How Poland’s medical courts work.

When a doctor treats patients badly, neglects medical records or behaves unethically, their professional liability is decided not by a common court but by the medical self-government. A disciplinary prosecutor (rzecznik odpowiedzialności zawodowej) brings the charges, and the regional medical courts and the Supreme Medical Court decide — doctors are judged by doctors.¹ The harshest penalties are rare in this system: in 2010–2025 20 doctors lost the right to practise with final effect, and in 6 of the 16 years — none.²

Below is the path of a case step by step, with examples from the catalogue of rulings (in Polish) — summaries of final rulings that the Supreme Medical Chamber (NIL) publishes without names.³ All the case summaries linked in this text are in Polish. The figures on penalties are described in our analysis Poland’s harshest penalty for doctors is almost never imposed.

What a doctor is liable for

The Act on medical chambers provides: “Members of medical chambers are subject to professional liability for breaching the principles of medical ethics and the provisions related to practising the profession of doctor” (our translation). Such a breach is professional misconduct.⁴ The principles of ethics are set out in the Code of Medical Ethics, adopted by the National Medical Congress.⁵

Misconduct does not have to concern treatment. The catalogue includes cases about the title of psychiatrist on a website used by a doctor without that specialisation (a fine), unpaid membership fees to the chamber (an admonition) and advertising on a television programme (an admonition).

The proceedings run independently of criminal proceedings concerning the same act. They may be stayed until the end of the criminal case if its outcome may affect the decision. The bodies of the self-government are bound by a final court decision “shaping a right or a legal relationship” (our translation).⁴

A criminal judgment does not close the case in the self-government. A doctor from an ambulance crew who diagnosed torticollis in a patient with a dilated aorta was fined by a criminal court and given a reprimand by the medical court. The Supreme Medical Court added that the criminal judgment did not make the self-government’s penalty pointless. In other cases the courts saw this differently — more on that below.

The path of a case

A doctor’s case passes through two instances of the self-government. It leaves the self-government only with a cassation appeal to the Supreme Court, and if the act is also a crime, criminal proceedings run separately.

Medical self-government

Common courts — separately

Brings the charges

Disciplinary prosecutor

Checks the complaint, gathers evidence, brings charges. The injured party may challenge a refusal to open proceedings and a discontinuation.

request for a penalty

First instance

Regional medical court

Panel of 3. May stay the case until the criminal trial ends and, after a criminal penalty, discontinue it as pointless.

If the act is a crime

Criminal court

The trial runs independently of the case in the self-government. The court may impose, among other things, a ban on practising the profession.

Example: fictitious pregnancies and sick notes (in Polish)

appeal · 14 days

Second instance

Supreme Medical Court

Panel of 5. Upholds, amends or sets aside the decision; its decision is final once announced.

Outside the self-government

cassation appeal · 2 months — the parties, the minister of health, the President of the Supreme Medical Council

Cassation appeal

Supreme Court

Only a flagrant breach of the law or a disproportionate penalty. In the catalogue, two cases went back to the Supreme Medical Court after a Supreme Court judgment.

After acquittal on cassation or reopening

Common court — compensation

The doctor may claim damages and compensation for harm from the chamber for a penalty already served.

path of the case in the self-governmentcases before courts outside the self-government

The act divides the proceedings into four stages: verification steps, the preliminary investigation, proceedings before the medical court and enforcement proceedings.¹

The injured party is a party to the proceedings, not just a witness. They may appoint up to two representatives, challenge a refusal to open proceedings and a discontinuation, appeal against the decision and lodge a cassation appeal. After their death these rights may be exercised by their next of kin. The accused may have up to two defence counsel, assigned ex officio if necessary.⁸ In the case of a psychiatric examination without consent the injured party’s representative appealed, demanding that the doctor be deprived of the right to practise. In the case of the reading of an X-ray the appeal was lodged by the family of the patient who had died.

