As from July 14, 2020, the following are imposed as terms, conditions and limitations on the certificate of registration held by Dr. Paul Ian Pancham in accordance with an undertaking and consent given by Dr. Pancham to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. PAUL IAN PANCHAM
("Dr. Pancham")
to
COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
(the "College")
A. PREAMBLE
(1) In this Undertaking:
"Code" means the Health Professions Procedural Code, which is Schedule 2to the Regulated Health Professions Act, 1991, S.O. 1991, c. 18, as amended;
"OHIP" means the Ontario Health Insurance Plan;
"Public Register" means the College's register that is available to the public.
(2) I, Dr. Pancham, certificate of registration number 67728, am a member of the College.
(3) I, Dr. Pancham, acknowledge that the College conducted an investigation bearing File Number 1106323 (the "Investigation") into whether I engage in professional misconduct and/or am incompetent in my Obstetrics/Gynecology practice.
B. UNDERTAKING
(4) I, Dr. Pancham, undertake to abide by the provisions of this Undertaking, effective immediately ("Effective Date").
(5) Practice Restrictions
(a) I, Dr. Pancham, undertake that I shall not conduct a pelvic or internal examination on a patient of any age, in any jurisdiction, unless the examination takes place in the continuous presence and under the continuous observation of a monitor who is a regulated health professional acceptable to the College (the "PracticeMonitor" or "Practice Monitors"), and unless the other requirementsprovided in this Undertaking are fulfilled.
(b) I, Dr. Pancham, undertake to inform my patients of the indication for any pelvic or internal examination and to document the discussion in the corresponding patient chart.
(c) I, Dr. Pancham, acknowledge that I have reviewed the Practice Monitor's undertaking in respect of my office-based practice, attached hereto as Appendix "A" and understand what is required of the Practice Monitor including, but not limited to:
(i) providing reports (as described in the Practice Monitor's undertaking) to the College on at least a monthly basis;
(ii) remaining present at all times during all pelvic or internal examinations I conduct on any patient;
(iii) carefully observing all pelvic or internal examinations I conduct on any patient. I further acknowledge my obligation to ensure the Practice Monitor's view of all pelvic or internal examinations I conduct is unobstructed at all times;
(iv) refraining from performing any other functions, except those required in the Practice Monitor's undertaking attached as Appendix "A", while observing me conduct any pelvic or internal examination on patients;
(v) maintaining a log of all pelvic or internal examinations I conduct on patients in the form attached to this Undertaking as Appendix "B" (the "Log") and in the manner described in Appendix "A", including listing the indication I described to my patient for any pelvic or internal examination performed and confirming that I have documented the discussion in the corresponding patient chart;
(vi) initialing all corresponding entries in the records of patients noted in the Log; and
(vii) submitting the original Log to the College on a monthly basis.
(d) I, Dr. Pancham, acknowledge that I have reviewed the Supervising Practice Monitor's undertaking in respect of my hospital-based practice, attached hereto as Appendix "C" and understand what is required of the Supervising Practice Monitor including, but not limited to:
1. providing reports (as described in the Supervising Practice Monitor's undertaking) to the College on at least a monthly basis;
2. remaining present, or ensuring another regulated health professional ("RHP") remains present, at all times during all pelvic or internal examinations I conduct on patients;
3. carefully observing, or ensuring another RHP carefully observes, all pelvic or internal examinations I conduct on patients. I further acknowledge my obligation to ensure that the Supervising Practice Monitor's (or any other RHP's) view of all pelvic or internal examinations I conduct on patients is unobstructed at all times;
4. ensuring that any RHP who works in a hospital area where I may conduct pelvic or internal examinations on patients has been notified that I am not permitted to conduct any pelvic or internal examinations on patients of any age unless the pelvic or internal examination takes place in the continuous presence and under the continuous observation of a monitor who is a regulated health professional;
5. refraining from performing any other functions, and ensuring any other RHP so refrains, except those functions required in the Supervising Practice Monitor's undertaking attached as Appendix "C", while observing me during all pelvic or internal examinations conducted by me on patients, except that the Supervising Practice Monitor or other RHP may assist in patient care if any emergency arises during a pelvic or internal examination;
6. maintaining a log of all pelvic or internal examinations I conduct on patients in the form attached to this Undertaking as Appendix "B" (the "Log") and in the manner described in Appendix "C";
7. initialing, or ensuring any other RHP initials, all corresponding entries in the records of patients noted in the Log; and
8. submitting the original Log to the College on a monthly basis.
