deliberate. The Tribunal does not accept this as being a relevant factor to be considered, especially given the finding that Dr Saedlounia, by his admitted conduct in not reading or seeking out a proper understanding of the conditions of his visa as they applied to him, wilfully blinded himself to the breaches of the conditions to which his practice was subject. The Tribunal is of the view that this level of indifference requires a finding of professional misconduct: Pillai v Messiter [No.2], at page 200.

108 Thirdly, it was submitted that a breach of visa conditions was an unusual basis upon which to base a complaint of professional misconduct. Whilst that may be so, the Tribunal does not accept that argument as a barrier to such a finding, and notes that the visa conditions underpinned Dr Saedlounia's right to practice conditionally. He could not have worked or trained without those visa conditions in place. The Tribunal considers that a breach of visa conditions in those circumstances is properly part of the overall fabric and pattern of the conduct that needs to be considered in evaluating whether there was professional misconduct: Pillai v Messiter [No.2], at page 200.

109 Fourthly, it was submitted that no harm has been shown to have occurred to any patient as a result of the matters raised in the complaints. The Tribunal does not see this as a relevant factor. It was entirely fortuitous that no patient came to harm. The relevant criterion on this issue is that the safety checks, balances and supervision requirements imposed by the Board were not met in the course of Dr Saedlounia's conduct. This created circumstances where, on multiple occasions, the public were not appropriately protected by the conditions the Board had imposed on Dr Saedlounia.

110 In seeking to avoid a finding of professional misconduct, Dr Saedlounia relied upon the manner in which professional misconduct was assessed in HCCC v Maendel [2013] NSWMT 3, which involved an accumulated course of events which, by majority in those proceedings, at [78], was held not to amount to professional misconduct.

111 This Tribunal does not accept that the aggregated circumstances of Dr Saedlounia's unsatisfactory professional conduct are comparable to the basal facts in HCCC v Maendel. In that case, at [64], it was found that the practitioner had made an initial wrong decision to treat his mother, and then took on a number of subsequent roles, some of which were based on family considerations and the assumed wishes of the patient, following which he was then subjected to a number of stressors that probably dominated his thought process and impeded his capacity to divert from the wrong clinical course he had initially chosen.

112 In contrast to the facts in HCCC v Maendel, Dr Saedlounia's unsatisfactory professional conduct was based on entirely different considerations that in large part emanated from his decision not to read the conditions to which his practice was subject. This led to a cascading series of breaches of those conditions over the course of an extended period of time between 2007 and 2009. This occurred in a variety of work settings on numerous occasions, and not comprising just one sentinel error of judgment involving one patient, as was the case in HCCC v Maendel.

113 For those reasons, this Tribunal considers that the decision in HCCC v Maendel is distinguishable from the present case, and offers no applicable analogy that requires a consideration and accommodation for comity of approach to the assessment of what amounts to professional misconduct.

114 Any assessment of whether professional misconduct has occurred, and whether the conduct in question is caught by the terms contemplated by the statutory definition of s 139E of the National Law must be based upon a recognition that each case must be determined according to its unique features. Whether misconduct has occurred is to be determined from the nature of the conduct in question, as was highlighted in HCCC v Maendel, at [67], citing Kirby P (as his Honour then was), in Pillai v Messiter [No. 2] (1989) 16 NSWLR 197, at page 200, which in turn cited the reference to Corpus Juris Secundum, vol 58, (1948) at 818.

115 On the foregoing considerations, the Tribunal is persuaded, that the prima facie impressions already identified, should be confirmed as the findings of the Tribunal. Accordingly, the Tribunal is satisfied to the required standard of proof, that Dr Saedlounia's pattern of unsatisfactory professional conduct, when considered together, is of a sufficiently serious nature that satisfies the test for justifying a finding of professional misconduct: s 139E(b) of the National Law.

116 The Tribunal therefore makes the finding that Dr Saedlounia has engaged in professional misconduct as alleged in the particulars of Complaint 3.

117 That said, it does not necessarily follow that suspension or cancellation of registration is the inevitable consequence of such a finding.

Consideration of the need for protective orders

118 The preceding findings of the Tribunal against Dr Saedlounia on each of the respective complaints makes it necessary to consider the need to impose protective orders in the circumstances.

