As from December 3, 2015, the following voluntary cease-to-practise Undertaking
by Dr. Martin Lorne Charlat is imposed as a term, condition and limitation on
the certificate of registration held by Dr. Charlat:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. MARTIN LORNE CHARLAT
("Dr. Charlat")
to
COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
(the "College")
________________________________________________________________________
A. PREAMBLE
(1) Dr. Charlat, certificate of registration number 58885, am a member of the
College. The College has inquired into my compliance with the requirement
to participate in a program of continuing professional development.
(2) I, Dr. Charlat, am currently not practising medicine in Ontario and I am
entering into this Undertaking as an alternative to complying with the
Continuing Professional Development requirement under section 29 of
Ontario Regulation 114/94 (made under the Medicine Act, 1991).
B. UNDERTAKING
(3) I, Dr. Charlat, undertake that, effective immediately, I will not
practise medicine in Ontario until each and every one of the following
conditions have been met:
(a) I provide a minimum of forty-five (45) days' notice to the College
of my intent to return to the practice of medicine;
(b) I provide the College with proof that I am participating in a
program of continuing professional development that meets the
requirements for continuing professional development of the Royal
College of Physicians and Surgeons of Canada, the College of Family
Physicians of Canada, or an organization that has been approved by
the College for that purpose that meets the requirements for
continuing professional development set by the Royal College of
Physicians and Surgeons of Canada or the College of Family
Physicians of Canada; and
(c) The College approves my return to the practice of medicine.
(4) I, Dr. Charlat, undertake that upon signing this Undertaking I shall
forward a request to the General Manager of the Ontario Health Insurance
Plan ("OHIP") that my billing number be deactivated for services rendered
after the date I cease to practise and before the date the College agrees
that I may return to practise in accordance with the provisions of this
Undertaking. If I do not have an active OHIP billing number, I undertake
to provide proof of same to the College.
(5) I, Dr. Charlat, undertake to abide by the College's Policy on Practice
Management Considerations for Physicians Who Cease to Practise, Take an
Extended Leave of Absence or Close Their Practice Due to Relocation, a
copy of which is attached hereto as Appendix "A".
C. ACKNOWLEDGEMENTS
(6) I, Dr. Charlat, acknowledge that all appendices attached to or referred
to in this Undertaking form part of this Undertaking.
(7) I, Dr. Charlat, acknowledge and agree that in considering my request to
return to practice, the Registrar may, among other things:
(a) request that I agree to specified terms, limitations or conditions
being placed upon my certificate of registration; and
(b) request that I enter into an appropriate assessment and/or
monitoring agreement with the College.
(8) I, Dr. Charlat, acknowledge and agree that I shall be solely responsible
for payment of all fees, costs, charges, expenses, etc. arising from the
implementation of any of the provisions of this Undertaking.
(9) I, Dr. Charlat, undertake to comply with the provisions and conditions of
this Undertaking and acknowledge that a breach by me of any provision of
this Undertaking may constitute an act of professional misconduct and/or
incompetence, and may result in a referral of specified allegations to
the Discipline Committee or Fitness to Practise Committee of the College.
(10) I, Dr. Charlat, acknowledge and confirm that I have read and understand
the provisions of this Undertaking and that I have obtained independent
legal counsel in reviewing and executing this Undertaking, or have waived
my right to do so.
(11) I, Dr. Charlat, acknowledge that this entire Undertaking constitutes
terms, conditions, and limitations on my certificate of registration for
the purposes of section 23 of the Health Professions Procedural Code,
which is Schedule 2 to the Regulated Health Professions Act, 1991, S.O.
1991, c. 18, as amended. I understand that this Undertaking shall be
information on the College's Register that is available to the public
during the time period that the Undertaking remains in effect.
(12) I, Dr. Charlat, acknowledge that the following summary will appear on the
College's Register that is available to the public during the time period
that this Undertaking remains in effect:
Dr. Charlat has voluntarily ceased to practise medicine in Ontario
and therefore cannot see any patients or provide any medical advice
or services.
D. CONSENT
(13) I, Dr. Charlat, give my irrevocable consent to the College to make
appropriate enquiries of OHIP and/or any person or institution who may
have relevant information, in order for the College to monitor my
compliance with the provisions of this Undertaking.
(14) I, Dr. Charlat, acknowledge that I have executed the OHIP consent form,
attached hereto as Appendix "B" and that the consent forms part of this
Undertaking.
Terms and conditions imposed on certificate by: Member