Bulanski, Emily Martha (CPSO#: 62683)

Current Status: Active Member as of 01 Jul 1990

CPSO Registration Class: Restricted as of 11 Jan 2018

Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Female

Languages Spoken: English, Polish

Education:University of Alberta, 1990

Practice Information

Primary Location of Practice
Delta Coronation FHO
Unit 201
614 Coronation Boulevard
Cambridge ON  N1R 3E8
Phone: (519) 620-7122
Fax: (519) 623-7342
Electoral District: 03
View Professional Corporation Information

Professional Corporation Information

Corporation Name: Emily M. Bulanski Medicine Professional Corporation

Certificate of Authorization Status: Issued Date:  Oct 28 2003

Shareholders:
Dr. E. Bulanski ( CPSO# 62683 )

Business Address:
Unit 201
614 Coronation Boulevard
Cambridge ON  N1R 3E8
Phone Number: (519) 620-7122

Business Address:
Cambridge Memorial Hospital
700 Coronation Boulevard
Cambridge ON  N1R 3G2
Phone Number: (519) 621-2333

Hospital Privileges

Hospital Location
Cambridge Memorial Hospital Cambridge

Specialties

Specialty Issued On Type
Family Medicine Effective: 09 Dec 1992 CFPC Specialist

Postgraduate Training

Please note: This information may not be a complete record of postgraduate training.

McMaster University, 01 Jul 1991 to 30 Jun 1992
Resident 2 - Family Medicine

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 01 Jul 1990
Transfer of class of registration to: Independent Practice Certificate Effective: 30 Aug 1991
Transfer of class of certificate to: Restricted certificate Effective: 11 Jan 2018
Terms and conditions imposed on certificate by member Effective: 11 Jan 2018

Practice Restrictions

Imposed By Effective Date Expiry Date Status  
member Effective: 11 Jan 2018 Active View Details [+]
            As from January 11, 2018, the following terms, conditions and limitations are
            imposed on the certificate of registration held by Dr. Emily Martha Bulanski,
            in accordance with an undertaking and consent Dr. Bulanski has given to the
            College of Physicians and Surgeons of Ontario:

                               UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT 
                                            ("Undertaking")

                                                  of

                                       DR. EMILY MARTHA BULANSKI
                                           ("Dr. Bulanski")

                                                  to 

                             COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
                                            (the "College")


            A.    PREAMBLE

            (1)   In this Undertaking:

                  "Code" means the Health Professions Procedural Code, which is Schedule 2
                  to the Regulated Health Professions Act, 1991, S.O. 1991, c. 18, as
                  amended; 
                  
                  "ICR Committee" means the Inquiries, Complaints and Reports Committee of
                  the College;
                  
                  "NMS" means the Drug Program Services Branch, the Narcotics Monitoring
                  System implemented under the Narcotics Safety and Awareness Act, 2010;

                  "OHIP" means the Ontario Health Insurance Plan;
                  
                  "Public Register" means the College's register that is available to the
                  public.
                  
            (2)   I, Dr. Bulanski, certificate of registration number 62683, am a member of
                  the College.  The College has received information regarding my standard
                  of practice.

            (3)   I, Dr. Bulanski, acknowledge that the College initiated an investigation
                  bearing File Number 399405 (the "Investigation") into whether I engaged
                  in professional misconduct and/or am incompetent in my family practice. 

            B.    UNDERTAKING

            (4)   I, Dr. Bulanski, undertake to abide by the provisions of this
                  Undertaking, effective immediately. 



            (5)   Clinical Supervision 

                  (a)   I, Dr. Bulanski, undertake to practise under the guidance of a
                        clinical supervisor(s) acceptable to the College (the "Clinical
                        Supervisor(s)"), for six (6) months ("Clinical Supervision"). 
                  