119 On behalf of Dr Saedlounia, it was submitted time has overtaken the events in question, in that since those events, he has gained the required recognition of his qualifications, and he has satisfied the requirements of the examiners for Fellowship of the Royal Australian College of General Practitioners. It was argued that in such circumstances, the need for protective orders takes on a diminished importance in this case.

120 For the reasons that follow, the Tribunal does not accept the validity or the substance of that submission.

121 In addition to satisfying the required theoretical and clinical acumen thresholds as necessary preconditions for the grant of a licence to practise medicine, practitioners so licensed are required to conduct themselves with the high standards of personal and professional probity expected of members of an honourable profession. Those expectations must necessarily be seen as extending to the requirement of scrupulously observing conditions of practice: s 139B(1).

122 When the Australian Government initially granted, and from time to time varied, Dr Saedlounia's 457 Visa, it did so in order to enable him to work in limited circumstances under the conditions imposed by the Board, whilst at the same time, and in the public interest, satisfy an unfulfilled area of community need in medical practice. That need was accommodated by extending practising privileges to Dr Saedlounia and at the same time requiring him to limit his practice to the defined conditions. In that way, his visa conditions and his conditional registration were linked conditions.

123 When from time to time, the Board placed conditions on Dr Saedlounia's right to practice, this also had the effect of limiting his right to practice until an appropriate period of time was considered to have elapsed for the Board and its successor the Council, to be satisfied that Dr Saedlounia should be granted the privilege of having full rights of practice after completing a specified period of further training and practice under supervision.

124 Those two separate sets of conditions were not designed to be in any way punitive to Dr Saedlounia. The conditions were entirely protective of the public and they were in the public interest. The sole purpose of those conditions was to provide a mechanism whereby public confidence could be satisfied that whilst Dr Saedlounia was proceeding to fulfil the requirements of full registration, professional work did not pose a needless risk to the safety of members of the public with whom he would come into contact when providing medical treatment.

125 It is against that background that the admitted and found breaches of applicable conditions must be viewed. Also relevant to the consideration of the relative seriousness of the breaches of Dr Saedlounia's conditions of practice, is the element of the public interest in ensuring that conduct that falls short of the required standards of probity for fitness to practice is appropriately dealt with, censured and not condoned: Law Society of NSW v Foreman, at page 471B-C.

126 Within that formulation, there is a strong need to deter the likelihood of further lapses in standards, both insofar as the individual practitioner is concerned, and at the same time signal to practitioners in similar circumstances of conditional practising rights, that a failure to observe important conditions of registration will not be condoned, especially where, as a result, the public has been placed at potential risk due to non-compliance with justifiably imposed conditions of practice.

127 In the circumstances particularised in the respective complaints, the Tribunal is comfortably satisfied that Dr Saedlounia has flouted his conditions of practice. The Tribunal considers that the explanations proffered by Dr Saedlounia for his failure to abide by his conditions of practice were glib, and aimed at downplaying the significance of those breaches. When Dr Saedlounia's explanations were explored, even after making due allowance for the possibility that there may have been cultural factors that could have influenced his explanations, the Tribunal nevertheless does not regard the proffered explanations to be exculpatory.

128 In determining the appropriate protective orders, the following factors are relevant to the consideration:

(a) The seriousness of the misconduct;

(b) The admissions made by the practitioner;

(c) The expressed contrition and the responsibility taken by the practitioner;

(d) The risk of re-offending;

(e) The need for deterrence.

129 As to (a) above, in this case, the misconduct was of a very serious character because when Dr Saedlounia effectively blinded himself to his conditions of practice, this resulted in a serious and repeated compromise of patient safety due to his unsupervised practise or purported practise of medicine. It is irrelevant that no episodes of consequential harm have been identified.

130 As to (b) above, the admissions made by Dr Saedlounia were guarded and were clearly aimed at avoidance of the disciplinary consequences of his actions.

131 As to (c) above, Dr Saedlounia's expressions of contrition and remorse were guarded and glib. He sought to avoid the consequences of his conduct by claiming his breaches were due to inadvertence and misunderstandings, and a selective misinterpretation of what his conditions permitted him to do by way of professional work. The Tribunal considers that those explanations by Dr Saedlounia indicated he had difficulty in facing up to the consequences of his actions.