When a case ends without a penalty

A doctor cannot be penalised until the misconduct has been established by a final decision. “Any doubts that cannot be removed in proceedings concerning doctors’ professional liability shall be resolved in favour of the accused” (our translation).⁹ A case can end without a penalty in three ways.

Acquittal means that there was no misconduct. Discontinuation can also happen when there was.

	When	Provision
Acquittal	the act was not committed, there is not enough evidence to sufficiently justify the suspicion, or the act does not constitute professional misconduct	Article 82(1) and Article 63(1)–(2)
Mandatory discontinuation	liability has lapsed (limitation), the accused has died, or proceedings concerning the same act have already ended with final effect or, opened earlier, are pending	Article 82(1) and Article 63(3)–(5)
Discontinuation at the court’s discretion	misconduct of minor gravity, or a penalty would be clearly pointless in view of a penalty imposed with final effect for the same act in other proceedings — if the interest of the injured party does not stand in the way	Article 82(2)

Acquittal. In the case of a nose operation the court of first instance banned the doctor from operating on the head for 12 months, and the Supreme Medical Court acquitted: it found no objective evidence of poor technique and resolved the doubts in favour of the accused. In the case of a death after an appendix operation the Supreme Medical Court noted that an untrue entry in the records must be “beyond doubt, not merely probable” (our translation).

Limitation. Proceedings are not opened if 3 years have passed since the act; each step taken by the prosecutor interrupts this period. Liability lapses 5 years after the act, and if the act is also a crime — not earlier than liability for the crime.⁹ In the catalogue the Supreme Medical Court discontinued for this reason four cases in which the first instance had imposed penalties, and in each it noted that the evidence did not justify an acquittal or that the act remained misconduct. In the case of orthodontic treatment that lasted more than ten years the Supreme Medical Court “regrets the length” of such cases (our translation). In the case of the examination without consent there were no criminal proceedings that would have extended the period.

Minor gravity. A doctor with a specialisation obtained abroad who, holding a conditional licence to practise, saw patients as an endocrinologist received no penalty. According to the court, the doctor’s conduct was “rather an expression of a certain recklessness” (our translation), and the finding of misconduct itself is meant to serve as a warning.

A penalty from other proceedings. In five cases in the catalogue the medical court discontinued the proceedings because a criminal court had already ruled on the same act. This was so with a heart attack missed in the emergency department, for which the doctor was fined, and with fictitious pregnancies and sick notes, for which a criminal court sentenced the doctor to, among other things, a temporary ban on practising the profession. In the latter case the Supreme Medical Court stressed that discontinuation is not acquittal: the act was attributed to the doctor, but the criminal penalty had already been severe.

Seven penalties and their consequences

The act gives the court seven penalties, from an admonition to revocation of the licence to practise. The provisions for each of them are listed next to the scale in the game (in Polish). Some rules become visible only in specific cases:

• A fine ranges from one third to four times the average monthly wage in the enterprise sector and goes to a social purpose related to healthcare.¹⁰ The maximum was imposed on an expert witness who for two years returned neither the opinion nor the case files.
• Penalties can be combined. To a restriction of the scope of practice or to a suspension the court may add a ban on holding managerial positions, and to penalties four to six — a fine.¹⁰ A head of ward who discharged a patient before the diagnosis was complete received a 2-year suspension and a 5-year ban; a doctor from a live stream about DMSO and hydrogen peroxide — a one-year suspension and a fine.
• A restriction of the scope of practice requires the court to specify the activities that the doctor may not perform.¹⁰ In the catalogue these include a 6-month ban on performing orthodontic procedures independently (orthodontics with a diet) and a ban on treating people under 18 (a teenager treated without indications).
• Publication in the chamber’s bulletin. With penalties four to seven the court may order it.¹⁰ It did so with the five-year suspension of an emergency department doctor who had dismissed a patient as a malingerer.
• A suspended doctor may not practise the profession “in any form” (our translation). Suspension and revocation are grounds for terminating an employment contract or a civil-law contract without notice.¹⁰
• Expungement. An admonition is expunged after a year, a reprimand 3 years after it becomes final, penalties three to five 3 years after they have been served, and a suspension 5 years after it has been served. Revocation of the licence to practise is never expunged.¹⁰ In that doctor’s case the court found no mitigating circumstances, partly because an earlier penalty had not been expunged. A doctor who for the second time worked an emergency department shift after drinking alcohol lost the right to practise. The Supreme Medical Court pointed out, among other things, that the doctor had not taken the “chance to improve” (our translation) given by an earlier decision.

