The fate of a Cape Breton doctor found guilty of incompetence and professional misconduct is being decided this week by the College of Physicians and Surgeons of Nova Scotia.

A panel began hearing evidence Monday into whether Dr. Stani Osif should lose her license to practice medicine or be allowed to upgrade her skills and resume working as a general practitioner.

Osif worked in the emergency department of the Northside General Hospital in North Sydney for 10 years. A disciplinary panel found her guilty of a number of charges in January. The panel concluded that she exhibited a pattern of carelessness that constituted incompetence.

In two cases, Osif was found guilty of professional misconduct.

The Nova Scotia College of Physicians and Surgeons argued Monday that Osif's license should be revoked.

Dr. Vonda Hayes, the director of faculty development in the Department of Family Medicine at Dalhousie University in Halifax, told the hearing she didn't believe course upgrades would be helpful, given the breadth, scope and number of Osif's deficiencies.

But Osif's lawyer introduced a list of courses she's taken since the disciplinary process began almost two years ago as proof she is willing to improve her skills.

The hearing is expected to continue Tuesday, after which the panel will likely issue a written decision.

Osif, a general practitioner in Sydney Mines, was suspended from practicing medicine in June 2007. She had been barred in 2006 from working in the Northside emergency department following a complaint.

Osif appeared before a disciplinary committee last fall to face nearly 40 charges under the Medical Act involving 24 different patients.

In one of the worst cases, the panel found that Osif diagnosed a urinary tract infection in a girl who came to the emergency department in December 2005. The 11-year-old was complaining of pain, vomiting and fever. Osif sent her home with an antibiotic.

The girl was later diagnosed with appendicitis and had two emergency surgeries.

The committee found that Osif failed to do an appropriate physical examination of the girl and provided an inaccurate account of the visit by recording an exam she did not perform.

In another case involving a 71-year-old man, the committee said Osif's approach to the patient amounted to indifference to his well-being.

The man made two visits to the emergency department in June 2003. Osif diagnosed an ear infection and sent him home with an antibiotic. He returned eight days later, and though Osif wanted to send him home again, the man's daughter refused.

The man was eventually admitted to hospital and diagnosed with brain and bowel cancer and died within three months.