132 As to (d) above, Dr Saedlounia gave assurances that he would not re-offend. He did so in the following terms:

"Q. ... [W]hat steps do you think would be necessary to take to ensure that you have a proper understanding of any applicable conditions?

A. Your Honour, you are in the position to answer that, but if you're asking me to answer it is to monitor and observe me to see I'm following the instructions.

Q. The question arises because you said that it's your intention to legitimately and diligently obey conditions, but the prerequisite to that state of mind is the acquisition of an understanding of what the conditions require and so my question is, how would you go about ensuring your understanding is adequate?

A. So I read the condition or conditions, if it is clear for me I obey them directly, if there is any issues needs clarification I will ask the expert person or persons or authorities and I will definitely understand what the concerns are and I will follow the instructions subsequently."

133 The Tribunal is of the view that such assurances need to be tested by a significant period of supervision and mentoring in order that the Council can have confidence that those assurances are likely to be met in the future, notwithstanding that since the conduct complained of, Dr Saedlounia has satisfied the examiners of the Royal Australian College of General Practitioners, and has been enlisted as an occasional examiner himself. We consider that such supervision and mentoring is the appropriate means by which to ensure that the past episodes of wilful blindness to the requirements of conditions on his practice will not recur, and so that the required high standards of his profession, will be met.

134 As to (e) above, in view of Dr Saedlounia's past failures to comply with conditions, including his selective failure to read important details affecting his right to practice, the Tribunal is of the view that a strong signal of deterrence is required to protect the public and to maintain the required high professional standards: Law Society of NSW v Foreman, at page 471A-B; Lee v HCCC [2012] NSWCA 80, at [31]; HCCC v Litchfield (1977) 41 NSWLR 630 at page 637D-E; Saville v HCCC (2006) NSWCA 298, at [45].

135 It is against that background that appropriate protective orders must be framed. The Tribunal emphasises that in framing the protective orders, apart from a fine, they are not intended to be punitive, although they may be seen as having that effect. The position with regard to a fine in this case is that it is required as a deterrence, and not as a punishment, although it might be seen differently by some.

136 The Tribunal has concluded that Dr Saedlounia should be censured for the found breaches of professional standards. The Tribunal has determined that the appropriate censure should be for the practitioner to be publicly reprimanded in these reasons.

137 The Tribunal has also concluded that a fine should be imposed on the practitioner as a strong signal of deterrence. Such deterrence serves a twofold purpose. First, it is intended to operate as a deterrence to the practitioner to ensure there is no repetition of an attitude of indifference, carelessness or recklessness with regard to regulatory requirements and any lapse in required standards of professional conduct. Secondly, it is intended to deter other persons with conditions on their practising rights and on their conditional visas from disregarding the need for protection of the public in the practice of medicine by ignoring or flouting conditions aimed at ensuring the protection of the public by adherence to the high standards of personal probity and conduct expected of registered medical practitioners. The Tribunal is of the view that the amount of the fine should be a significant deterrent, and has determined that the appropriate amount under s 146B of the National Law, should be 50 penalty units, which under s 17 of the Crimes Sentencing Procedure Act 1999, is equivalent to the sum of $5,500.

138 The Tribunal is also of the view that at his own expense, the practitioner should, within 12 months of today's date, complete a recognised course on medical ethics, and that he should for the next 2 years, have the benefit of a professional mentor and a separate professional supervisor to provide him with the opportunity to consolidate and reinforce adherence to ethical standards of practice. The Tribunal recognises that these conditions are onerous, but considers they are nonetheless necessary in light of past breaches to ensure adherence to proper standards of practice. Scope will be incorporated within the protective orders for variations of these orders by the Council should the Council consider they are no longer necessary for the protection of the public.

139 The Tribunal is also of the view that to ensure safety of the public, in light of the events that are the subject of these complaints, and unless the Council otherwise directs, the practitioner should be required, for the next 5 years from today's date, to provide the Council with copies of any professional curriculum vitae he provides to any person, and that he also provides any future employer with a copy of these reasons of the Tribunal.

