A junior doctor who worked in psychiatry at St Loman's Psychiatric Hospital in Mullingar is facing 24 allegations of professional misconduct and or poor professional performance at a Medical Council inquiry.
It is alleged that 36-year-old Dr Muthulingam Kasiraj did not show an understanding of how to manage a basic medical emergency, cardiopulmonary resuscitation (CPR) or the difference between a branded or generic drug.
The inquiry has heard that Dr Kasiraj is from India and qualified in medicine in Bulgaria in 2005.
He has indicated that he is also known as 'Dr Sripathy'.
He worked in the child and adolescent psychiatry service in Mullingar for the first half of 2013.
He then took up a post for six months at St Loman's adult psychiatric hospital.
JP McDowell, lawyer for the council, said a letter of complaint from his supervising consultant at St Loman's led to this inquiry.
Among the allegations are that Dr Kasiraj prescribed the incorrect dosage of drugs for some patients and failed to record adequate medical notes, or treatment plans.
It is also alleged that he did not understand the basics of cardiac life support, or understand common conditions like Herpes simplex, inflammatory bowel disease or malignant melanoma.
It is also alleged that he failed to mark-up an updated suicide assessment on a patient.
Dr Kasiraj is representing himself at the inquiry which is scheduled to last two days.
The inquiry has heard from Dr Ciaran Corcoran, who was Dr Kasiraj's supervising consultant psychiatrist at St Loman's.
He has described him as very pleasant, polite and punctual.
He told the inquiry that he interviewed Dr Kasiraj for the post in July 2013, along with another consultant colleague.
He could not recall if Dr Kasiraj was given any induction when he started at the hospital.
Dr Corcoran said he developed concerns about the doctor's writing abilities, clinical notes and knowledge of medicines.
It was also unusual to find him unable to perform a neurological examination, which was a basic skill.
Dr Corcoran said he gave Dr Kasiraj some final year medical books and also suggested he seek help from other doctors.
Because of concerns, he took Dr Kasiraj off on-call and the day time rota.
Dr Corcoran said no patients were harmed, as the incorrect drug doses were written by Dr Kasiraj in letters for patients' GPs.
He reported the issue to the Medical Council because of the doctor's ongoing supervision needs and potential patient safety issues, were Dr Kasiraj to work elsewhere unsupervised.
J P McDowell for the Council, told the inquiry that Dr Kasiraj may attribute his performance to medical issues, or a psychiatric condition.
There are two medical reports from Indian doctors and one from an Irish consultant on this issue.
The fitness to practise committee has indicated that some of this evidence may be taken in private.
The inquiry has heard Dr Kasiraj has anankastic personality disorder, an obsessive compulsive condition.
He has submitted to the inquiry that his performance at St Loman's has to be considered in the context of his subsequent diagnosis with this condition in India.
As part of the condition, tasks are performed in a certain way but if the person is interrupted, they must start again.
The inquiry has heard Dr Kasiraj makes the case that he has been treated for it, counselled and is on medication and is able to work as a doctor.
When asked about this, Dr Corcoran said it might possibly have contributed to the situation at St Loman's.
But he said it would be important to see if things are different now that Dr Kasiraj has undergone pharmaceutical intervention.
Dr Enda Hayden, a consultant psychiatrist at St Loman's who worked with Dr Kasiraj, said that a personality disorder is usually apparent by teenage years.
He said that if Dr Kasiraj had a personality disorder, it is doubtful he would have made it through medical school.
The inquiry has adjourned until Monday.
