By order of the Executive Committee of the College of Physicians and Surgeons
of Ontario, the following Undertaking from Dr. Philip Daniel Kernerman is
imposed as terms, conditions and limitations on Dr. Kernerman's certificate of
registration, effective March 27, 2019:
SCHEDULE "A"
TO THE ORDER OF THE EXECUTIVE COMMITTEE OF
THE COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. PHILIP DANIEL KERNERMAN
("Dr. Kernerman")
to
THE COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
("the College")
A. PREAMBLE
(1) I, Dr. Kernerman, acknowledge that the Executive Committee of the
College, pursuant to s.74(1) of the Health Professions Procedural Code,
reinstated my certificate of registration on June 24, 2014, and the
imposed terms, conditions, and limitations on my certificate of
registration as set out in the Undertaking I executed on June 25, 2014.
(2) I, Dr. Kernerman, understand and agree that this Undertaking replaces the
Undertaking I executed on June 25, 2014, and that I will be bound by the
terms, conditions and limitations imposed on my certificate of
registration, as well as the terms of this Undertaking from the date on
which I sign it.
B. UNDERTAKING
Phase One
Practice Restriction: Not the MRP
(3) I, Dr. Kernerman, undertake that I shall not engage in the practice of
medicine as the Most Responsible Physician ("MRP"), as that term is
defined in the Guidelines for College-Directed Supervision, until
approved to do so by the College in writing, and shall practise only in a
practice setting approved by the College and in accordance with the
Re-entering Practice Plan defined below.
Practice Restriction: Ambulatory-Care Internal Medicine
(4) I, Dr. Kernerman, undertake that I shall practice only ambulatory or
office-based internal care medicine unless and until the following
conditions are met:
i) I have successfully completed Phase One and Phase Two of the
Re-Entering Practice Plan and Clinical Supervision as set out in
paragraphs 5-11 below;
ii) I have successfully completed an Assessment of my practice as set
out in paragraphs 22-25 below; and
iii) The College has reviewed the reports of my Clinical Supervisor(s)
and Assessor(s) and has approved me to return to hospital-based
internal medicine practice.
Re-entering Practice Plan and Clinical Supervision
(5) I, Dr. Kernerman, undertake to complete a Re-entering Practice Plan in
internal medicine (the "Re-entering Practice Plan") under the guidance
and supervision of a clinical supervisor acceptable to the College (the
"Clinical Supervisor"). The Clinical Supervisor must have experience
supervising in a post-graduate medical education setting. The
Re-entering Practice Plan must be approved in advance by the College and:
i) Prior to the commencement of the Re-entering Practice Plan, I shall
submit, for the College's approval, an Individualized Educational
Plan prepared by my Clinical Supervisor and the College;
ii) Phase One (the Re-entering Practice Plan) shall be a minimum of
twelve (12) months from the commencement of my re-entry to
practice, in which I am restricted from being the MRP and practice
under the high supervision of a Clinical Supervisor who will be
required to report to the College on a monthly basis throughout
Phase One of this Undertaking;
iii) I shall only practise in a clinical setting approved by the
College, and during Phase One, will be a setting in which the staff
have experience supervising post-graduate medical trainees.
(6) I, Dr. Kernerman, acknowledge that I have reviewed the Clinical
Supervisor's Undertaking attached hereto as Appendix "A" and understand
what is required of the Clinical Supervisor. I understand that I may not
engage in the practice of medicine until such time as I have obtained a
Clinical Supervisor, acceptable to the College, and the Clinical
Supervisor has executed the aforementioned Undertaking.
Phase Two
Clinical Supervision
(7) I, Dr. Kernerman, agree that after practising for at least twelve (12)
months under Phase One of my Re-entering Practice Plan, and upon
satisfactory reports, as determined by the College in its sole
discretion, from all Clinical Supervisors and physicians involved in my
re-training who have reported to my Clinical Supervisor, the College may
allow me to be the MRP under moderate-level supervision as defined in the
Guidelines for College-Directed Supervision. I shall be required to have
one or more Clinical Supervisors acceptable to the College, whose duties
shall include, among other things itemized in the Clinical Supervisor's
Undertaking attached hereto as Appendix "B(a)", direct observation of my
practice, chart reviews, and monthly meetings with me.