(e) I, Dr. Pancham, undertake to maintain an up to date copy of the Log(s) from both my office-based and hospital-based practices by ensuring a copy is made at the end of each business day, and to make it available to the College upon request.
(6) I, Dr. Pancham, undertake to inform the College of each and every location at which I practise or have privileges, including, but not limited to, any hospitals, clinics, offices, and any Independent Health Facilities with which I am affiliated, in any jurisdiction (collectively my "Practice Location" or "Practice Locations"), within five (5) days of executing this Undertaking. Going forward, I further undertake to inform the College of any and all new Practice Locations within five (5) days of commencing practice at that location.
(7) Posting a Sign
(a) I, Dr. Pancham, undertake that I shall post a sign in all waiting rooms, examination rooms and consulting rooms, in all of my Practice Locations, except hospital units, in a clearly visible and secure location, in the form set out in Appendix "D" that states: "Patients please note that Dr. Pancham will perform all internal/pelvic examinations in the continuous presence and under the continuous observation of a registered nurse or registered practical nurse".
(b) I, Dr. Pancham, undertake to post a certified translation in any language in which I provide services, of the sign described in section (7)(a), in all waiting rooms, examination rooms and consulting rooms, in all of my Practice Locations, except hospital units, in a clearly visible and secure location, in the form set out at Appendix "D."
(c) I, Dr. Pancham, undertake to provide the certified translation described in section (7)(b), to the College within thirty (30) days of executing this Undertaking.
(d) I, Dr. Pancham, undertake that if I elect, after the execution of this Undertaking, to provide services in any other language, I will notify the College prior to providing any such services.
(e) I, Dr. Pancham, undertake to provide to the College the certified translation described in section (7)(b) prior to beginning to provide services in any language described in section (7)(d).
(8) Clinical Supervision
(a) I, Dr. Pancham, undertake to practise under the direct observation of a clinical supervisor or clinical supervisors acceptable to the College (the "Clinical Supervisor" or "Clinical Supervisors"), in my hospital practice, for a minimum of 72 clinical hours, to be completed within a period of six (6) months ("Clinical Supervision").
(b) I, Dr. Pancham, acknowledge that I have reviewed the Clinical Supervisor's undertaking, attached hereto as Appendix "E", and understand what is required of the Clinical Supervisor. The Clinical Supervisor will, at minimum,
(i) Review the materials provided by the College;
(ii) Directly observe me in my hospital practice for a minimum of 72 clinical hours over a six (6) month period. Such observation shall include observation of all pelvic and internal examinations done by me during the 72 clinical hours;
(iii) Make recommendations to me for practice improvements and ongoing professional development;
(iv) Perform any other duties, such as reviewing other documents or conducting interviews with staff or colleagues, that the Clinical Supervisor deems necessary to my Clinical Supervision; and
(v) Submit a written report to the College at the end of Clinical Supervision, or more frequently if the Clinical Supervisor has concerns about my standard of practice.
(c) I, Dr. Pancham, undertake to cooperate fully with the Clinical Supervision of my practice, conducted under the term of this Undertaking and Appendix "E" to this Undertaking, and to abide by the recommendations of my Clinical Supervisor, including but not limited to, any recommended practice improvements and ongoing professional development.
(d) I, Dr. Pancham, undertake to ensure that Appendix "E" to this Undertaking is signed and delivered to the College within thirty (30) days of the date I execute this Undertaking.