                  (b)   I, Dr. Bulanski, acknowledge that I have reviewed the Clinical
                        Supervisor(s)'s undertaking, attached hereto as Appendix "A", and
                        understand what is required of the Clinical Supervisor(s). The
                        Clinical Supervisor(s) will, at minimum: 
                  
                        (i)   Facilitate the education program set out in the
                              Individualized Education Plan ("IEP"), attached hereto as
                              Appendix "B";
                  
                        (ii)  Meet with me at my Practice Location, or another location
                              approved by the College, once every month;
                  
                        (iii) Review at least twenty (20) of my patient charts at every
                              meeting;
                  
                        (iv)  Discuss any concerns arising from the chart reviews;
                  
                        (v)   Make recommendations to me for practice improvements and
                              ongoing professional development and inquire into my
                              compliance with the recommendations; 
                  
                        (vi)  Perform any other duties, such as reviewing other documents
                              or conducting interviews with staff or colleagues, that the
                              Clinical Supervisor(s) deem necessary to my Clinical
                              Supervision; and
                  
                        (vii) Submit written reports to the College at least once every
                              month, or more frequently if the Clinical Supervisor(s) has
                              concerns about my standard of practice.
                  
                  (c)   I, Dr. Bulanski, acknowledge that the charts reviewed shall be
                        selected by the Clinical Supervisor(s) based on the educational
                        needs identified in the IEP, attached hereto as Appendix "B", as
                        well as the areas of concern identified in the report(s) of
                        assessor, dated November 3, 2016 and November 8, 2016, and concerns
                        that may arise during the period of Clinical Supervision.
                  
                  (d)   I, Dr. Bulanski, undertake to cooperate fully with the Clinical
                        Supervision of my practice, conducted under the term of this
                        Undertaking and Appendix "A" to this Undertaking, and to abide by
                        the recommendations of my Clinical Supervisor(s), including but not
                        limited to, any recommended practice improvements and ongoing
                        professional development.
                  
                  (e)   I, Dr. Bulanski, undertake to ensure that Appendix "A" to this
                        Undertaking is signed and delivered to the College within thirty
                        (30) days of the date I execute this Undertaking.
                  
                  (f)   I, Dr. Bulanski, undertake that if a person who has given an
                        undertaking in Appendix "A" to this Undertaking is unable or
                        unwilling to continue to fulfill its provisions, I shall, within
                        twenty (20) days of receiving notice of same, obtain an executed
                        undertaking in the same form from a similarly qualified person who
                        is acceptable to the College and ensure that it is delivered to the
                        College within that time.
                  
                  (g)   I, Dr. Bulanski, undertake that if I am unable to obtain a Clinical
                        Supervisor on the provisions set out under sections (5)(e) and/or
                        (f) above, I will cease practising medicine until such time as I
                        have obtained a Clinical Supervisor acceptable to the College.  
                  
                  (h)   I, Dr. Bulanski, acknowledge that if I am required to cease
                        practise as a result of section (5)(g) above this will constitute a
                        term, condition or limitation on my certificate of registration and
                        that term, condition or limitation will be included on the public
                        register.
                  
            (6)   Professional Education

                  (a)   I, Dr. Bulanski, undertake to participate in and successfully
                        complete all aspects of the detailed IEP, attached hereto as
                        Appendix "B", including all of the following professional education
                        (the "Professional Education"):
                  
                        (i)   a program(s) satisfactory to the College in: 
                              1.    medical record keeping; and
                        (ii)  any additional professional education recommended by my
                              Clinical Supervisor(s).
                  
                  (b)   I, Dr. Bulanski, undertake to provide proof to the College of my
                        successful completion of the Professional Education, including
                        proof of registration and attendance and participant assessment
                        reports, within one (1) month of completing it. I acknowledge that
                        the College will determine, in its sole discretion, whether I have
                        successfully completed the Professional Education.
                  
                  (c)   I, Dr. Bulanski, acknowledge that a report or reports may be
                        provided to the College regarding my progress and compliance with
                        the Professional Education.
                  
                  (d)   I, Dr. Bulanski, undertake to complete this requirement by June 1,
                        2018, or, if no satisfactory program is available by that time, by
                        the first possible opportunity thereafter.
                  