(8) I, Dr. Kernerman, acknowledge that this moderate-level supervision shall
be required for at least six (6) months after it has been determined that
I may assume responsibility as MRP.
(9) I, Dr. Kernerman, agree that, after the minimum six (6) month period
referred to above, and upon satisfactory reports from the Clinical
Supervisor(s), and with approval of the College, the level of supervision
may be reduced to low level supervision as defined in the Guidelines for
College Directed Supervision. This supervisory period shall continue for
a minimum period of twelve (12) months, during which the Clinical
Supervisor(s) will meet with me at least every three (3) months, and
provide reports to the College on a quarterly basis. The additional
duties of the Clinical Supervisor during this low level supervision are
set out in the Clinical Supervisor's Undertaking attached hereto as
Appendix "B(b)".
(10) I, Dr. Kernerman, undertake to participate in and successfully complete
any professional remedial education courses that are recommended by my
Clinical Supervisor(s).
(11) I, Dr. Kernerman, acknowledge that I have reviewed the Clinical
Supervisor's Undertaking attached as Appendix "B(a)" and "B(b)", and
understand what is required of the Clinical Supervisor(s) at each stage.
Phase Three
Hospital-Based Clinical Supervision
(12) I, Dr. Kernerman, undertake that, if I intend to practice internal
medicine in a hospital-based setting after the Clinical Supervision set
out above, and upon satisfactory reports from the Clinical Supervisor(s)
and Assessor(s) and approval from the College, I will practice in a
hospital setting under the guidance of a clinical supervisor acceptable
to the College (the "Hospital-based Clinical Supervisor") for a minimum
of six (6) months. Clinical Supervision will end only upon approval of
the College (the "Hospital-based Clinical Supervision").
(13) I, Dr. Kernerman, agree that the Hospital-based Clinical Supervision
shall consist of moderate-level supervision as defined in the Guidelines
for College-Directed Supervision. I shall be required to have one or
more Hospital-based Clinical Supervisors acceptable to the College, whose
duties shall include, among other things itemized in the Clinical
Supervisor's Undertaking attached hereto as Appendix "B(c)", direct
observation of my practice, chart reviews, and monthly meetings with me.
(14) I, Dr. Kernerman, undertake to participate in and successfully complete
any professional remedial education courses that are recommended by my
Hospital-Based Clinical Supervisor(s).
(15) I, Dr. Kernerman, acknowledge that I have reviewed the Hospital-based
Clinical Supervisor's Undertaking attached as Appendix "B(c)", and
understand what is required of the Hosptital-based Clinical
Supervisor(s).
C. WORKPLACE MONITORING
(16) I, Dr. Kernerman, undertake to the College that, upon my re-entry to
practice, I shall be supervised by a Workplace Monitor acceptable to the
College ("the Workplace Monitor") for a period of at least three (3)
years, or until such further time as the Workplace Monitor may recommend
and the College approves.
(17) I, Dr. Kernerman, acknowledge that I have reviewed the Workplace
Monitor's Undertaking, attached hereto as Appendix "C", and understand
what is required of my Workplace Monitor including, but not limited to:
i) Monitoring my conduct with persons with whom I come into contact in
the course of my professional duties;
ii) Meeting with me on a monthly basis for the first twelve (12) months
following my re-entry to practice, and thereafter meeting with me
every three (3) months for a minimum of two years to discuss my
conduct and any concerns identified;
iii) Obtaining feedback, every three (3) months for the first year and
then every six (6) months thereafter, from my physician colleagues,
allied health staff, and patients, in a multi-source feedback form,
attached as Appendix 1 to Appendix "C", and including the results
of this feedback in reports to the College;
iv) Submitting reports to the College every three (3) months for the
first two years following my re-entry to practice, and every six
(6) months thereafter for the remaining year, which shall contain
all information that he or she believes will assist the College in
monitoring my conduct and behaviour; and
v) Making an immediate report to the College if he or she believes
that my behaviour or conduct is improper or poses a risk to public
or patient safety.
(18) I, Dr. Kernerman, understand that I may not engage in the practice of
medicine until such time as I have obtained a Workplace Monitor
acceptable to the College, and the Workplace Monitor has executed the
aforementioned Undertaking.
