A doctor who said a patient in Fife sounded like a terrorist and showed pornographic images to colleagues is continuing to work in the profession in England.
While employed as a locum at Kirkcaldy’s Victoria Hospital, Nikolay Tsvetanov Tsakov turned to a medical student and said a patient “sounded like they worked for Al Qaeda” after reading names from a clinic list.
The ear, nose, and throat (ENT) consultant also quoted comedy character Ali G by stating an increase in incidents of candida was due to “men drinking too much from the furry cup”.
The Medical Practitioners Tribunal Service (MPTS) found his behaviour brought the profession into “disrepute”.
He escaped being struck off though and is registered as a locum with the agency ID Medical.
He has worked shifts in recent months at the Princess Alexandra Hospital in Harlow in Essex.
NHS Fife say he no longer works as a locum or in any other capacity at the health board.
As part of conditions on his registration, he must be supervised and inform the General Medical Council if he takes up any future positions.
What else did the doctor do?
All the Fife incidents took place in November 2016.
He told the same student he showed patients a photograph of himself holding an air gun and laughed about doing so.
And he said he had completed a course to be “more PC” after being in trouble for making inappropriate comments previously.
Dr Tsakov was also found to have committed misconduct at a number of other UK health boards.
While working at Hinchingbrooke Hospital in Huntingdon near Cambridge in October 2017, he stated to a pregnant colleague, “…is that what happens when you sleep with no knickers on?”
And in another incident, the Bulgarian native showed pornographic images of naked women to female colleagues.
In Northern Ireland in December 2017, he showed a picture of a toy rabbit with an erect penis on his mobile phone to more women he worked alongside.
Lastly, in Rotherham, he caused a child distress after shaking the patient’s head “vigorously” from side-to-side to remove tubes inserted for surgery.
He also told a healthcare assistant she reminded him of “a German Nazi with blonde hair and green eyes”.
‘Comedic persona’ an issue
The tribunal heard evidence from colleagues who he has worked with since the incidents.
They described him as “extremely hard working”, “courteous” and “professional”.
The tribunal acknowledged Dr Tsakov has taken steps to remediate his misconduct and completed courses in maintaining boundaries.
The chair Andrew Lewis said he believes one of the main issues is the specialist has difficulty taking his “comedic persona” out of his medical professional life.
During his oral evidence Dr Tsakov apologised for his behaviour, describing it as “disgraceful” and “outrageous” and expressed remorse and regret.
The tribunal accepted the Sofia-born doctor now understands the gravity of his language and that he has learned a lot from the incidents.
It determined that Dr Tsakov’s fitness to practise is currently impaired by reason of misconduct and his conditions include being supervised in all future posts for 12 months.