Findings

140 The Tribunal makes the following findings:

(1) The practitioner is found to have engaged in unsatisfactory professional conduct as alleged in Complaints 1 and 2;

(2) The practitioner is found to have engaged in professional misconduct as alleged in Complaint 3.

Protective orders

141 The Tribunal makes the following protective orders:

(1) The practitioner is reprimanded;

(2) The practitioner is fined the sum of $5,500 to be paid to the Council on or before the expiry of 90 days from the date of these reasons;

(3) The practitioner is to pay the applicant's costs of these proceedings.

(4) For a period of 2 years from 21 June 2013, the practitioner's registration permitting him to engage in the practice of medicine is to be subject to conditions in the form that immediately follows.

Practice Conditions

142 The practice conditions referred to in sub-paragraph [4] of paragraph [141] above are as follows:

(1) The practitioner is to complete at his own expense the course on Medical Ethics conducted in distance mode by the Department of General Practice, Monash University, Victoria:

(a) The course must be completed within twelve months of the date of the Medical Tribunal decision;

(b) The practitioner must provide evidence of enrolment in the course within six months of the date of the Medical Tribunal decision;

(c) Upon completion of the course the practitioner is to provide documentary evidence to the Medical Council that he has satisfactorily completed the course.

(2) Within 14 days of receipt of the Medical Tribunal decision the practitioner is to provide for approval by the NSW Medical Council the name and professional address of a registered practitioner who has agreed to act as his professional mentor. The nature and frequency of contact with the mentor is to be determined by the mentor in accordance with the NSW Medical Council's Guidelines for mentors. The mentor is to be provided with a copy of Policy PCH 10 and a copy of this Medical Tribunal decision and the relevant orders:

(a) He is to authorise the mentor to report, in an approved format, to the NSW Medical Council every three months about the fact of contact, and to inform the NSW Medical Council if there is any concern about his professional conduct or personal wellbeing;

(b) He is to authorise the mentor to notify the NSW Medical Council of any failure to attend, termination of the mentoring relationship against the advice of the mentor, or any other matter the mentor considers appropriate;

(c) He will meet with the mentor for an initial period of 12 months from the date of the first consultation and thereafter for such period as the NSW Medical Council may determine / authorises the mentor to notify the NSW Medical Council when of the view that professional mentoring is no longer required;

(d) In the event that the approved mentor is no longer willing or able to continue as mentor, the practitioner is to nominate another mentor for approval by the NSW Medical Board within 28 days of the cessation of the original mentor relationship;

(e) The practitioner is to be responsible for any costs associated with the mentoring process.

(3) The practitioner is to nominate a supervisor within the next 28 days to be approved by the NSW Medical Council, to monitor and review his clinical practice and compliance with (Practice) Conditions in accordance with Level 3 Supervision as contained in the NSW Medical Council's Guidelines for Supervision (Policy PCH 7.4). The supervisor is to be provided with a copy of the NSW Medical Board's Policy PCH 7.4 and a copy of this Medical Tribunal decision. The practitioner is to be responsible for all costs associated with the supervision arrangement. The practitioner is to ensure that:

(a) He and the supervisor meet on a fortnightly basis for at least one hour, the first meeting to occur within one month of being advised by the NSW Medical Board that his nominated supervisor has been approved.

(b) At each meeting they address any relevant ethical issues, compliance with practice conditions, and any other matter relevant to the practitioner's practice.

(c) At each meeting, the supervisor completes a record of matters discussed at the meeting in a format prescribed or approved by the NSW Medical Council.

(d) The supervisor forwards to the NSW Medical Council, on a monthly basis a Supervision Report in a format prescribed or approved by the NSW Medical Council.

(e) The supervisor is authorised to inform the NSW Medical Council immediately if there is any concern in relation to the practitioner's compliance with the supervision requirements, compliance with other conditions of registration, clinical performance, health or if the supervisor relationship ceases.

(f) In the event that the approved supervisor is no longer willing or able to provide the supervision required, details of a replacement supervisor are forwarded for approval by the NSW Medical Council within 21 days of the cessation of the original supervisory relationship.

(g) The practitioner is to be responsible for any costs associated with the supervision process.

(4) Unless otherwise directed by the Council, the practitioner is to provide to the Council a copy of any professional Curriculum Vitae he provides to any person in the next 5 years.

