‘Extraordinary pressure’ led intern to fraud, forgery

Overwhelmed with administrative tasks, an intern found her workplace “suffocating and undoubtedly stressful” and was desperate to get a different job… so she faked her practice hours to get away

A former pharmacy honours student and intern, who had been granted general registration under false pretences, has been reprimanded and struck off for at least six months by the Queensland Civil and Administrative Tribunal.

The Office of the Health Ombudsman alleged that the pharmacist’s behaviour constituted professional misconduct when she claimed to have completed her supervised practice requirements – despite having more than 650 hours to go before she reached the minimum number of hours.

The pharmacist had begun her internship in January 2018, working at the pharmacy where the behaviour occurred from before her internship, until late September 2018.

From late September, she began to work part-time.

The Tribunal made note of the requirements for interns to work a minimum number of hours of supervised practice during their internship: 1824 hours, which interns are expected to keep a record of, and preceptors are required to sign each week.

In early December 2018, the intern brought a statutory declaration, relating to a weekly record of supervised practice hours, to a pharmacist at a different store in Brisbane.

This statutory declaration stated that the intern had completed 1844 supervised hours.

It appeared to have been signed by the intern’s preceptor, the complainant in the matter.

The intern brought the statutory declaration to the second pharmacist to have the preceptor’s signature witnessed – and the second pharmacist signed it, “purporting to witness the signature of the complainant, despite the document already having been signed”.

The intern had not completed her minimum supervised hours at all – and the preceptor had not signed the declaration.

“The respondent had dishonestly altered the hours recorded in the document, by erasing them and replacing them with a higher figure, and she had forged the complainant’s signature on the statutory declaration,” the Tribunal observed.

Still in December 2018, the intern submitted the false declaration to the Pharmacy Board in an application for general registration as a pharmacist.

“The discrepancy between the supervised hours actually worked, and the number of hours required for registration was 677.5 hours,” wrote the Tribunal.

The Board granted the intern her registration, though she was not entitled to be registered.

The preceptor became aware that the intern had become registered as a pharmacist in January 2019, and complained to the Office of the Ombudsman that day.

When dealing with Ahpra’s ensuing investigation, the intern made full admissions about her conduct.

“I had originally written several of my hours in pencil. The declaration was never signed weekly but in one go,” she said in a written submission.

“In other words (the complainant), would either sign the declaration several months at a time or in some cases, pre-signed a few fortnights as the rosters were released in advance.

“I admit I have erased the written hours and adjusted them in order to submit my application near the end of 2018.”

She also wrote that during the course of her internship, she had been overworked with administrative tasks and she felt overwhelmed.

She said that this “has led to several breakdowns and severely affected my mental health.

“To be entirely honest, I wanted to finish my internship elsewhere, as working for (the complainant) not only in my intern year, but from July 2016, was absolutely suffocating and undoubtedly stressful… but I could not come around to giving notice.

“I successfully passed the written examination and the oral examination in one attempt, despite being approximately 250 hours less than needed for the oral examination.”

The intern’s general registration was suspended from mid-February 2019, and she was later charged with fraud, forgery, uttering a forged document and making a false entry in a record.

During this case her lawyer told the Brisbane Magistrates Court that the administrative tasks in question had included “errands for her including things such as picking up wedding portraits, going out and buying lunch, walking (the boss’) dog and taking her car in to get washed”.

She was also preparing medicines for up to 90 residential aged care patients every week while studying.

The relationship between the intern and preceptor had deteriorated after the internship began.

When the intern complained about her workload and the administrative tasks, the preceptor responded by cutting her hours to part-time, her lawyer said.

“She was a young person under extraordinary pressure who found herself making a regretful decision…

“In her mind she thought the only way out of a bad situation was to get registered and get another job,” her lawyer told the Court.

At the time, she was fined $2,000 and no conviction was recorded.

Now, the Tribunal has reprimanded her and cancelled her registration.

She is disqualified from applying for registration as a registered health practitioner for six months.

The Tribunal noted her “remorse and insight” and that “it appears that she was motivated to engage in criminal conduct by a desire to remove herself from a stressful working environment which was having a negative impact on her mental health, during a period when she was experiencing family and medical issues”.

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  1. James O'Loughlin

    I have personally experienced interns (especially overseas interns) being abused and overworked in many community pharmacies. Running errands for the owners, staying back till midnight at the end of the month to set the shop up for new catalogue sales but getting paid the same hourly rates, being assigned 100s of webster pack patients to pack, while also keeping on top of the claim. The list goes on and on.