            (7)   Reassessment of Practice

                  (a)   I, Dr. Bulanski, undertake that, approximately six (6) months after
                        having completed both the Clinical Supervision set out in section
                        (5) above and Appendix "A" to this Undertaking and the Professional
                        Education set out in section (6) above and Appendix "B" to this
                        Undertaking, I will submit to a reassessment of my practice ("the
                        Reassessment") by an assessor or assessors selected by the College
                        (the "Assessor(s)").  I acknowledge that the Reassessment may
                        include a chart review, direct observation of my care, interviews
                        with colleagues and co-workers, feedback from patients and any
                        other tools deemed necessary by the College.
                  
                  (b)   I, Dr. Bulanski, undertake to co-operate fully with the
                        Reassessment, conducted under the term of this Undertaking. 
                  
                  (c)   I, Dr. Bulanski, acknowledge that my Clinical Supervisor(s) may
                        receive and review the findings of the Assessor(s), and may discuss
                        with the Assessor(s) any issues or concerns arising from the
                        Reassessment.  I also acknowledge that the results of the
                        Reassessment will be provided to me and reported to the College and
                        the report may form the basis of further action by the College. 
                  
                  (d)   I, Dr. Bulanski, acknowledge that if I am of the view that any of
                        the Assessor(s)'s recommendations are unreasonable, I will have
                        thirty (30) days following my receipt of the recommendations within
                        which to provide the College with my submissions in this regard.  I
                        further acknowledge that thereafter, the ICR Committee will
                        consider my submissions and make a determination regarding whether
                        or not the recommendations, or any of them, are reasonable and if
                        so, whether they, or any of them, constitute limitations or
                        restrictions on my practice, and that decision will be provided to
                        me. 
                  
                  (e)   I, Dr. Bulanski, undertake that, following the decision referenced
                        in section (7)(d) above, I will abide by those recommendations of
                        the Assessor(s) that the ICR Committee has determined are
                        reasonable. 
                  
                  (f)   I, Dr. Bulanski, hereby consent to the following being included on
                        the public register as terms, conditions or limitations on my
                        certificate of registration, for the purposes of section 23 of the
                        Code: 
                  
                        (i)   any recommendations of the Assessor(s) which the ICR
                              Committee has identified in its decision referenced in
                              section (7)(d) as terms, conditions or limitations on my
                              practice.
                  
            (8)   Monitoring 

                  (a)   I, Dr. Bulanski, undertake to inform the College of each and every
                        location that I practise or have privileges, including, but not
                        limited to, hospital(s), clinic(s) and office(s), in any
                        jurisdiction (collectively my "Practice Location(s)"), within five
                        (5) days of executing this Undertaking.  Going forward, I further
                        undertake to inform the College of any and all new Practice
                        Locations within five (5) days of commencing practice at that
                        location.
                  
                  (b)   I, Dr. Bulanski, undertake that I will submit to, and not interfere
                        with, unannounced inspections of my Practice Location(s) and
                        patient records by a College representative for the purposes of
                        monitoring my compliance with the provisions of this Undertaking.
                  
                  (c)   I, Dr. Bulanski, give my irrevocable consent to the College to make
                        appropriate enquiries of OHIP, NMS and/or any person who or
                        institution that may have relevant information, in order for the
                        College to monitor my compliance with the provisions of this
                        Undertaking. 
                  
                  (d)   I, Dr. Bulanski, acknowledge that I have executed the OHIP and NMS
                        consent form(s), attached hereto as Appendix "C" and Appendix "D",
                        respectively. 
                  
            C.    ACKNOWLEDGEMENT

            (9)   I, Dr. Bulanski, acknowledge that all appendices attached to or referred
                  to in this Undertaking form part of this Undertaking.

            (10)  I, Dr. Bulanski, acknowledge and undertake that I shall be solely
                  responsible for payment of all fees, costs, charges, expenses, etc.
                  arising from the implementation of any of the provisions of this
                  Undertaking. 

