Cyprus is among the 15 EU countries that didn’t open any alerts about banned doctors sent through the European Commission’s Internal Information System (IMI) last year.
According to newly obtained data, the Cypriot authorities also never logged into the EU portal to open the alerts issued in 2021 and 2022 about a doctor disciplined and banned in Sweden and in Norway, who continues to work in Cyprus to this day. The Cyprus Medical Council, which is the regulatory authority, only accessed these alerts when OCCRP, CIReN and media partners published Bad Practice in October which exposed how doctors are able to hop jurisdictions and keep working despite losing their licenses in a certain country for serious offenses.
Alerts for “substantial reasons” are part of a European Union system designed to facilitate the exchange of information between public authorities across the bloc – and to warn countries about doctors disciplined for serious professional misconduct. But the alerts are routinely ignored by national authorities, according to the obtained records that shed light on how the system functions in practice.
The system, known as the Internal Market Information system, or IMI, is a secure EU-wide network that allows governments to cooperate on supervision of regulatory affairs pertaining to the single market. This includes the exchange of information on professionals, who relocate or offer services outside of their national borders. In healthcare, it includes an alert mechanism requiring authorities to notify other member states when a doctor is suspended or struck off for substantial reasons, such as serious malpractice or patient harm.
IMI alert access logs, recently obtained by journalists, record when alerts were opened and by which authorities, providing insights as to how national authorities engage with the system.
An analysis of access logs revealed a strikingly low level of engagement, showing that many of these warnings go unread.
Of more than 500 internal alerts issued in 2024 and 2025, only about one-third were opened by the receiving jurisdictions. Even fewer went on to view the personal data attached to the alerts, including sanctioned doctor’s identity and details of the disciplinary action. Perhaps more concerning, half of the states participating in the IMI, including Cyprus, did not open a single alert filed for “substantial reasons” during the past year – among them, Cyprus.
While member states are required to issue alerts, the relevant directive leaves it to their discretion on whether to access or ignore incoming alerts from other countries.
Others that failed to access any of these alerts include Bulgaria, Croatia, Czechia, France, Greece, Hungary, Iceland, Latvia, Lithuania, Lichtenstein, Luxembourg, Portugal, Slovakia and Slovenia.
These findings call into question the effectiveness of a system that costs roughly two million euros a year and is meant to stop doctors who are barred or restricted in one European country from quietly resuming practice in another, while also raising broader concerns about public health and patient safety.
While several countries do consistently read alerts, including authorities from Sweden, Spain, Norway, Netherlands, Malta, Poland, Ireland Italy and Denmark, the system’s very design may be part of the problem.
Norwegian Minister of Health and Care Services Jan Christian Vestre said it needs improvement.
“It is not satisfactory, and it challenges patient safety throughout Europe,” he said in an emailed response to questions.
When an alert is issued through the system, registered authorities automatically receive an email notification. The message includes only basic information -the issuing country, the profession involved, and the alert category – but omits the substance of the warning and the professional’s identity.
Cyprus’s national IMI coordinator told CIReN that the email notifications are redacted for data-protection reasons.
The limited information makes it difficult for local regulators to fully assess the risk posed by an incoming alert, potentially undermining the system’s purpose. To see the full details, recipients must log into the system and manually request additional information from the issuing country – a process that adds extra steps and administrative labor to determine whether the alert concerns professionals active in their jurisdiction.
Norway has deployed a bot to scan all alerts sent through the IMI system, but the measure has not created a foolproof review process as Norwegian media partners VG identified multiple doctors who were licensed in Norway despite being banned in other countries over serious offences.
Their findings were part of the Bad Practice investigation that identified more than 100 doctors across Europe who were licensed and working despite having been sanctioned elsewhere.
In Cyprus, one such case was discovered. It involved Simon Moskofian, a doctor whose medical licenses were revoked in Sweden and Norway after authorities concluded that his conduct posed a risk to patients.
Swedish regulators found that he lacked basic medical knowledge, carried out consistently inadequate investigations and, in one case, exposed a patient to “obvious danger of death” after improperly administering medication. They also filed an alert to the IMI system immediately, going out to 29 other countries.
Norway followed Sweden’s 2021 decision with its own revocation in early 2022, and sent out its own alert a few months later.
Despite the actions taken abroad, Moskofian held an active medical license in Cyprus, where he was registered with the national health system and practiced medicine at a Larnaca clinic since 2019.
When CIReN raised the issue to the Cyprus Medical Council – the country’s medical regulator – it said on September 22 that it had “already started to investigate the case and would take all the necessary measures.”
However, access logs from the IMI system later showed that alerts sent by Swedish and Norwegian authorities were opened by the Council on October 3 – one day after the investigation was published.
That same day, Cyprus sent an information request to Norway through the system. Norwegian authorities opened the request three days later and transmitted a copy of their decision that day.
The sequence of events raises questions about whether the Council’s review of the alerts coincided with the start of its investigation, or came afterward. The Cyprus Medical Council neither confirmed nor denied opening the alerts on that day. In a statement, it said that it “examines every means at its disposal to support its work and to inform its counterpart IMI users,” adding that “the investigation is ongoing.”
In connection to his case, Dr. Moskofian told CIReN that two months after our story was published he was summoned to a meeting at the Ministry of Health with the Council, the Cyprus Medical Association, and their lawyers where he was asked to explain his position regarding the Swedish medical authority’s decision.
He was also asked to provide the letter the Swedish Medical Responsibility Board had sent him regarding the revocation of his license, he said. Moskofian claimed that the letter did not concern a revocation decision, but rather a translation error, and that the Board had downgraded his status from a supervising doctor to a supervisee instead of revoking his license. He added that he considers Sweden’s decision to be “unfair.”
In response, the Cyprus Medical Association told CIReN that “the competent body under the law for any examination, investigation, or possible change in a doctor’s registration status is the Cyprus Medical Council,” and that the Association “will act according to the results of the investigation and the decisions of the Council.”