A DOCTOR who said a Fife patient "sounded like they worked for Al Qaeda" and showed pornographic images to colleagues has been cleared to continue his career.

While working as an ear nose and throat consultant at the Victoria Hospital in Kirkcaldy, Dr Nikolay Tsakov, who had considered a career as a comedian in his native Bulgaria, had also shown a medical student a photo of himself holding an air gun to patients and laughed about doing so.

He faced a string of misconduct charges covering a two-year period while he was working in Fife, Huntingdonshire, Rotherham and Mid-Ulster.

Dr Tsakov avoided being struck off but last year the Medical Practitioners Tribunal Service determined his fitness to practise was impaired by serious professional misconduct and imposed conditions on his registration for 12 months.

After hearing that he had taken steps to address his conduct, including completing courses on maintaining boundaries, a tribunal that met on May 31 has now published its findings and removed those restrictions.

The chairman, Tanveer Rakhim, said: "The tribunal was satisfied, in the light of all the evidence before it today, that Dr Tsakov’s conduct has now been remediated and the risk of repetition is very low."

He added that there was no evidence to suggest any further misconduct had taken place and that his fitness to practise "was no longer impaired".

The tribunal heard testimonials from his colleagues and a reflective statement from Dr Tsakov.

He said: "The allegations against me are a cause of great shame, as someone who wants to help and heal.

"To find that I have offended and upset people is absolutely devastating.

"The process of being before the MPTS was one of the toughest things I have ever been through.

"I felt exposed and vulnerable as every aspect of my life was under the spotlight.

"I am determined to learn from it and never repeat the mistakes that I have made."

Dr Tsakov, who qualified at the Medical Academy of Sofia in Bulgaria in 1999, came to the UK 10 years later and was employed as an ear nose and throat consultant.

Four offences took place while he was working for NHS Fife in November 2016.

Dr Tsakov told a medical student that the name of a patient on the clinic list “sounded like they worked for Al Qaeda”.

He also made inappropriate remarks about oral sex and showed a student a photograph of himself holding an air gun to patients and laughing about doing so.

He told the student he had been in trouble for making inappropriate comments previously and had completed a course to be “more PC”.

Other offences while working for other health boards between 2016 and 2018 included stating to a pregnant colleague: "Is that what happens when you sleep with no knickers on?” and showing colleagues pictures of naked women.

He also told a health care assistant, who had suffered a recent bereavement, that she reminded him of “a German Nazi with blonde hair and green eyes”, and caused a five-year-old boy distress by shaking his head "vigorously" to try and dislodge grommets (small tubes placed in a child's ear during surgery), a procedure carried out without the mother's consent.

Counsel Matthew McDonagh told the tribunal that his client was a "good doctor who is highly-regarded professionally and clinically by his colleagues" and that the issues related to his "language and his behaviour with his colleagues".

He added that Dr Tsakov "was of some national renown in his native country where he was considering a career as a comedian" and that his client had now realised "the way to lighten the mood or put colleagues and patients at ease was not through the mechanism of humour, but through professionalism, confidence and clinical skill".

He said the tribunal had found there was "never any intention to cause harm" and that the consultant "came from a place of good intentions, although things had gone wrong".