But his critics say the surgeon was for years able to get away with inappropriate personal behaviour- including frequent references to colleagues about rape and sodomy- and that his deficiencies in the operating room were tolerated due to his seniority. Fairfax Media has decided to not name the surgeon, after a request from his medical practitioner. The surgeon was also responsible for helping to teach junior surgeons. Over the past three months, internal investigators have recorded complaints that the surgeon had consistently made highly inappropriate sexual remarks to male and female colleagues. They include a young doctor who was reduced to tears after she was told - in what appears to have been an attempt at humour - to take her clothes off. The surgeon's supporters say his behaviour was inappropriate but was the product of his misguided efforts to be jocular. The surgeon is from overseas and struggled to fit in with some of his colleagues.

A dozen doctors interviewed by Fairfax Media about the surgeon said the case highlighted the difficulty faced by medical professionals in speaking out about the activities of their senior colleagues. The Alfred's Mr Way said the complaints made about the surgeon performing sub-standard surgery had not been upheld, although he said a review had queried some of his surgical decision-making. Mr Way said the inquiry found that if a different surgical decision had been made, it would not have resulted in a different outcome for any patient. Mr Way said he was still assessing the findings of an internal investigation into the surgeon when the surgeon told him last week he would resign, citing ill health. Mr Way said the hospital needed to "think carefully" about how to encourage junior doctors to feel comfortable raising complaints against senior colleagues.

The surgeon's supporters also concede that a more effective complaint and oversight process at The Alfred may have identified and rectified concerns about his surgery and workplace practices. They also said this was not a problem confined to The Alfred, but was system-wide. "The tragedy about this case is that [the surgeon] is a dedicated public servant. Had people felt more comfortable to raise their concerns years ago, this could have all been prevented," said one supporter who worked closely with the surgeon. However, some of the key complainants told Fairfax Media that the hospital had failed to conduct a full and independent investigation into the surgeon's surgical work and questioned how he was able to get away with repeatedly making sexual and derogatory remarks to junior surgeons. The first complaints about the surgeon's surgical competency were raised by two senior doctors in 2008 and resulted in a six-month period of greater supervision. On July 4 last year, five junior surgeons met with the one of the hospital's top medical staff, Professor Jeffrey Rosenfeld, to detail fresh concerns about the "recent surgical outcomes" of the surgeon.

Those complaints triggered an investigation which examined 20 operations and found that, while there had been no adverse patient outcomes as a result of malpractice, the surgeon's decision making could be improved. It was only after this investigation that a whistleblower contacted the hospital to urge a thorough investigation into the surgeon's alleged sexual harassment of colleagues. Fairfax Media has spoken to several doctors who participated in this review. All detailed instances of sexual harassment. But the doctors told Fairfax Media that they hadn't previously raised concerns because they did not want to imperil their careers. "It is a failure of the system," said one. "[The surgeon who resigned] didn't like to be challenged and I didn't want to hurt my career." The case is not the first involving a high profile surgeon at the Alfred Hospital. In 2008, the state ombudsman was highly critical of how senior hospital staff handled concerns held by multiple doctors about the activities of a top surgeon, Professor Thomas Kossmann. Mr Kossmann has always denied any wrongdoing and received a pay-out from the hospital after launching legal action.