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An 80-year-old man was sent home with pain-relieving gel. The next day he died of a heart attack.
An old woman was exposed to life-threatening danger when she was given the highest dose of morphine patches.
A third patient received anti-vertigo medication when she had life-threatening kidney failure.
That’s how badly three doctors graduated from Eastern European universities treated their Swedish patients.
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Doctors who were trained at foreign universities and had their licenses revoked are more often grossly unskilled than other doctors, Läkartidningen’s review of revoked medical licenses in 2021 shows.
Of 41 doctors who had their credentials revoked that year, eleven had been grossly incompetent, according to Hsan, the Health and Medical Service’s responsibility board. Most of them – 7 out of 11 – were educated abroad.
In Aftonbladet’s review of cheating at Eastern European medical training, we took a closer look at seven men and one woman educated in Armenia, Latvia, Lithuania, Romania and Hungary who were branded as grossly incompetent and lost their Swedish medical credentials between 2018 and 2023.
Zero hours of practice
The review is based on decisions in Hsan on revoked medical credentials, where it is extremely rare to see any details about the teaching the doctors received as students.
An exception applies to a 31-year-old man, who held a Swedish medical license between 2019 and 2022. He had zero hours of practice during medical training at the University of Szeged in Hungary. Nevertheless, he received a Hungarian medical ID, which meant that shortly afterwards he was also able to issue a Swedish medical ID.
This is how the Inspectorate for Care and Care, Ivo, describes how the Hungarian teaching went:
“The training was mostly theoretical because he does not know Hungarian and therefore could not talk to or examine patients, write medical records or prescribe medication. When they had practical teaching sessions, they stood and observed the Hungarian doctor talking to the patient. They studied medical Hungarian and therefore understood some of what the doctor said to the patient. After the visit, the doctor also translated parts of what was said into English. The sixth year corresponded to the Swedish AT service, but this service also consisted of observation, no independent work.”
“Large gaps in knowledge”
It was therefore not surprising that the health center where the man received his first and – as it turned out – only employment as a doctor, quickly discovered his lack of knowledge. He was provided with tutors and received internal training. But nothing helped. An external doctor, who was commissioned to review and analyze the doctor’s competence, wrote:
“His medical knowledge does not reach the levels a Swedish medical student has at the end of his basic education before the AT duty. He has large knowledge gaps that make it impossible for him to be allowed to assess and treat patients on his own. The shortcomings that exist mean that one can question whether such a Hungarian medical exam should be able to give Swedish identification”, wrote the external district doctor Per Zetterlund.
When Aftonbladet calls Zetterlund, he does not want to make any further comments.
After four months of employment, where the doctor was only allowed to independently check the blood pressure and pulse of a few patients, he was fired in December 2019. Hsan stated that he was grossly incompetent and revoked the man’s medical license in 2022.
The ex-doctor: Harassment
On one occasion, when he himself prescribed medicine despite the fact that he was forbidden to prescribe medicine without consulting his supervisor, there was a risk that the patient would suffer medical damage, Ivo judged. It was partly connected with the fact that the man realized his limitations after all.
– He acts with adequate caution in medical decisions, realizing his limited knowledge, wrote Per Zetterlund.
Other now unlicensed doctors that Aftonbladet reviewed have not done so. On the contrary.
A 65-year-old ex-doctor trained at Semmelweis University in Hungary, who held a Swedish medical license between 2012 and 2023, claimed that patients were happy with him and that he never committed any misconduct. He described the criticism against him as “undeserved harassment”.
Twice he missed symptoms that shortly afterwards caused heart attacks in two men, who, however, survived.
Died of a heart attack
An 80-year-old man who had the misfortune of being treated by another doctor, trained at Kaunas Medical University in Lithuania, did not.
The patient presented for persistent chest pain.
The doctor prescribed pain-relieving gel, and advised the man to make an appointment with a physiotherapist. The next day, the 80-year-old died of a heart attack.
– The doctor’s handling had a disastrous outcome, wrote Hsan, and stated that it was just one in a series of the doctor’s maltreatments.
In addition, he was convicted of aggravated drunken driving and illegal driving in 2015. Then he served the sentence with foot shackles at the health center where he worked – without informing the chief doctor about it.
The now 41-year-old man had a Swedish medical license between 2012 and 2018. Since then, he has been convicted of minor drug offenses three times.
Another ex-doctor, trained in Romania, put an 80-year-old woman in danger.
The doctor prescribed the highest strength fentanyl patch, 100 milligrams per hour. The maximum level for such old patients who have not had a morphine patch before is 12 milligrams per hour.
Fired from 5 health centers
The drug dose was so strong that it was difficult to wake the woman up the next day. Another doctor saw to it that the patch was removed immediately.
– Through the prescription, the patient has been exposed to life-threatening danger, stated Hsan.
The doctor, a woman who received a Swedish identity card in 2014, lost it in 2023.
Two more doctors trained in Romania have lost their licenses in recent years.
One was fired from five health care centers in turn, among other things because he only gave allergy medicine to an 80-year-old woman with life-threatening kidney failure.
The other prescribed so many drugs classed as narcotics that the police finally informed Ivo of how many prescriptions for narcotic preparations the doctor had issued.
A 64-year-old man educated in Armenia, who had a Swedish medical license between 2010 and 2021, was also grossly incompetent. He gave a 72-year-old woman such a poorly executed cortisone injection that both her lungs were punctured, without reason. She was thus exposed to obvious danger to her life, notes Hsan.
“Significant patient risk”
One cannot conclude that all the universities attended by the eight doctors have substandard teaching, based on what appears in Hsan’s decision on the revoked medical credentials. But in one case it is clear that teaching in English was not a guarantee of good results.
A 59-year-old man, who had his medical license revoked in 2019, trained at Latvijas Universitate in Latvia.
– The doctor’s inability to discuss medical management and treatment constitutes a significant patient safety risk, stated Ivo.
Just as with the other doctors in Aftonbladet’s review, his record keeping was flawed:
– He seems ignorant of his responsibility as licensed staff to record his patient treatments, Ivo believed.