(e) I, Dr. Pancham, undertake that if a person who has given an undertaking in Appendix "E" to this Undertaking is unable or unwilling to continue to fulfill its provisions, I shall, within twenty (20) days of receiving notice of same, obtain an executed undertaking in the same form from a similarly qualified person who is acceptable to the College and ensure that it is delivered to the College within that time.
C. ACKNOWLEDGEMENT
(9) I, Dr. Pancham, acknowledge that all appendices attached to or referred to in this Undertaking form part of this Undertaking.
(10) I, Dr. Pancham, acknowledge and undertake 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.
(11) I, Dr. Pancham, acknowledge 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.
(12) I, Dr. Pancham, acknowledge that the College will provide this Undertaking to any Chief of Staff, or a colleague with similar responsibilities, at any Practice Location ("Chief of Staff" or "Chiefs of Staff").
(13) I, Dr. Pancham, acknowledge that a breach of any provision of this Undertaking may constitute an act of professional misconduct and may result in a referral of specified allegations to the Discipline Committee.
(14) I, Dr. Pancham, acknowledge that this Undertaking constitutes terms, conditions, and limitations on my certificate of registration for thepurposes of section 23 of the Code.
(15) Public Register
(a) I, Dr. Pancham, acknowledge that, during the time period that thisUndertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. Pancham, acknowledge that, in addition to this Undertaking being posted in accordance with section (15)(a) above, the following summary shall be posted on the Public Register during the time period that this Undertaking remains in effect:
A College investigation was conducted into whether Dr. Pancham engaged in professional misconduct and/or was incompetent in his Obstetrics/Gynecology practice. As a result of the investigation:
Dr. Pancham must not conduct pelvic or internal examinations on patients of any age, in any jurisdiction, unless the examination takes place in the continuous presence and under the continuous observation of a practice monitor who is a regulated health professional acceptable to the College.
Dr. Pancham shall post a sign in all waiting rooms, examination rooms and consulting rooms, in all Practice Locations, except hospital units, in a clearly visible and secure location, that states: "Patients please note that Dr. Pancham will perform all internal/pelvic examinations in thecontinuous presence and under the continuous observation of aegistered nurse or registered practical nurse".Dr. Pancham will practise under the guidance of a ClinicalSupervisor for a minimum of 72 clinical hours.
D. CONSENT
(16) I, Dr. Pancham, give my irrevocable consent to the College to make appropriate enquiries of OHIP and/or any person who or institution thatmay have relevant information, in order for the College to monitor my compliance with the provisions of this Undertaking.
(17) I, Dr. Pancham, acknowledge that I have executed the OHIP consent form, attached hereto as Appendix "F".
(18) I, Dr. Pancham, consent to submit and not interfere with, unannouncedinspections of my Practice Locations and to the inspection of patientcharts by the College and to any other activity the College deemsnecessary in order to monitor my compliance with the provisions of thisUndertaking.
(19) I, Dr. Pancham, give my irrevocable consent to the College to provide the following information to all Practice Monitors and to all RHPs carryingout duties under the Supervising Practice Monitor's undertaking, and to all Clinical Supervisors:
(a) any information the College has that led to the circumstances of myentering into this Undertaking;
(b) any information arising from any investigation into, or assessment of, my practice; and
(c) any information arising from the monitoring of my compliance with this Undertaking.
(20) I, Dr. Pancham, give my irrevocable consent to all Practice Monitors and RHPs carrying out duties under the Supervising Practice Monitor's undertaking, Clinical Supervisors and Chiefs of Staff, to disclose to the College, and to one another, any of the following:
(a) any information relevant to this Undertaking;
(b) any information relevant to the provisions of the Practice Monitor's undertakings set out at Appendix "A" and "C" to this Undertaking;
(c) any information relevant to the provisions of the Clinical Supervisor's undertaking set out at Appendix "E" to this Undertaking;
(d) any information relevant for the purposes of monitoring my compliance with this Undertaking.
(21) I, Dr. Pancham, give my irrevocable consent to the College to provide all Chiefs 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.
Terms and conditions imposed on certificate by: Member