OMAR J. ADAMS, M.D., )
vs. ) CASE NO. 83-428
Respondent. )
Pursuant to notice; a hearing was held before Arnold H. Pollock, a Hearing Officer with the Division of Administrative Hearings, on August 15, 1983, in Daytona Beach, Florida. The issue for consideration was whether the Respondent had properly denied Petitioner a license to practice medicine in the State of Florida by endorsement under Sections 458.313 and 458.331(1)(a), Florida Statutes.
For Petitioner: Edward F. Simpson, Jr., Esquire
For Respondent: John E. Griffin, Esquire
By Order dated January 14, 1983, the Respondent, Board of Medical Examiners, denied Petitioner a license to practice medicine in the State of Florida by endorsement. Thereafter, on January 31, 1983, Petitioner requested a hearing on that determination.
At the hearing, Petitioner testified in his own behalf, called Dr. Bernard Breiter, and introduced Petitioner's Exhibits 1 through 17. Respondent did not call any witnesses or produce any testimony, relying solely on cross-examination of Petitioner and his witness.
Petitioner, Omar J. Adams, was born in Pahokee, Florida, on July 18, 1950. He attended the University of Florida from 1968 to 1973 and was awarded the degree of Bachelor of Science in chemistry upon graduation. Immediately
upon graduation, he spent one year teaching special high school students and in 1974 applied for admission to the medical school of the University of Florida but was not accepted. He also applied to other medical schools and, likewise, was not accepted.
He thereafter applied for admission to the Program in Medical Sciences (PIMS) conducted jointly by Florida State University (FSU), Florida A & M University (FAMU) and the University of Florida College of Medicine (UF Med) and was accepted. This program is designed to provide to individuals not accepted to medical school a two-year course of study parallel to that given to first- and second-year medical students enrolled at UF Med, so that if a vacancy occurred in UF Med at the completion of the first two years of academics the PIMS student could step into that vacancy for the third and fourth years of clinical training.
After two years in PIMS at FSU and FAMU in Tallahassee, Petitioner transferred to the University of Florida for two more semesters of science courses. UF MED was aware of his efforts to he admitted. In fact, his studies at the University of Florida after the PIMS years were courses taken at UF Med, and UF MED sponsored him for admission to a course in gross anatomy at McHarry College in Tennessee, although he was not enrolled in the medical school as a medical student. Petitioner's grade point average for the PIMS years and the additional studies at the University of Florida was 3.8 out of a possible 4.
Petitioner fully expected to be admitted to UF Med in 1977 and was sponsored by that institution to take Part I of the examination of the National Board of Medical Examiners (National Boards), which he took both in June 1977 and June 1979, achieving a passing score each time. However, because an act passed by the United States Congress in 1977 gave preference for funds for admission to U.S. medical schools to U.S. students in foreign medical schools, he again was not admitted to UF MED or to any other medical school in the United States to which he had applied.
In the fall of 1977, he heard that some foreign medical schools would permit their students to do their clinical training in the United States. After several months in both the Dominican Republic and Mexico studying Spanish and attempting to gain admission to medical school, he applied to medical school in the Dominican Republic and was provisionally accepted. He chose not to go there, because they would not give him transfer credit for his PIMS work and would have required him to take his third and fourth years of medical school in that country.
When Petitioner left the Dominican Republic, he went to Mexico where, in early 1978, he applied for admission to and was accepted at the school of medicine of the Centro de Estudios Universitarios "Xochicalco," A.C. (CEUX), which was incorporated into the Universidad Autonoma de Guerrero (UAG). This school is approved by the World Health Organization. CEUX gave him full credit for the PIMS courses he took in 1976 and 1977 even though he did not take even one day of classes at that institution, which, coincidentally, was not established until December 18, 1977; nor did he ever see any of the institution's classrooms or laboratories. He paid a fee of approximately $5,000 per year for each of the two years work for which he was given credit and was admitted to the school's clinical program conducted out of a sparsely manned office in New York City.
Under this program, Petitioner was responsible for arranging his own clinical training, which he did at teaching hospitals in the New York City area
during 1978, 1979 and 1980. These hospitals and the medical schools with which they were affiliated, at which Petitioner took his externships, were:
Medical, OB/GYN: New York Infirmary (NYU School of Medicine)
Neurology, Pediatrics: Elmhurst City Hospital Center (Mount Sinai School of Medicine)
Surgery: Beeckman Downtown Hospital (Cornell University Medical College)
Cardiology: Downstate Medical Center (SUNY College of Medicine)
Radiology, Pneumology: Mount Sinia Medical Center (Mount Sinai School of Medicine)
Basic Medical Science Review: College
of Physicians and Surgeons (Columbia University School of Medicine)
Urology, Psychiatry: Beth Israel Medical Center (Mount Sinai School of Medicine)
Otorhinolaryngology, Ophthalmology: Manhattan EET Hospital (Cornell University Medical College)
Nephrology: VA Hospital (Bronx) (Mount Sinai School of Medicine)
Forensic Medicine: Chief Medical Examiner' s Office (NYU School of Medicine)
Family Practice: Brookdale Hospital (SUNY College of Medicine)
Family Practice: Lutheran Medical Center (SUNY College of Medicine)
Medicine, Dermatology: VA Hospital (Brooklyn)(SUNY College of Medicine)
Family Practice: Halifax Hospital (Daytona Beach)(UP School of Medicine)
Upon completion of these externships, Petitioner was awarded a Certificate of Completion on June 23, 1980, by the Dean of the School of Medicine at UAG. He was not awarded a diploma because, under the Mexican requirements, he would have had to complete a year of community service in Mexico as a condition precedent to the award of a diploma. He did not desire to
do this and instead enrolled in the Fifth Pathway Program conducted-by the Mount Sinai Medical Center (Mount Sinai) in New York.
