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Former Name: No Former Name
Gender: Male
Languages Spoken: English, Polish
Education: Jagiellonian University Medical College, 1983
(1 of 2) As from August 9, 2017, the following is imposed as a term, condition and limitation on the certificate of registration held by Dr. Andrew John Kiellerman, in accordance with an undertaking and consent given by Dr. Kiellerman to the College of Physicians and Surgeons of Ontario: UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT ("Undertaking") of DR. ANDREW JOHN KIELLERMAN ("Dr. Kiellerman") 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; "Discipline Committee" means Discipline Committee of the College; "OHIP" means the Ontario Health Insurance Plan; "Public Register" means the College's register that is available to the public; "QAC" means the Quality Assurance Committee of the College. (2) I, Dr. Kiellerman, certificate of registration number 97058, am a member of the College. B. UNDERTAKING (3) I, Dr. Kiellerman, undertake to abide by the provisions of this Undertaking, effective upon the date this Undertaking is approved by the QAC ("Effective Date"). (4) Practice Restrictions (a) I, Dr. Kiellerman, undertake that I will cease to engage in "walk-in" practice. (5) I, Dr. Kiellerman, 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. (6) I, Dr. Kiellerman, undertake that I will not engage in "walk-in" practice until each and every one of the following conditions have been met: (a) I provide a minimum of forty-five (45) days' notice to the College of my intent to return to "walk-in" practice and (b) I provide the College with proof that I am participating in a program of continuing professional development that meets the requirements for continuing professional development of the Royal College of Physicians and Surgeons of Canada, the College of Family Physicians of Canada, or an organization that has been approved by the College for that purpose that meets the requirements for continuing professional development set by the Royal College of Physicians and Surgeons of Canada or the College of Family Physicians of Canada (7) I, Dr. Kiellerman, undertake that upon my return to the "walk-in" practice, I shall, at minimum, submit to a reassessment of my "walk-in" practice within three (3) to six (6) months after resuming my "walk-in" practice. (8) I, Dr. Kiellerman, undertake that I will submit to, and not interfere with, unannounced inspections of my Practice Locations and patient charts by a College representative for the purposes of monitoring my compliance with the provisions of this Undertaking. C. ACKNOWLEDGEMENT (9) I, Dr. Kiellerman, 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. (10) I, Dr. Kiellerman, 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. (11) I, Dr. Kiellerman, 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"). (12) I, Dr. Kiellerman, 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 any one or more of the following: consideration by the QAC, an investigation by the College, or further action by the College, including a referral of specified allegations to the Discipline Committee. (13) I, Dr. Kiellerman, acknowledge that this Undertaking constitutes terms, conditions, and limitations on my certificate of registration for the purposes of section 23 of the Code. (14) Public Register (a) I, Dr. Kiellerman, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register. (b) I, Dr. Kiellerman, acknowledge that, in addition to this Undertaking being posted in accordance with section (14)(a) above, the following summary shall be posted on the Public Register during the time period that this Undertaking remains in effect: Dr. Kiellerman has voluntarily ceased "walk-in" practice. D. CONSENT (15) I, Dr. Kiellerman, give my irrevocable consent to the College to make appropriate enquiries of OHIP 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. (16) I, Dr. Kiellerman, acknowledge that I have executed the OHIP consent form, attached hereto as Appendix "A" and that the consent forms part of this Undertaking. (17) I, Dr. Kiellerman, give my irrevocable consent to the College to provide all Chief(s) of Staff with any information arising from the monitoring of my compliance with this Undertaking. (18) I, Dr. Kiellerman, give my irrevocable consent to any Chief of Staff to disclose to the College, and to one another, all information relevant to this Undertaking and/or relevant for the purposes of monitoring my compliance with this Undertaking. (2 of 2) The certificate of registration held by Dr. Andrew John Kiellerman also carries the following term, condition and limitation imposed by the Registration Committee, effective November 25, 2011: Dr. Andrew John Kiellerman may practice medicine independently in General/Family Medicine, only.
Source: Fitness to Practice Committee Active Date: March 22, 2018 Expiry Date: Summary: Effective March 13, 2021, Dr. Keillerman has completed all elements of this SCERP.Specified Continuing Education and Remediation Program:Where the Quality Assurance Committee has made a decision on or after June 1, 2016 in which the disposition includes a Specified Continuing Education and Remediation Program (“SCERP”), the College By-laws require that the elements of the SCERP be posted on the register. A SCERP is one of the dispositions that the Quality Assurance Committee may make in connection with a matter before it, and this disposition requires the member to complete an education and remediation program specified for the member. A note will also be posted when all the elements of the SCERP have been completed.On March 22, 2018, the Quality Assurance Committee (“QAC”) required General Family/Complementary Medicine physician, Dr. Andrew John Kiellerman, to complete a specified continuing education and remediation program (“SCERP”). The SCERP requires Dr. Kiellerman to: • Attend and provide proof of successful completion of the following course: o University of Toronto Medical Record course• Practise under the guidance of a Clinical Supervisor acceptable to the College for 12 months;• Review the following policies, guidelines or tools with reference to how each is applicable to family medicine: o CPSO Medical Records Policy o CPSO Complementary/Alternative Medicine Policy o CPSO Test Results Management Policy o Relevant Clinical Practice Guidelines• Undergo a reassessment with an assessor selected by the College, approximately 6 months following the completion of the Education Plan.
Source: Member Active Date: August 9, 2017 Expiry Date: Summary: Summary of the Undertaking given by Dr. Andrew John Kiellerman to the College of Physicians and Surgeons of Ontario, effective August 9, 2017:Dr. Kiellerman has voluntarily ceased “walk-in” practice.