(5) Unless otherwise directed by the Council, during the next 5 years, the practitioner is to provide a copy of this Tribunal Decision to all of his future employers, supervisors and mentors.

Review body for NSW and interstate review of conditions

(6) These conditions may be altered, varied or removed by the Medical Council of New South Wales and the Medical Council is the appropriate review body for the purposes of Division 8 of Part 8 of the Health Practitioner Regulation National Law (NSW).

(7) If the practitioner seeks to change or remove any of the conditions imposed as a result of the Tribunal's orders when his principal place of practice is anywhere in Australia other than in New South Wales, sections 125 to 127 inclusive of the Health Practitioner Regulation National Law are to apply, so that a review of these conditions can be conducted by the Medical Board of Australia.

 

Appendix

Statement of Agreed Facts

(Typographical errors as in the original)

Background

1. In 2000, Dr Saedlounia obtained a Bachelor of Medicine, Bachelor of Surgery from the Islamic Azad University (Tehran, Iran). In 2002, he obtained a Doctorate in medicine from the same university.

2. He migrated to Australia in 2005.

3. Between 19 May 2005 and 21 May 2007 Dr Saedlounia was entitled to remain and work in Australia pursuant to a work and holiday visa.

First registration as a medical practitioner

4. Prior to 1 July 2010, the former NSW Medical Board ("the Board") administered the Medical Practice Act 1992 (the "repealed Act") and was responsible for the registration and co-regulation of medical practitioners in New South Wales (co-regulation with the Health Care Complaints Commission).

5. The Board had the responsibility to ensure medical practitioners are fit to practise medicine and that they maintain proper standards of conduct and competence.

6. Pursuant to s 4 of the repealed Act, a person was entitled to be registered as a medical practitioner if he or she had "recognised medical qualifications" (as defined in the repealed Act) and had successfully completed a period of internship or supervised training as required by the Board.

7. A Bachelor of Medicine, Bachelor of Surgery and a Doctorate in Medicine from the Islamic Azad University (Tehran, Iran) (the qualification obtained by Dr Saedlounia in 2000 and 2002 respectively) were not a "recognised medical qualification" for the purposes of the repealed Act.

8. Pursuant to s 7 of the repealed Act, the Board had a discretion to grant conditional registration in certain circumstances to persons who were entitled to general registration under s 4.

9. A person could be registered under s 7(1)D at the discretion of the Board for the purpose of enabling an unmet area of need to be met if the Board was satisfied that the person had suitable qualifications and experience to practise medicine in that area of need.

10. A person could be registered under s 7(1)G at the discretion of the Board on a temporary basis if the Board was satisfied that it was in the public interest to do so.

11. Overseas trained doctors who did not qualify for general registration under s 4 of the repealed Act, could be granted limited and conditional registration under s 7 of the repealed Act. This allowed overseas trained doctors registered under s7 to provide medical services under supervision.

12. On 1 March 2007 Dr Seadlounia was registered as a medical practitioner in NSW under s 7(1)D of the repealed Act as a Conditional Area of Need Registrant, with the registration limited to medical practice under supervision at the Wellington Aboriginal Corporation Health Service. Additional condition 2 required that "Dr Saedlounia should have some contact with Wellington and Dubbo Base Hospitals. This is an introduction to hospital and specialist staff, and being show the facilities the hospital offers. It would not need to be a medical training or assessment exercise".

First grant of a 457 visa

13. At all relevant times, Australian employers have been able to sponsor overseas doctors to work in Australia for up to 4 years on a Temporary Business (Long Stay) - Standard Business Sponsorship Visa ("457 visa").

14. 457 visas are the usual pathway to permanent residency for doctors who do not yet hold full medical registration in Australia. Overseas trained doctors can commence a period of supervised practice and formal assessment in Australia by working under a 457 visa to meet the requirements for full medical registration.

15. On 21 May 2007 Dr Saedlounia was granted a 457 visa, with: Sponsor listed as Wellington Aboriginal Corporation Health Service; Primary Visa Holder Occupation listed as General Practitioner; and Location/Postcode of proposed employment listed as the postcode for Wellington, NSW ("the original 457 visa"). The original 457 visa was in effect until 8 October 2009.

