In June 2025, a fitness-to-practise committee of the Irish Medical Council found that a man who had tried to register as a specialist cardiologist had done so using a forged diploma. He claimed a specialist qualification in cardiology from Charles University in Prague. University officials and the Czech Ministry of Health confirmed the document was false — the reference numbers on it actually corresponded to a different person’s award in gynaecology and obstetrics. The committee found the behaviour “disgraceful and dishonourable” and recorded that, had the attempt succeeded, there was “a very high likelihood of patients coming to harm” and it “could well” have led to deaths. The forgery was caught. The system worked. But the case is a useful place to start, because it shows exactly what the verification system is for — and exactly how much rides on it not failing.

What this article is and is not. This is about credential verification and regulatory enforcement — the machinery that checks a qualification is real before a person is let near a patient. It is not about nationality. The overwhelming majority of doctors who qualified abroad and practise in Ireland are properly qualified, properly verified, and a load-bearing part of the health service. Primary-source verification exists precisely so that the rare fraud is caught regardless of where the paperwork comes from. The patient-safety question is whether that verification — and the enforcement behind it — is resourced to keep pace with a fast-growing register. That is the subject here.

How Ireland decides who is a doctor

To practise medicine in Ireland you must be on the register maintained by the Medical Council. The register now holds more than 30,000 medical practitioners. For doctors who qualified outside Ireland, the Council does not simply take a certificate at face value: qualifications are checked through primary-source verification — the issuing university or authority is contacted directly to confirm the award is genuine and belongs to the applicant. It is this step that exposed the forged Prague diploma. The verifier asked the source, and the source said no.

That verification burden is not trivial, because of the shape of the Irish medical workforce. Ireland is one of the most internationally-reliant health systems in the developed world.

~43% Share of doctors working in Ireland who qualified overseas (2023) — the second-highest of seventeen European countries in the Medical Council’s analysis, and among the highest in the OECD. Source: Irish Medical Council / OECD.
25.7% Share of doctors qualified outside Ireland, the EU and the UK (2023), up from 23.3% the previous year. The fastest-growing segment of the register is the one that requires verification against institutions furthest from Irish oversight. Source: Medical Council, August 2024.

This is not a criticism of the doctors concerned. It is a description of the verification task. A health service that draws 43% of its doctors and more than half of its nurses from overseas training systems is a health service whose regulator has to verify a very large volume of qualifications, from a very wide range of institutions, many of them outside the EU’s mutual-recognition framework. The OECD, in its 2025 health workforce review, singled Ireland out for its “over-reliance” on foreign-trained staff. The verification system is the safeguard that reliance runs through.

The documented failures

Two kinds of failure show up in the regulator’s own records: forged qualifications submitted at the registration gate, and people practising — or claiming to practise — medicine without being registered at all.

The forged-diploma cardiologist is the clearest recent example of the first kind. It is rare, and it was caught at the verification stage before the applicant reached patients. That is the system functioning as designed. The uncomfortable counterfactual the committee itself put on the record — deaths “could well” have followed had it not been caught — is the reason the verification step cannot be allowed to weaken.

The second kind is unregistered practice, and the numbers here are more active than most people would assume.

18 Investigations opened by the Medical Council in 2025 into alleged unregistered medical practice. One file was reported to An Garda Síochána and the Minister for Health; one was closed; sixteen remained ongoing. Source: Medical Independent / Medical Council.

Eighteen investigations in a single year into people alleged to be practising or holding themselves out as doctors without being on the register is not a trivial figure. It is the part of the problem that does not announce itself at a registration desk — it surfaces through complaints, through employers, through patients who sense something is wrong. By definition, the cases that are investigated are the ones somebody noticed.

What the law says — and what it threatens

The legal framework is not weak on paper. Under section 37 of the Medical Practitioners Act 2007, it is a criminal offence for anyone who is not a registered medical practitioner to practise medicine or to advertise medical services. Where the Council’s chief executive has reasonable grounds to believe a person is practising medicine while unregistered, or claiming to be a doctor while unregistered, the matter is investigated under section 105 and reported to An Garda Síochána.

The penalties are serious. A summary conviction carries up to €5,000 and/or six months’ imprisonment. On indictment, a first offence carries up to €130,000 and/or five years; a subsequent offence up to €320,000 and/or ten years. In June 2025 the Council published a dedicated Unregistered Practice Policy setting out how it will manage and mitigate the risk of people practising while unregistered — an acknowledgement, in itself, that this is a live and recurring problem rather than a theoretical one.

The honest scale — and the real question

It is important to keep the proportions straight, because the patient-safety case is weakened, not strengthened, by overstatement. In 2023 the Medical Council opened 353 complaints against doctors — about 1.3% of the then 29,488 practitioners on the register. Of those, 61 were referred to the fitness-to-practise committee and 49 inquiries were concluded. The overwhelming majority of registered doctors in Ireland are competent, properly qualified, and never the subject of a complaint. Forgery at the registration gate is rare, and the Prague case shows it can be caught.

But “rare” and “caught” are properties of a system that is adequately resourced to verify and to enforce. The register is growing — past 30,000 and rising. The fastest-growing segment is the one requiring verification against institutions outside the EU recognition framework. Unregistered-practice investigations are running at eighteen a year and the Council felt the need to publish a new policy to manage them. The question this raises is not about where doctors come from. It is whether the verification function and the unregistered-practice enforcement function are funded and staffed to keep catching what they currently catch, as the volume and complexity of what they have to check keeps rising.

That is a patient-safety question, a resourcing question, and a public-accountability question — the kind the State tends to answer only after a verification failure reaches a patient rather than before. The forged cardiology diploma was stopped at the gate. The value of asking how robust that gate is, now, is that the next forgery is cheaper to catch at the registration desk than in a coroner’s court.

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June 2026

Follow the Money: IPAS Inc.

Another State system where the oversight on paper and the oversight in practice turned out to be two different things.

Investigation