A Sydney, N.S., gynecologist accused of inappropriate behaviour says he did not ask sexualized questions to two patients who are accusing the physician of misconduct.

Dr. Manivasan Moodley began testifying on Thursday at a College of Physicians and Surgeons hearing in Bedford about his behaviour.

Moodley, who is from South Africa, said he moved to Cape Breton in 2017 for the sake of his three children. He said in 28 years of practise, he never had his licence suspended and he never worked with restrictions.

Just a few months into his new position in Sydney, Moodley faced two complaints from patients he saw one week apart in July 2017.

He said he was left "in a state of shock" when learning from the college that there were complaints about his behaviour.

A.B.'s allegations

Moodley's testimony focused largely on patient A.B., whose identity is protected under a publication ban. She had just one appointment with the specialist, and he said he does not have any recollection of their meeting.

Earlier in the week, she testified he asked graphic questions about sex, including if she used sex toys, the type of orgasms she had, and talked about stimulation techniques.

She also said he put lubricant directly on her vagina without her consent during a pap test.

Moodley's defence

When asked why A.B. might have made a claim against him, Moodley shared his theory that she did so in an attempt to see a female ob-gyn sooner, even though that did not happen. He also had no evidence to prove that claim.

In July 2017, Moodley's records only consisted of a letter back to the referring physician, and they only included discoveries. They did not include items that he had eliminated or any details about conversations.

Moodley said he has now switched to a new, detailed record-keeping system.

Clinical questions

While it's not in his notes, A.B. said she asked the doctor to investigate if she had prolapsed.

During his testimony, he said questions about orgasms or the elasticity of the vagina could have been discussed in that context in a clinical manner, but he said he would never have asked details about her sex life, or if she used sex toys.

He rejected the accusation that he commented on her hip tattoos, saying he sees tattoos all the time and never makes reference to them.

Length of appointment

The hearing has also focused on timing, as A.B. and Moodley offered dramatically different time frames for her appointment, with her saying it lasted an hour.

In response to the college, Moodley said he spent 12 to 15 minutes with her.

On Thursday, he said that was a mistake, and the appointment likely lasted 30 minutes.

He came up with that number by comparing it with his average clinical interview and time needed to conduct a pap test, as he has no recollection of the patient.

Marjorie Hickey, the lawyer representing the college, questioned why, given many opportunities over 2½ years, Moodley hadn't once suggested the longer time frame or connection to prolapse as part of his defence.

Dr. Naeem Khan, Dr. Erin Awalt, Raymond Larkin, Gwen Haliburton and Dr. Gisele Marier are the panel members for the College of Physicians and Surgeons of Nova Scotia's hearing looking into misconduct and incompetence allegations against Dr. Manivasan Moodley. (Carolyn Ray/CBC)

Moodley said he only had time to think about it now, and in early 2019, he was focused on passing his Royal College specialist exams.

A.B.'s complaint also included that he touched her vagina during a pap test without her consent.

Moodley said he did put lubrication directly on her, and always did so as he was trained that way. He said he always talked through the procedure so the patient was informed.

Hickey asked Moodley if he had told the woman he was putting the lubricant on the introitus — the medical term for an entrance — to the vagina.

He said it was possible, but he cannot remember. He added if a patient didn't know what he was referring to, she could ask for clarification.

Techniques changed after complaint

He said after receiving the complaint, he changed his technique and only puts lubricant on the speculum, the metal instrument used in the inspection. He said it was up to the college to determine his previous method was not an accepted standard.

Hickey reviewed the notice of hearing from the college and asked Moodley to answer to every accusation line by line.

He firmly rejected all suggestions of inappropriate comments.

Moodley also addressed some of the claims made by patient C.D., who is also protected by a publication ban.

He said he would not have walked her to the blood clinic, he would not have time and there was another appointment scheduled after her.

Moodley said he never asked C.D. for an additional vaginal exam and wouldn't have needed to know if she was menstruating during her third appointment.

He added he did not give her the impression she was dying or had cancer, nor did he ask about the location of the bedrooms of her children in her home. "It's not my business," he said.

Moodley says he showed up at patient's job

However, Moodley did say he went to C.D.'s place of work, a business. He said he was with his wife and they were looking for an item. He remembered his patient worked there and since she had missed an appointment, he decided to ask for her.

It was his practise in South Africa to contact patients directly. He was still doing that in July 2017, because he had just started and didn't realize his receptionist, Angela MacKenzie, would take on that task.

Hickey will continue the cross-examination Friday, with questions specifically about Moodley's response to C.D.'s complaint.

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