Mohammed Shamsul ISLAM

1. To notify the GMC within seven calendar days of signing these undertakings:

a of the details of my current post, including my job title, job location and responsible officer (or their nominated deputy) information

b of the contact details for my employer and/or contracting body, including my direct line manager

c of any organisation where I have practising privileges and/or admitting rights

d of any training programmes I am in

e for GPs only: of the organisation on whose medical performers list I am included.

2. To notify the GMC:

a of any post I accept, before starting it

b if any formal disciplinary proceedings against me are started by my employer and/or contracting body, within seven calendar days of being formally notified of such proceedings

c if I apply for a post outside the UK.

3. To allow the GMC to exchange information with any person involved in monitoring my compliance with my undertakings.

4a To have a workplace reporter approved by my responsible officer (or their nominated deputy) and to inform the GMC of these arrangements.

b Not to start/restart work until my responsible officer (or their nominated deputy) has approved my workplace reporter and this approval has been forwarded to the GMC.

5a To design a personal development plan (PDP), approved by my responsible officer (or their nominated deputy), with specific aims to address the deficiencies in the following areas of my practice.

• Use of IT

• Patient data handling

• Audit

b To give the GMC a copy of my approved PDP within three months of the date I agree these undertakings.

c To give the GMC a copy of my approved PDP on request.

d To meet with my responsible officer (or their nominated deputy), as required, to discuss my achievements against the aims of my PDP.

6a To have an educational supervisor approved by my responsible officer (or their nominated deputy) and to inform the GMC of these arrangements.

b Not to start/restart work until my responsible officer (or their nominated deputy) has approved my educational supervisor and this approval has been forwarded to the GMC.

7. To get the approval of the GMC before starting work in a non-NHS post or setting.

8. Not to work:

a. as a locum/ in a fixed term contract

b. out-of-hours

c. on-call.

9a. To be supervised in all my posts by a clinical supervisor, as defined in the Glossary for undertakings and conditions. My clinical supervisor must be approved by my responsible officer (or their nominated deputy) and I must inform the GMC of these arrangements.

b Not to start/restart work until my responsible officer (or their nominated deputy) has approved my clinical supervisor and this approval has been forwarded to the GMC

10. To disclose the Expert Report of Anna-Maria Rollin dated 22 September 2009 to:

a. my employer and/or contracting body;

b. my responsible officer (or their nominated deputy);

c. Any other individual involved in his retraining and supervision.

11. Not undertake any circumcision procedures

12. Not to undertake any work as a forensic medical examiner

13. Not to work in any post for more than eight sessions per week.

14. To inform the following persons of the undertakings listed at (1) to (13):

a my employer and/or contracting body

b my responsible officer (or their nominated deputy)

c my immediate line manager at my place of work, at least 24 hours before starting work (for current and new posts, including locum posts)

d any prospective employer and/or contracting body, at the time of application

e the responsible officer of any organisation where I have, or have applied for, practising privileges and/or admitting rights, at the time of application

f for GPs only: the organisation on whose medical performers list I am included or seeking to be included, at the time of application]

15. To allow the GMC to disclose the above undertakings to any person requesting information about my registration status.