D. HEALTH MONITORING
(19) I, Dr. Kernerman, will continue to receive treatment from my treating
physician, and/or other similarly qualified physicians acceptable to the
College, who will act as my Health Monitor(s). The Health Monitor(s)
will sign an Undertaking in the form attached as Appendix "D" to this
Undertaking.
(20) I, Dr. Kernerman, agree that, for a period of at least three (3) years
from June 25, 2014, I will meet with my Health Monitor(s) at such
frequency as he or she determines but not less than quarterly. I
understand that my Health Monitor(s) shall provide reports to the
College, to my Clinical Supervisor(s) and to my Workplace Monitor, on a
quarterly basis throughout this minimum three year period.
(21) I, Dr. Kernerman, further agree that, at all times while I am under the
care of my Health Monitor(s), I shall comply with any treatment
recommendations.
E. ASSESSMENT
(22) I, Dr. Kernerman, undertake that, at the conclusion of Phase Two of this
Undertaking (i.e. after having practised as the MRP for a period of at
least eighteen (18) months, and once the Clinical Supervisor(s) is of the
opinion that I may practise independently), under the direction of the
College, I will submit to an assessment (the "Assessment") of my practice
by an assessor(s) selected by the College (the "Assessor(s)").
(23) I, Dr. Kernerman, undertake to co-operate fully with the Assessment of my
practice, which may include, among other things, an observation
component, consultation with my Clinical Supervisor(s), Workplace
Monitor(s) and Health Monitor(s), and a chart review.
(24) I, Dr. Kernerman, further agree that I shall comply with any
recommendations of the College that result from that Assessment. I also
understand and agree that if any of the recommendations made by the
Assessor(s) limit or in any way restrict my practice such limitations or
restrictions constitute terms, conditions or limitations on my
certificate of registration and may be included on the public register if
required by the College in its sole discretion.
(25) I, Dr. Kernerman, further understand and acknowledge that, if I do not
complete the Assessment, or I fail to comply with any recommendations
that result from the Assessment, as determined by the College, the
Registrar may suspend my certificate of registration until I successfully
complete the Assessment or comply with the recommendations.
F. PHASE THREE ASSESSMENT
(26) I, Dr. Kernerman, undertake that, at the conclusion of Phase Three of
this Undertaking (i.e. after having practised as the MRP for a period of
at least twenty-four (24) months and having practiced in a hospital-based
setting for a period of at least six (6) months, and once the Clinical
Supervisor(s) is of the opinion that I may practise independently), under
the direction of the College, I will submit to an assessment (the "Phase
Three Assessment") of my practice by an assessor(s) selected by the
College (the "Assessor(s)").
(27) I, Dr. Kernerman, undertake to co-operate fully with the Phase 3
Assessment of my practice, which may include, among other things, an
observation component, consultation with my Clinical Supervisor(s),
Workplace Monitor(s) and Health Monitor(s), and a chart review.
(28) I, Dr. Kernerman, further agree that I shall comply with any
recommendations of the College that result from the Phase Three
Assessment. I also understand and agree that if any of the
recommendations made by the Assessor(s) limit or in any way restrict my
practice such limitations or restrictions constitute terms, conditions or
limitations on my certificate of registration and may be included on the
public register if required by the College in its sole discretion.
(29) I, Dr. Kernerman, further understand and acknowledge that, if I do not
complete the Assessment, or I fail to comply with any recommendations
that result from the Assessment, as determined by the College, the
Registrar may suspend my certificate of registration until I successfully
complete the Phase Three Assessment or comply with the recommendations.
G. GENERAL MONITORING
(30) I, Dr. Kernerman, acknowledge that, if at any time during the supervisory
period, one of my Clinical Supervisors, my Workplace Monitor and/or my
Health Monitor(s) are of the opinion that I pose a risk to the public or
patient safety, or that my conduct is in any way improper, or if any
patient or individual expresses a concern regarding inappropriate
behaviour by me, the Clinical Supervisor, the Workplace Monitor and/or
the Health Monitor shall immediately report such concerns to the College.
(31) I, Dr. Kernerman, agree that if any person who has given an Undertaking
in relation to the Order of the Executive Committee is unable or
unwilling to continue to fulfill its terms, I shall, within fifteen (15)
days, obtain an Undertaking in the same form from a similarly qualified
person who is acceptable to the College. If this condition cannot be
satisfied, I shall cease to practise until the condition is fulfilled.