            (11)  I, Dr. Bulanski, acknowledge that I have read and understand the
                  provisions of this Undertaking and that I have obtained independent legal
                  counsel in reviewing and executing this Undertaking, or have waived my
                  right to do so.

            (12)  I, Dr. Bulanski, acknowledge that the College will provide this
                  Undertaking to any Chief of Staff, or a colleague with similar
                  responsibilities, at any Practice Location ("Chief(s) of Staff").

            (13)  I, Dr. Bulanski, acknowledge that a breach by me of any provision of this
                  Undertaking may constitute an act of professional misconduct and/or
                  incompetence, and may result in a referral of specified allegations to
                  the Discipline Committee of the College.

            (14)  I, Dr. Bulanski, acknowledge that this Undertaking constitutes terms,
                  conditions, and limitations on my certificate of registration for the
                  purposes of section 23 of the Code. 



            (15)  Public Register

                  (a)   I, Dr. Bulanski, acknowledge that, during the time period that this
                        Undertaking remains in effect, this Undertaking shall be posted on
                        the Public Register.
                  
                  (b)   I, Dr. Bulanski, acknowledge that, in addition to this Undertaking
                        being posted in accordance with section (15)(a) above, the
                        following summary shall be posted on the Public Register during the
                        time period that this Undertaking remains in effect:
                  
                        A College investigation was conducted into whether Dr. Bulanski
                        engaged in professional misconduct and/or is incompetent in the
                        practice of family medicine. As a result of the investigation:
                  
                              Dr. Bulanski will practise under the guidance of a Clinical
                              Supervisor acceptable to the College for six months. 
                  
                              Dr. Bulanski will engage in professional education in medical
                              record-keeping.
                  
                              Dr. Bulanski's practice will be reassessed by an assessor
                              selected by the College within approximately six months of
                              the end of the period of Clinical Supervision and
                              Professional Education.
                  
            D.    CONSENT

            (16)  I, Dr. Bulanski, give my irrevocable consent to the College to provide
                  the following information to any person who requires this information for
                  the purposes of facilitating my completion of the Professional Education
                  and to all Clinical Supervisors, and/or Assessors:

                  (a)   any information the College has that led to the circumstances of my
                        entering into this Undertaking;
                  
                  (b)   any information arising from any investigation into, or assessment
                        of, my practice; and 
                  
                  (c)   any information arising from the monitoring of my compliance with
                        this Undertaking.
                  
            (17)  I, Dr. Bulanski, give my irrevocable consent to the College to provide
                  all Chief(s) of Staff with any information the College has that led to
                  the circumstances of my entering into this Undertaking and/or any
                  information arising from the monitoring of my compliance with this
                  Undertaking.



            (18)  I, Dr. Bulanski, give my irrevocable consent to any persons who
                  facilitate my completion of the Professional Education, and to all
                  Clinical Supervisors, Chiefs of Staff and Assessors, to disclose to the
                  College, and to one another, any information:

                  (a)   relevant to this Undertaking;
                  
                  (b)   relevant to the provisions of the Clinical Supervisor's undertaking
                        set out at Appendix "A" to this Undertaking;
                  
                  (c)   relevant to the Reassessment;
                  
                  (d)   relevant for the purposes of monitoring my compliance with this
                        Undertaking; and/or  
                  
                  (e)   which comes to their attention in the course of providing the
                        Professional Education and which they reasonably believes indicates
                        a potential risk of harm to my patients.

Concerns

Source: Member
Active Date: January 11, 2018
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Emily Martha Bulanksi to the College of Physicians and Surgeons of Ontario, effective January 11, 2018:

A College investigation was conducted into whether Dr. Bulanski engaged in professional misconduct and/or is incompetent in the practice of family medicine. As a result of the investigation:

Dr. Bulanski will practise under the guidance of a Clinical Supervisor acceptable to the College for six months.

Dr. Bulanski will engage in professional education in medical record-keeping.

Dr. Bulanski’s practice will be reassessed by an assessor selected by the College within approximately six months of the end of the period of Clinical Supervision and Professional Education.