No ticket, no surgery

Key Points
  • Assisting or knowingly enabling an unregistered local or overseas practitioner constitutes unsatisfactory professional conduct.
  • Full and frank disclosure of the performing surgeon’s role and limitations to the patient is required to avoid improper and unethical conduct.
  • Registration is mandatory for all local and overseas visiting practitioners regardless of your reputation or competency.


The Professional Standards Committee of the Medical Council of NSW found a medical practitioner guilty of unsatisfactory professional conduct for allowing a visiting surgeon to operate without being registered to practise in NSW.

A colorectal surgical conference incorporated a televised surgical procedure, which was performed by a world-renowned surgeon. Attempts to obtain temporary registration for the visiting surgeon to practise in New South Wales were unsuccessful. Nonetheless, the surgeon proceeded to participate in the surgery. This resulted in an anonymous complaint to the Health Care Complaints Committee. The NSW based surgeon who had organised the televised surgery was then required to appear before a Professional Standards Committee of the Medical Council of NSW (the Committee).

The allegations made were that the NSW surgeon was guilty of unsatisfactory professional conduct for knowingly enabling the visiting surgeon to perform the surgery despite knowing he was not registered and that the NSW surgeon’s conduct was improper and unethical as he had failed to inform the patient that the visiting surgeon was performing the surgery.

Regarding the first allegation, the Committee determined that the NSW surgeon’s conduct, which involved telling a fellow surgeon and the visiting surgeon to commence the operation without informing any team member of the visiting surgeon’s unregistered status, was an intentional enablement of the visiting surgeon’s involvement in the operation. Therefore, the Committee was satisfied that the conduct constituted unsatisfactory professional conduct. Furthermore, the Committee determined that NSW surgeon did not provide full and frank disclosure to the patient regarding the visiting surgeon’s role in performing the operation, as well as further neglecting to mention that the visiting surgeon did not have adequate personal professional indemnity insurance arrangements to cover himself for the surgery. Therefore, the Committee determined that the conduct would objectively be regarded under the ‘reasonable persons’ test as falling below the standards of conduct expected of a medical practitioner, thus rendering his conduct improper and unethical. The NSW surgeon was reprimanded and fined $5,500.

The rationale behind the Committee’s decisions centred on the National Law’s focus on public protection, which meant ensuring visiting practitioners were registered before performing any medical procedure.

This decision highlights the necessity of ensuring that any overseas visiting practitioner who intends to ‘practise’ medicine whilst in Australia, be it for educational or clinical purposes, has sought and obtained  temporary registration. In the event that Australian based practitioners are organising for overseas based practitioners to practise temporarily in Australia, it is advisable that they apprise themselves of the status of any temporary registration for the practitioner as well as what professional indemnity arrangements are in place. A failure to do so will expose other practitioners to adverse disciplinary findings.

Post by Enoch Hui and Karen Kumar 

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