    I feel sorry for her and hopefully she sees Community Pharmacy for what it is… If you’re reading this comment, I would strongly suggest retraining and starting a different career. Things are not going to get any better in Pharmacy.

  2. Vic Zelenka

    It seems unreasonable that the intern was forced to do jobs unrelated to her professional services and then is penalised. Why is the pharmacist in charge not held accountable for this behavior?
    This kind of work practice is not unusual but is not in any way acceptable.

  3. Benjamyn Sung

    I wish I could interview the poor student. But her conduct is definitely not condoned, even though her dilemma is sympathized. The preceptor should be sued also for abusing the student. There is a contract that the preceptor needs to sign for her conduct of being a preceptor and for the education she provides…why isn’t anybody look into this?

    • Jason Meiers

      Because….. owner has all the money and power, owner more than likely in the guild, or has the sympathy and solidarity of said body. Who lobbies both sides of politics most extensively “on behalf” of pharmacy?

  4. Kingsley Coulthard

    And we wonder why bright young graduates are demoralized with the profession and leaving ! The intern behavior was inappropriate. If her claims about the work place environment are true where is the investigation by Ahpra into the conduct of the preceptor?

  5. Jeff Lerner

    I have empathy for the intern in this case, partly based on my rather different experience in 1960s England. It used to be permissible to do one’s internship (usually known then as practical training) either before or after the university course. It suited me to follow the pre-grad route – I was amongst the last to do so – and I obtained a position at a branch of a well-known large multiple. So I started at age 17, and within about three months I was allowed to dispense mostly unchecked and unsupervised. As far as I know I didn’t kill anyone! The pharmacist/manager was rarely on the floor or in the dispensary, spending much of his time at the tea-room table doing paperwork. The company used unqualified dispensers whose training was limited to filling prescriptions promptly and accurately. My interactions with the pharmacist/manager were minimal and I learned very little from him.
    Pharmacy practice back then was very different. If a doctor wanted the patient to know the name of the prescribed medicine, the prescription would be marked “NP” (Nomen Proprium) — otherwise the labels would read “The Tablets”, “The Mixture”, “The Ointment” etc. Time and effort were expended in removing identifying labels at the time of dispensing. I was trained that any questions from the patient about the medication had to be met with: “We can’t discuss that with you; please check with your doctor.”
    To the intern, if you’re reading this:
    I encourage you to spend your suspension time thinking about different options for your future. Another commenter here suggests that you consider a change of career and I wouldn’t necessarily argue, but much depends on your circumstances. Many years ago I wanted to do that, but felt trapped by financial and family matters. Much of my 49 years as a pharmacist was spent in community pharmacy, including some years as an owner, but with a low sense of satisfaction with the conditions. As an employee I greatly disliked being involved in the sale of products that I felt had no place in pharmacy. (Ear candles and homeopathic products come to mind.) The final 18 years of my career were spent in a manufacturing facility in oncology compounding. Those years were infinitely more satisfying and it was a significant relief to have escaped from retail.
    There are several other routes you can follow. Please spend your time wisely on the sidelines by researching them. I wish you well.

  6. Michael Post

    I don’t condone the fraud but I can understand how a low quality preceptor can make life very difficult for an intern.
    5 years training to effectively manage simple medication supply logistics in a community setting with a modest degree of clinical reasoning is an unnecessarily long period.
    Make community pharmacy a 2 year TAFE course and the training should be on the job with interposed study .
    I recommend hospital ( clinical) pharmacy or a different profession to any prospective student.

  7. Riccardo Seeber

    Another point and shoot example by the board, no real root cause analysis to hold the preceptor and buisness to account regarding their workloads and managment. While this pharmacy rakes in the $$$ from all the DAA’s, this intern’s mental health suffered – that constitutes harm – doesnt the board protect the public from harm or are interns excluded from the public?
    Interns need to speek out early too, do not accept or tolerate a negative and overworked environment that should be for your professional development and learning – NOT stuck packing DAA’s all days of the week, NOT stuck on the front till all day.

  8. Jason Meiers

    This was occurring extensively when I was a pre-reg 15 odd years ago, and I’m sure the only change would be in the exponential growth of bureaucratic crap and “professional services “ that can be offloaded onto the quivering, shell-shocked shadow of a person, formerly known as a pharmacy student.

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