DOCTORS WITH FAKE QUALIFICATIONS
This paper first appeared in the Spring edition of the 'Skeptical Intelligencer', 2023, pp 4-5.
From time to time we hear in the news about people who have been working for years as doctors, either privately or in the National Health Service, until it has been discovered that they lacked the relevant professional qualifications. Usually they faked the evidence that they possessed such qualifications. Once their misdeeds are publicly exposed there is a hue and cry about how they managed to get away with what they did for so long.
A recent case is that of Zholia Alemi (note 1) who came to the UK in 1995 with documents indicating that she qualified in medicine at the University of Auckland. She was granted provisional registration by the General Medical Council and after working in hospitals in Northern Ireland, was granted full registration in 1997. For the next twenty years she worked as a NHS psychiatrist, becoming a member of the Royal College of Psychiatrists in 2003, passing part I of their exams after four attempts and part II after three attempts. In 2012 she entered the GMC specialist register in psychiatry, enabling her to apply for consultant posts. Thereafter she worked in hospitals and clinics in the UK and occasionally abroad, specialising in learning disability and dementia. In that time it is estimated that she earned up to £1.3 million from the NHS and enjoyed a lavish lifestyle.
In 2018 Alemi was convicted of fraud and jailed for five years for faking an 87-year-old patient's will in an attempt to inherit her £1.3m estate. The patient attended a dementia clinic in Cumbria. Alemi's defence of 'having autism' was rejected by the court.
A reporter for Cumbria's News & Star then undertook an investigation of her professional qualifications and it transpired that her University of Auckland degree certificate and other documents were 'clearly forged'. In fact she had failed to obtain a medical degree. She was convicted of fraud and sentenced to seven years in prison.
How was Alemi able to dupe the psychiatry hierarchy, the GMC, and her own professional colleagues? At the outset, no one properly checked the authenticity of her qualifications on her arrival in the UK. Apparently, it was easy to discover that they were faked, as the investigation by the News & Star revealed. Maybe suspicions should have arisen when she had so much difficulty passing the exams for membership of the Royal College of Psychiatrists. But what about her day-to-day performance as a psychiatrist? The evidence on this is not encouraging (note 2). Over the years, Alemi was the subject of numerous allegations and formal complaints, including inappropriate behaviour towards patients and staff, prescribing and dishonesty. In July 2017 she received a twelve-month suspension from the medical register, which was renewed in August 2018. Finally, she moved around a great deal, registering with locum agencies in diverse locations of the UK, as well as working in Pakistan and the US, probably making it less likely for her unqualified status to be detected.
Probably the aspect of cases such this that the public find most intriguing is this business of the unqualified individual being able to work undetected for years in a profession such as medicine, for which a great deal of training, knowledge, expertise and experience is required.
The Alemi case is certainly less extraordinary than others in this respect; after all her fitness to practice as a psychiatrist was confirmed by the Royal College. More dramatic instances of 'imposter doctors' have been reported (note 3), one of the most spectacular of these being Christian Eberhard, a German banker who forged his medical qualifications and worked as a hospital surgeon for 14 months participating in 190 operations, including amputations, before being found out. His only relevant experience was 10 months working in a hospital in lieu of his national service.
It's hard to understand how Eberhard, working as a surgeon, was able to pull off something like this, more so, perhaps, than someone working as a consultant psychiatrist. I am not disparaging psychiatry here, but my feeling is that it is quite feasible for an unqualified person to enact the role of a consultant psychiatrist, albeit at a mediocre level, in a hospital or clinic without detection. By that stage they will have had several years of experience and have the support of a multidisciplinary team, including other doctors. Also. medical professionals and those in professions allied to medicine undergo regular CPD (continuing professional development) training. It seems that Alemi's failings were a lot to do with her personality and lack of principles. In my experience, as well as being clinically proficient and well-informed, essential qualities for 'a good psychiatrist' are conscientiousness, empathy, good interpersonal skills, and leadership ability, qualities not necessarily absent in a fake psychiatrist, though they apparently were in Alemi's case. All of this also applies to my own profession, clinical psychology.