16. At the time of grant of the original 457 visa, all 457 visas were subject to condition 8107, which then provided that the visa holder must not:

(a) If the visa was granted to enable the holder to be employed in Australia:

i. cease to be employed by the employer in relation to which the visa was granted; or

ii. work in a position or occupation inconsistent with the position or occupation in relation to which the visa was granted; or

iii. engage in work for another person or on the holder's own account while undertaking the employment in relation to which the visa was granted.

Changes to registration and work at Wellington District Hospital

17. In October 2007, Dr Saedlounia's registration as a medical practitioner was modified by the Board to include the position of Visiting Medical Officer at the Wellington District Hospital.

18. Between 1 December 2007 and 2 April 2008, as well as working for the Wellington Aboriginal Health Corporation, Dr Saedlounia worked for Wellington District Hospital as General Practitioner Visiting Medical Officer on:

1, 12, 13, 14, 18, 19, 20, 22, 24, 25, 26, 27, 28 December 2007;

1, 10, 11, 14, 15, 16, 22, 25, 26, , 29, 30, 31 January 2008;

1, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 19, 21, 26, 27, 29 February 2008;

1, 4, 6, 7, 8, 11, 12, 13, 15, 16, 17, 18, 20, 21, 22, 25, 26 March 2008;

1, 2 April 2008.

19. This was in breach of condition 8107 of his original 457 visa. It was not in breach of his registration by the Board.

20. On 23 May 2008, the Board withdrew Dr Saedlounia's registration as a medical practitioner following advice by the Wellington Aboriginal Corporation Health Service that it was no longer to provide appropriate supervision due to a lack of staff.

21. Between 23 May 2008 and 29 July, Dr Saedlounia was not registered as a medical practitioner.

Work at Worksafe Medics

22. Between 26 May 2008 and 28 January 2009, Dr Saedlounia worked for Worksafe Medics as a casual clinical support person on:

(a) 26 May 2008;

(b) 2, 16, 23, 30 June 2008;

(c) 7, 17, 29 July 2008;

(d) 8 August 2008;

(e) 1, 23 September 2008;

(f) 2 October 2008;

(g) 21 November 2008;

(h) 12 December 2008;

(i) 28 January 2009.

23. The duties he was required to perform included spirometry, audiometry testing, urine and drug screening and requesting patients to answer a standard questionnaire related to their medical and alcohol/drug history.

24. None of the work that Dr Saedlounia was employed to perform for Worksafe Medics required him to be a medical practitioner.

25. Dr Saedlounia's employment by Worksafe Medics was in breach of condition 8107 of his original 457 visa, which required that he work only as a General Practitioner at Wellington Aboriginal Corporation Health Service.

Second registration as a medical practitioner

26. On 29 July 2009, Dr Saedlounia was granted public interest category registration as a medical practitioner by the Board valid until 24 July 2010 subject to the following conditions:

"To work under supervision in position/s approved by the Board;

(a) Position: SENIOR RESIDENT MEDICAL OFFICER

(b) Field: ADDICTION MEDICINE

(c) Location: SYDNEY ROAD CLINIC MANLY, HERBERT STREET CLINIC ROYAL NORTH SHORE HOSPITAL, MANLY HOSPITAL

May not undertake any work as a medical practitioner outside the approve position/s.

To demonstrate satisfactory performance in accordance with the Board's requirements.

Must provide the Board with supervision reports each quarter - 24th October2009, 24th January 2010, 24th April 2010 & 24th July 2010."

Work at Herbert St Clinic

27. From 27 July 2009 to 7 August 2009,Dr Seadlounia worked as a Senior Resident Medical Officer at the Herbert St Clinic of the Northern Sydney Drug and Alcohol service, supervised by Dr Dore. This was in breach of condition 1807 of his original 457 visa.

28. On 8 August 2009, Dr Saedlounia was stood down from his position at the Herbert St Clinic because he was informed by Dr Dore that his visa did not permit him to work there.

29. On 8 August 2009 Dr Saedlounia lodged an application for a new 457 visa.

30. Dr Saedlounia received no income for the work undertaken by him at Herbert St Clinic in that period.

Work at Grassmere Terrace

31. In about early August 2009, Dr Saedlounia provided his curriculum vitae to Yourworld Recruitment agency. A copy of the curricumlum vitae is at tab 22. It describes his position at Worksafe Medics as "Occupational Medical Practitioner (Casual)". It is inaccurate as he was not working there as a medical practitioner but as a support person/assistant to Dr Shenouda, a registered medical practitioner.