How often the harshest penalties are imposed

In 2020–2025 the regional medical courts imposed 2,516 penalties at first instance. 86% of them were an admonition, a reprimand or a fine. Suspension of the licence to practise was ordered 233 times, revocation — 27 times.²

• 2,256 other penalties — from an admonition to a restriction of the scope of practice
• 233 suspension of the licence to practise for 1–5 years
• 27 revocation of the licence to practise

1 cell = 1 penalty imposed at first instance

ExactNIL, reports of the regional medical courts 2020–2025 (our compilation)

These are first-instance penalties — some of them change on appeal. With final effect, 20 doctors lost the right to practise in 2010–2025, just over one a year.²

In Norway and Sweden the right to practise is decided by state authorities, and in the United Kingdom by a tribunal separate from the professional regulator.¹¹¹²¹³ Relative to the number of doctors,¹⁴¹⁵ in 2020–2025 they withdrew the right to practise from about 16 to about 90 times as often as Polish medical courts.

Relative to the number of doctors, the authorities in Norway and Sweden withdrew the right to practise about 90 times as often as Polish medical courts did.

1. Norway state authority≈110.4
2. Sweden state authority≈110.3
3. United Kingdom tribunal≈19.1
4. Poland medical courts≈1.2

The figures year by year, broken down by country and with sources, are shown in our analysis Poland’s harshest penalty for doctors is almost never imposed.

Temporary suspension

Before a decision is issued, the medical court may, at the prosecutor’s request, temporarily suspend a doctor’s licence to practise or restrict the scope of practice — for up to a year. There are two conditions: the evidence points “with high probability” (our translation) to serious misconduct, and its nature indicates that the doctor’s continued work endangers patient safety or risks further misconduct. The order is immediately enforceable, even after a complaint to the Supreme Medical Court. If no final decision is issued within that time, the court examines of its own motion whether the suspension should continue. The period of suspension is counted towards the penalty.¹⁶

In 2024 the regional medical courts issued 36 orders temporarily suspending the licence to practise and 3 temporarily restricting the scope of practice.¹⁷

What is public

“Proceedings before a medical court take place at a public hearing” (our translation). The court excludes the public, however, if openness could, among other things, breach medical confidentiality or an important private interest. The announcement of the decision is public, and the presiding judge gives its main reasons orally.¹⁸

An acquitted doctor may demand that the chamber publish the acquittal in its bulletin at its own expense. The Register of Penalised Doctors, kept by the Supreme Medical Council, is open only to persons and institutions that show a legal interest.¹⁸

Since 2024 the Supreme Medical Chamber has also published final rulings with their written reasons on a portal run by the President of the Supreme Medical Council. It includes rulings of the Supreme Medical Court served on the President of the Council after 1 January 2024, and of the regional courts — after 1 July 2024. A version with narrower anonymisation is available only to members of the medical courts and to disciplinary prosecutors.¹⁹

In the public version, among other things, the case number, the dates of the decision and of the misconduct, the name of the court, first names and surnames, licence numbers and amounts are removed, and place names are replaced with an ellipsis. If the presiding judge of the court neither approves the anonymisation nor sends it back for correction within 7 days, the ruling is published automatically. The rules allow the rulings to be used “only for scientific, educational and information purposes” (our translation).¹⁹

The cases in the catalogue come from this portal. That is why it gives no amounts for fines: in the case of an OCT scan without indications all that is known is that the fine was twice the average wage.