(32) I, Dr. Kernerman, acknowledge that, in the event that any of the reports
contemplated by this Undertaking are not received in accordance with the
time frame specified, or are unsatisfactory to the College, and if such
failure is not rectified within thirty (30) days of notice of the
non-compliance being given to me, the Registrar may suspend my
certificate of registration.
H. ACKNOWLEDGEMENT
(33) I, Dr. Kernerman, shall comply with the terms and conditions of this
Undertaking and acknowledge that a breach by me of any term 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 of the College (the "Discipline Committee").
(34) I, Dr. Kernerman, acknowledge that if a referral of specified allegations
to the Discipline Committee is made in relation to the terms of this
Undertaking, the College will be entitled to introduce this Undertaking
as evidence at a hearing before the Discipline Committee.
(35) I, Dr. Kernerman, acknowledge and agree that I shall be solely
responsible for all costs associated with the terms, conditions and
limitations imposed on my certificate of registration, and any other
fees, costs, charges, expenses, etc. arising from the implementation of
any of the terms of this Undertaking.
(36) I, Dr. Kernerman, acknowledge and confirm that I have read and understand
the terms and conditions provided in this Undertaking and that I have
obtained independent legal counsel in reviewing and executing this
Undertaking, or have waived my right to do so.
I. CONSENT
(37) I, Dr. Kernerman, give my irrevocable consent to the College to provide
the following information to any person who requires this information for
the purposes of facilitating my completion of the Re-entering Practice
Plan and/or Clinical Supervision set out above and to all Clinical
Supervisors, Workplace Monitor, Health Monitors, the Assessor, and the
Chief(s) of Staff, or a colleague with similar responsibilities, as
determined by the College, at any hospital or Practice Location where I
practise or have privileges:
(a) any information the College has that led to the circumstances of my
entering into this Undertaking;
(b) any information relevant to the terms of the Clinical Supervisor's
Undertaking set out at Appendix "A";
(c) any information relevant to the terms of the Clinical Supervisor's
Undertaking set out at Appendices "B(a)", "B(b)" and "B(c)";
(d) any information relevant to the terms of the Workplace Monitor's
Undertaking set out at Appendix "C";
(e) any information relevant to the terms of the Health Monitor's
Undertaking set out at Appendix "D";
(f) any information relevant to any assessments; and
(g) any information arising from the monitoring of my compliance with
this Undertaking.
(38) I, Dr. Kernerman, give my irrevocable consent to any person who
facilitates my completion of the Re-entering Practice Plan and/or
Clinical Supervision, and to all Clinical Supervisors, Assessors,
Workplace Monitors and Health Monitors, to disclose to the College, and
to one another, any information:
(a) relevant to this Undertaking;
(b) relevant to the terms of the Clinical Supervisor's Undertaking set
out at Appendix "A";
(c) relevant to the terms of the Clinical Supervisor's Undertaking set
out at Appendices "B(a)", "B(b)" and "B(c)";
(d) relevant to the terms of the Workplace Monitor's Undertaking set
out at Appendix "C";
(e) relevant to the terms of the Health Monitor's Undertaking set out
at Appendix "D";
(f) relevant to the Assessment;
(g) relevant for the purposes of monitoring my compliance with this
Undertaking; and/or
(h) which comes to his or her attention in the course of providing
re-training which he or she reasonably believes indicates a
potential risk of harm to my patients or members of the public.
(39) I, Dr. Kernerman, give my irrevocable consent to the College to provide
this Undertaking to any Chief(s) of Staff, or a colleague with similar
responsibilities approved by the College, at any hospital or Practice
Location where I practise or have privileges ("Chief(s) of Staff"), and
to provide said Chief(s) of Staff with any information the College has
that led to the circumstances of my entering into this Undertaking and/or
any information arising from the monitoring of my compliance with this
Undertaking.
(40) I, Dr. Kernerman, acknowledge that the terms and conditions contained in
this Undertaking are deemed to be specified terms, conditions and
limitations imposed on my certificate of registration for the purpose 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 such specified terms, conditions and
limitations shall be information on the College's Register that is
available to the public.
Terms and conditions imposed on certificate by: Discipline Committee
