Two married doctors trained in South Africa have lost their licences to practise medicine in B.C. — and approximately 1,200 former patients are being advised to seek medical advice from other doctors.
In 2011, Dr. Rosemarie Cambridge, 42 and Dr. Sean Cambridge, 50 — who was one of the top-billing doctors in the province for four years — were given provisional licences to practise family medicine in Chilliwack, because it was an under-serviced area.
But they repeatedly failed their qualifying exams.
Some former patients now want to know if they received proper diagnoses in the six years the Cambridges practised at the Valley Family Practice in Chilliwack, about 120 kilometres east of Vancouver.
However, the doctor shortage could make it very hard to get a second opinion.
The Cambridges practised in Chilliwack, B.C., with provisional licenses for almost six years. But a sign in their office now tells their patients they are off work to study for their Canadian medical exams, which they have repeatedly failed.(Chilliwack Division of Family Practice website)
“It was a huge surprise,” said long-haul truck driver Ray White.
Fifty-nine years old, he has a heart condition that requires medication. When he tried to renew his prescription, he said his pharmacist said it was no longer valid because the Cambridges had lost their licences.
“I’m very concerned,” White said. “When you’re dealing with the heart, it’s gotta work. If it doesn’t work, then you’re dead.”
Cambridges failed exams
CBC News has learned that after passing their initial evaluating exam, the couple repeatedly failed their crucial qualifying exams. Rosemarie Cambridge failed four times in six years. Her husband, Sean Cambridge, failed five times in the same period.
The qualifying exam evaluates a physician’s clinical skills and medical knowledge, according to health officials.
Despite the failures, the College of Physicians and Surgeons of British Columbia, which regulates the province’s doctors, repeatedly granted the couple extensions.
The college refused to answer specific questions about the Cambridges, citing privacy concerns.
CBC News has also learned that the college’s counterpart in Saskatchewan made its own determination on both doctors in just a few months, rather than years.
Denied licences in Saskatchewan
The College of Physicians and Surgeons of Saskatchewan confirmed the couple first tried to establish themselves there after arriving in Canada from South Africa in late 2010.
In an email to the CBC, associate registrar Bryan Salte notes Rosemarie Cambridge “was not successful in her initial assessment” in Saskatchewan within two weeks, while Sean Cambridge had his licence to practice “terminated” within five months, following an assessment.
The Cambridges moved west. Shortly after their arrival in 2011, they were deemed eligible to practice family medicine in Chilliwack.
Sean Cambridge billed more than double average
Sean Cambridge’s repeated failure to pass his qualifying exam didn’t stop him from becoming one of the top-paid family doctors in the province.
Despite having a provisional licence that the college website said imposes “limits and conditions,” he billed B.C. taxpayers an average of $ 600,000 a year for each of the four full years he practiced, according to publicly available figures.
An analysis by CBC News shows that placed him in the top five to seven per cent of all doctors — including specialists — that billed the province between 2012 and 2016.
It was more than double the amount charged by an average family physician in Chilliwack — and more than twice the national average.
Rosemarie Cambridge billed slightly below that average.
The Cambridges, who are originally from South Africa, worked out of Valley Family Practice in Chilliwack from 2011 to 2017. Before that, they both tried to practise in Saskatchewan, where they were both rejected within six months.(Dillon Hodgin/CBC )
Under the terms of their provisional licences, both physicians were supposed to be supervised by another fully licensed doctor.
But one former supervisor who spoke to the CBC on condition of anonymity said it was impossible to keep up with Sean Cambridge’s volume of patients.
Another doctor worried the couple’s patients would now be left “high and dry.”
A sign dated April 3 in Valley Family Practice’s reception area tells the couple’s former patients that their medical practice has been closed — and that other doctors at the clinic are unable to take on their caseload after May 31.
Patient load ‘came at the expense of studying’
The Cambridges declined the CBC’s request for an interview.
But in a written statement issued by their lawyer, Sean Cambridge said he perhaps should have reduced his patient caseload in order to spend more time studying.
“We are proud of how hard we worked to serve our patients. But it undoubtedly came at the expense of studying for our examination,” Cambridge said.
Sean Cambridge told CBC in a statement that he and his wife “are proud of how hard we worked to serve our patients. But it undoubtedly came at the expense of studying for our examination.”(Facebook)
“In retrospect, this may not have been the best approach.”
“However, reducing my clinic hours would have not come without some guilt as I would have been unable to care for all the unattached patients that we took on.”
According to figures provided by their lawyer, the Cambridges had a total of 1,180 patients in the last full year of their practice.
‘Deeply troubling’ pattern
Even after the college stripped them of their registrations, the Cambridges tried to appeal.
According to a September 2017 review of the case by the Health Professions Review Board, a provincial tribunal that reviews decisions made by the college, “two internationally trained applicant physicians (husband and wife)” practising in the Fraser Valley asked for a review of the college’s decision.”
The board ultimately rejected the appeal. But it still expressed sympathy for the couple and took a shot at the college.
“There is a pattern emerging which this panel finds deeply troubling,” the board wrote.
“These concerns bring us to question precisely how the (college) is serving the public by letting physicians practice with large patient loads for many years without passing the requisite exams, only to then determine that the same physician is not qualified to provide the services based on not passing these exams?”
In a response emailed to CBC, the college said the tribunal’s comments “transcend the board’s jurisdiction” and “create erroneous expectations that the college has the legal authority to independently fix systemic issues.”
It also noted it grants extensions “in some rare circumstances.”
Requirements ‘weren’t enforced’
B.C.’s Minister of Health said there is much to learn from this case.
“I think the College of Physicians and Surgeons is also learning from (what happened),” Adrian Dix said. “They’ve always had supervisory requirements for sponsoring physicians, and I think a fair person would say they weren’t enforced as much as they might be.”
Meanwhile, the Cambridges aren’t giving up their shared goal.
“Our focus and priority right now is to prepare for and pass our examinations,” they wrote to the CBC. “(We) hope that we can return to serving patients in Chilliwack.”
But Ray White isn’t waiting around. His trucking business takes him to Alberta and he found a new doctor in Calgary.
Truck drivers would never be allowed on the road if they failed the required tests, he said.
“People that come from other countries … still have to qualify immediately before getting behind the wheel of a truck. So it should apply to everybody — doctors, lawyers, everybody,” he said.
“It’s public safety.”
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