Arguments and limits

The Constitution allows professional self-governments to be created by statute to represent persons practising professions of public trust and to “exercise care over the proper practice of these professions within the limits of the public interest and for its protection” (our translation).²⁰ The Act on medical chambers entrusts this care to the doctors’ self-government, and the regional medical court and the disciplinary prosecutor are bodies of every chamber.⁴

The self-government does not decide without outside review. A cassation appeal to the Supreme Court may also be lodged by the minister of health, and compensation for a doctor acquitted after reopening or cassation is decided by a common court.⁷ The injured party has the rights of a party, including the right to appeal and to lodge a cassation appeal.⁸ The first ground for excluding the public from a hearing is medical confidentiality, which protects information about patients.¹⁸

The catalogue and the game

The catalogue of rulings (in Polish) contains 59 outcomes from 55 final rulings published on the NIL portal. Each has its own page with the facts, the charge and the outcome, and most also have a summary of the written reasons. In the game Do you rule like a medical court? (in Polish) you read the facts, choose a penalty from the scale and see what the court decided.

Notes 21laws, data and statements we relied on

1. Act of 2 December 2009 on medical chambers (in Polish), consolidated text Dz.U. 2021 item 1342 (PDF): Article 55 (stages of proceedings, verification steps), Article 56 (parties), Article 58(1) (the accused), Article 67 (opening a preliminary investigation), Article 68 (complaint against a refusal to open proceedings and against discontinuation), Articles 71–74 (preliminary investigation, charges, discontinuation, request for a penalty), Article 76 (time limits and complaint about excessive length), Article 78 (medical courts and their jurisdiction), Article 80(1) (composition of the regional medical court). ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶

2. Supreme Medical Chamber, “Dane liczbowe dotyczące sądów lekarskich” (“Figures on the medical courts”, in Polish): annual reports of the regional medical courts and the Supreme Medical Court 2010–2025 and the summary of rulings of the regional courts (OSL) and the Supreme Medical Court (NSL) for 2000–2014. Totals for the 24 chambers and the breakdown by year — our compilation (see “Method”). Share of dental specialties in requests for a penalty — the “Specjalizacje” (“Specialties”) sheets of the OSL reports for 2020–2025. ↩ ↩² ↩³

3. Supreme Medical Chamber, “Portal prawomocnych orzeczeń sądów lekarskich” (“Portal of final rulings of the medical courts”, in Polish), category I (public). The case descriptions in the catalogue are summaries of these rulings. ↩

4. Act on medical chambers (in Polish, PDF): Article 2(2) (representing the profession and overseeing its practice), Article 21 (bodies of the regional chamber), Article 53 (professional misconduct), Article 54 (independence from criminal and disciplinary proceedings, staying the proceedings), Article 62 (being bound by a final court decision). ↩ ↩² ↩³

5. Supreme Medical Chamber, “Kodeks Etyki Lekarskiej” (“Code of Medical Ethics”, in Polish): history of the code and the 2024 amendment adopted by the Extraordinary 16th National Medical Congress; text in force from 1 January 2025 (PDF, in Polish). ↩ ↩²

6. Patient Ombudsman, “Izba lekarska — kiedy i jak może pomóc” (“The medical chamber — when and how it can help”, in Polish). ↩

7. Act on medical chambers (in Polish, PDF): Article 80(2) (composition of the Supreme Medical Court), Article 90 (appeal), Article 92 (decisions of the Supreme Medical Court and the ban on convicting a doctor who was acquitted), Article 94(1) (finality), Articles 95–96 (cassation appeal to the Supreme Court), Article 99 (reopening), Article 106 (compensation after reopening or cassation — decided by a common court). ↩ ↩² ↩³ ↩⁴

8. Act on medical chambers (in Polish, PDF): Articles 56–57 (parties, the injured party, representatives, rights of next of kin after the injured party’s death), Article 58(2)–(5) (defence counsel), Article 68(1) (complaints), Article 90(1) (appeal), Article 95(1) (cassation appeal). ↩ ↩²