32. On 14 September 2009, legislative amendments to condition 8107 allowed medical practitioners on a 457 visa to have "flexible working arrangements". Since this date, doctors holding a subclass 457 visa must still work in their nominated occupation but they can work for employers other than their sponsor or an associated entity of their sponsor without the need for futher application.

33. The effect of this change was that from 14 September 2009, under his original 457 visa, Dr Saedlounia was authorized to work for employers other than Wellington Aboriginal Corporation Health Service, but only as a General Practitioner.

34. In late September 2009, YourWorld Recruitment placed Dr Saedlounia in a position at Grasmere Terrace Aged Care Facility, working as a locum general practitioner.

35. Between 26 September 2009 and 14 November 2009 Dr Saedlounia worked for Carrington Centennial Care as a locum general practitioner, providing services at Grasmere Terrace Aged Care Facility on:

a. 26 September 2009

b. 3,10, 18, 24, 31 October 2009

c. 7, 14 November 2009.

36. This was in breach of the conditions of his registration with the Board as such a position had not been approved by the Medical Board.

Grant of a new 457 visa

37. On 8 October 2009 Dr Saedlounia was granted a new 457 visa, with condition 1807 (as amended on 14 September 2009) imposed with: Sponsor listed as Northern Sydney and Central Coast Area Health Service; Primary Visa Holder Occupation listed as Psychiatry Registrar and Location/Postcode of proposed employment listed as 2059 ("the new 457 visa").

38. The effect of the grant of the new 457 visa was that Dr Saedlounia was authorized to work as a Psychiatry registrar only. Dr Saedlounia contravened the conditions of his new 457 visa by working as a General Practitioner at Grasmere Terrace Aged Care Facility (see paragraph 35 above) for the period between 9 October and 14 November, but not for the period between 14 September 2009 - 8 October 2009.

Return to Herbert St Clinic

39. On 9 October 2009 Dr Saedlounia forwarded to Dr Dore at the Royal North Shore Hosptial by email a confirmation from the Immigration Office that Dr Saedlounia had been granted the new 457 visa and setting out the terms and conditions of that visa.

40. On 9 November 2009, Dr Saedlounia was reinstated to his position at the Herbert Street Clinic, supervised by Dr Dore.

41. On 17 and 20 November 2009, Dr Dore wrote to the Board complaining, inter alia, that Dr Saedlounia appeared to have worked as a medical practitioner at another facility during the period he was stood down from the Herbert St Clinic.

42. On 20 November 2009 Dr Saedlounia resigned from his position at the Herbert St Clinic.

43. On 23 November 2009, the Board withdrew Dr Seadlounia's registration as a medical practitioner because it had received notification from Dr Dore that Dr Saedlounia had resigned from his position at the Herbert St Clinic and that, had he not done so, Dr Dore would have withdrawn as his supervisor.

Subsequent registration as a medical practitioner

44. On 1 December 2009 Dr Saedlounia was granted limited registration as a medical practitioner in Victoria, to practice as a General Practitioner in an Area of Need at the Elmwood Medical Centre in Wodonga, Victoria, under the supervision of Dr Thant Syn and Dr L Moran, having applied for that registration in about October 2009. This limited registration expired on 22 December 2011.

45. On 1 July 2010 the National Law came into effect.

46. From 22 December 2011 to current, Dr Saedlounia has been registered as a specialist General Practitioner with no conditions, practicing in a group medical practice at Rouse Hill, NSW, having been admitted as a Fellow of the RACGP in June 2011.

47. On 26 March 2013, Dr Saedlounia acquired Australian citizenship.

48. No proceedings have been initiated against Dr Saedlounia by the Department of Immigration and Citizenship in respect of any alleged offences.

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Amendments

16 July 2013 - Name of solicitor for applicant
Amended paragraphs: Representation

16 July 2013 - Slip Rule correction to paragraph [137]
Amended paragraphs: 137

Decision last updated: 16 July 2013