Who is a specialist in Trinidad and Tobago? New Medical Board rules

The Arima case

On 20 November 2025, Timothy Malchan, 39, of D'Abadie appeared before the Arima Third Magistrates' Court on three charges under the Medical Board Act (Chap. 29:50): using medical titles while not registered, assuming the title of doctor without registration, and diagnosing human ailments without a licence. He pleaded not guilty and was granted TT$50,000 bail, with a return date of 17 June 2026¹².

The investigation began in January 2025, when the Eastern Regional Health Authority reported that he had contacted its patients about their confidential medical records and asked them to pay for "consultations"¹. Medical Board inquiries found he was not a registered medical practitioner and held no recognised qualification in the specialties he advertised (cardiovascular disease, thoracic surgery and cardiothoracic surgery) on social media and on the front of an office in Arima¹². Police said "covert operations were done which revealed the doctor performed a medical procedure and gave medical advice for a fee"³. A search warrant was executed on 19 November and records were seized¹. The charges have not been proven in court, and we found no report of the outcome of the June hearing.

What the Medical Board says

The Medical Board of Trinidad and Tobago (MBTT) registers doctors and specialists, issues licences, investigates complaints and can warn, suspend or remove doctors from the register under the Medical Board Act. Its public notice is blunt: "It is an offence to practice medicine in Trinidad and Tobago without proper registration", and doctors must not "Claim to be a Specialist Doctor if not listed in the Specialist Register". It asks the public to check a doctor's registration and specialist status on mbtt.org⁴. The Board's registration rules add that only fully registered practitioners may practise privately and that the Doctor of Osteopathic Medicine (D.O.) "is not a recognised medical degree" for registration⁶.

The new specialist register rules

The Policy Guidelines for Eligibility to the Medical Specialist Register 2025, effective 1 January 2026, are issued under section 16 of the Medical Board Act. Section 10A, added in 2007, requires the Council to keep the Medical Specialist Register; section 17 lets the Secretary erase entries "incorrectly or fraudulently made"⁵. The register began in 2016 and was first revised in 2020⁵.

The revision targets Pathway B, the route for doctors who passed specialty examinations such as the MRCS, MRCP or MRCOG but did not complete a recognised training programme. The Board calls the old requirement of time at a "Senior Level" "a very ambiguous term" and now requires a logged portfolio of specialist training activities: clinics, calls, audits, morbidity and mortality meetings and certified procedure logs⁵. It notes that membership examinations alone are not evidence of specialisation⁵. Applicants training under the 2020 rules had until 30 June 2026 to ask to be considered under them, with eligibility before 31 December 2027, and Pathway B will end for all specialties covered by a University of the West Indies Doctor of Medicine programme on 31 December 2028⁵.

Aesthetics: excluded on paper

The dermatology section is the one aesthetic clinics will read. Specialist entry requires the MRCP, four years in dermatology, the Specialty Certificate Examination and an approved MSc, and the guidelines state: "Online courses and Aesthetic qualifications are excluded from these criteria"⁵. The procedure log includes laser, botulinum toxin chemodenervation and soft tissue augmentation with skin fillers, 15 of each, performed or observed, and "Observed" does not include online or virtual courses: the candidate must be present with live subjects⁵. In other words, a weekend injectables certificate does not make anyone a dermatologist in Trinidad and Tobago.

Why regulators care: the evidence on unlicensed practice

A 2026 analysis of cosmetic malpractice complaints found that unlicensed providers accounted for 25.7 % of cases, mostly fillers and botulinum toxin, often in private homes (53.8 %); their cases mainly involved infections and tissue necrosis (62.2 %)⁸. In a Brazilian survey of 1,058 physicians, 12.69 % of patients they saw had been treated by non-medical professionals, and 17 % of the complications led to permanent sequelae⁹. A scoping review of iatrogenic botulism found that 46 % of cases involved unlicensed botulinum toxin products¹⁰. In the United States, a state-by-state review found that neuromodulator injections, fillers and ablative laser resurfacing are "uniformly classified as the practice of medicine"⁷.

Advertising is the common thread. The Arima office was promoted on social media¹, the same channel the Ministry of Health flagged in January 2025 when it referred online Ozempic sales to the police¹². The Food and Drugs Act (Chap. 30:01) separately bans advertising drugs to the public as treatments for conditions such as obesity, diabetes and sexual impotence (section 4)¹¹.

What it means for physicians

Patients can and should check the register⁴. For physicians, the new rules mean that a specialist title in Trinidad and Tobago depends on documented training, not on certificates from short or online courses⁵. Referrals to colleagues who advertise a specialty are worth checking against the Medical Specialist Register, and suspected unregistered practice can be reported to the Board⁴.