9. Act on medical chambers (in Polish, PDF): Article 61 (presumption of innocence, doubts resolved in favour of the accused), Article 63 (grounds for discontinuation and for refusing to open proceedings), Article 64 (limitation), Article 82 (acquittal and discontinuation). ↩ ↩²

10. Act on medical chambers (in Polish, PDF): Article 83 (list of penalties and combining them with a ban on holding managerial positions), Article 84 (publication in the bulletin), Article 85 (fine), Article 86 (restriction of the scope of practice), Article 108 (consequences of suspension and revocation), Article 110(3)–(5) (expungement of penalties). ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶

11. Helsetilsynet, statistics on reactions against healthcare personnel (in Norwegian): annual announcements on the withdrawal of doctors’ authorisations or licences; 2010–2018 from the archive of announcements and the “Tilsynsmelding” reports, 2019–2024 from current announcements. ↩

12. Hälso- och sjukvårdens ansvarsnämnd (HSAN), annual report for 2025 (PDF, in Swedish), table 6: withdrawals of doctors’ licences — 2023: 55, 2024: 48, 2025: 64 (including 4 temporary); dentists in a separate row; 2010–2017 from earlier reports. Applications for withdrawal of a licence are made by, among others, the IVO inspectorate, and HSAN also considers applications from doctors themselves. ↩

13. General Medical Council, annual fitness to practise statistics: report for 2025 (PDF), table 3b (tribunal outcomes 2020–2025, row “Impairment – erasure”; the role of the MPTS; health-only cases do not end in erasure; publication of information about hearings), report for 2024 (PDF), table 6, and earlier annual reports (2010–2019; fall in the number of hearings in 2020 because of the pandemic — report for 2020). Calendar year of decision; excluding erasures following a review of sanctions and voluntary erasures. ↩

14. Number of doctors: Poland — 164,892 practising doctors, excluding dentists, Central Register of Doctors, NIL, breakdown by age (in Polish), as at 31.12.2025; Norway — SSB, table 07938 (in Norwegian), employed doctors with and without a specialisation, 4th quarter: 31,753 in 2020, 35,997 in 2025, average for 2020–2025 about 34,000; Sweden — Socialstyrelsen, 2026 (PDF, in Swedish), table 1: 46,020 doctors, including specialists, employed in healthcare in May 2025, 13% more than in May 2020; we estimate the average for 2020–2025 (about 43,000) as the mean of these two figures, i.e. assuming steady growth. ↩

15. General Medical Council, The state of medical education and practice in the UK: workforce report 2025 (PDF), part 2: 328,149 licensed doctors in 2024 against 272,255 in 2020. ↩

16. Act on medical chambers (in Polish, PDF): Article 77 (temporary suspension and restriction), Article 87(3)–(4) (counting towards the penalty). ↩

17. Supreme Medical Chamber, report of the regional medical courts for 2024 (XLSX, in Polish), rows 5.1–5.2 (orders issued at the request of prosecutors under Article 77), total for the 24 chambers. ↩

18. Act on medical chambers (in Polish, PDF): Article 79 (public hearing and exclusion of the public), Article 88 (announcement of the decision), Article 109 (publication of an acquittal), Article 110(1) (Register of Penalised Doctors). ↩ ↩² ↩³

19. Supreme Medical Chamber, “Regulamin portalu prawomocnych orzeczeń sądów lekarskich” (“Rules of the portal of final rulings of the medical courts”, PDF, consolidated text, in Polish): § 1 (running the portal), § 2(3)–(4) (categories and scope), § 4 (anonymisation and time limits), § 5(3) (purposes of use), § 7(5) (entry into force on 1 May 2024). ↩ ↩²

20. Constitution of the Republic of Poland (in Polish), Dz.U. 1997 no. 78 item 483 (PDF), Article 17(1). ↩

21. Supreme Medical Chamber, “Prawomocne orzeczenia sądów lekarskich” (“Final rulings of the medical courts”, in Polish): tables for the first and second halves of 2024 and the first half of 2025, row SUMA (total) — 827 rulings, including 200 discontinuations and acquittals. ↩