This program, otherwise known as a supervised clinical clerkship, was established at that school in 1975 in accordance with guidelines proposed by the Council on Medical Education of the American Medical Association (AMA) to provide a year of supervised clinical training for students who completed their premedical requirements in the United States, were qualified but where unable to gain admission to a United States-medical school, and had completed the formal requirements of a foreign medical school except for internship and/or social service.
The primary aim of the program is to provide an opportunity for superior students from foreign medical schools to benefit from a formal, supervised clinical training experience in an American medical school and to develop and refine their clinical abilities in preparation for obtaining the maximum benefits from internship and residency in the United States. Following completion of the program, the student is awarded a Certificate and is eligible to enter the first year of an AMA-approved graduate training program (internship and residency). Students are also eligible for licensure in those states in which the program is acceptable. Petitioner successfully completed the program in June 1981. Florida accepts this program when accompanied with passage of the ECFMG examination and completion of one year of internship or residency.
Over a year prior to entering the Fifth Pathway Program in January 1979, Petitioner took and passed the written examination of the Educational Commission for Foreign Medical Graduates (ECFMG) and, in June 1981, passed the FLEX examination for certification for medical licensure in New York State. As a result, on October 13, 1981, Petitioner was issued license number 148022 to practice medicine and surgery by the State of New York.
After getting his New York license, Petitioner decided he wanted a specialty in Family Practice, which requires a three-year residency. He applied to and was accepted in August 1981 into the program at Halifax Hospital in Daytona Beach, Florida, where he is currently enrolled under the supervision of Dr. Bernard Breiter, Director of the Family Practice Residency Program. In this program, Petitioner is subjected to an ongoing system of evaluation by all physicians with whom he works in the residency. Based on input from these evaluating physicians and his own observations of Petitioner, Dr. Breiter has very positive feelings about him and considers him well above average. Petitioner is comparable with all other residents at his same level of experience, all of whom are graduates of American medical schools.
In May 1982, Petitioner applied to the State Board of Medical Examiners of Florida (Respondent) for licensure to practice medicine and surgery in Florida by endorsement. On the application, he listed his basis for the application as Federation Licensure Examination (FLEX). He also reflected he had attended the University of Florida from September 1968 to August 1973, which was true, and FSU from September 1975 to June 1976, which was also true. He neglected to reflect his schooling at FSU-FAMU during the 1974-1975 school year by oversight. The grades earned during that period, all As, certainly give no reason for intentional concealment.
He also indicated on the application that he attended UAG from January 1976 to June 1980, and that he obtained the degree of Doctor of Medicine from that same university. Both entries are technically incorrect. Petitioner was not enrolled in UAG until 1978, at which time he was given credit for courses as
if he had taken them in 1976 and 1977. A Certificate of studies issued by UAG medical school in March 1978 so indicates and was admitted into evidence as Petitioner's Exhibit 4. In addition, Petitioner was not awarded the degree of Doctor of Medicine, or its Mexican equivalent "Titulo," because he failed to perform the one-year community service requirement of the school. That this is a common situation for American graduates of foreign medical schools is recognized in the literature of the Fifth Pathway Program, introduced as Petitioner's Exhibit 10.
The application form utilized by the Florida Board of Medical Examiners does not provide answer blocks appropriate to Petitioner's situation. He should have answered accurately and attached a certificate of explanation. He did not do so, however, though his entries, while technically false, are not fraudulent.
Though Petitioner did not attend classes at a medical school as a full-time registered medical student, during 1978, 1979 and 1980, he was a full- time registered medical student when he attended his clinical training as outlined in paragraph 7, supra.
The parties have stipulated Petitioner is of good moral character and there is no evidence to suggest he is not capable of safely engaging in the practice of medicine.
CONCLUSIONS OF LAW
The Division of Administrative Hearings has jurisdiction over the parties and the subject matter of these proceedings.
Petitioner has been denied his license by endorsement on the basis that he has not demonstrated he meets the statutory requirements pursuant to Sections 458.313 and 458.331 (1)(a), Florida Statutes (1981).
Section 458.313, Florida Statutes, provides:
The department shall issue a license by endorsement to any applicant who, upon applying to the department and remitting a fee not to exceed $250 set by the board, demonstrates to the board that he has met
the qualifications for licensure in section
458.311 and:
Is more than 18 years of age;
Is of good moral character and has not committed any act or offense within or without the state which would constitute the basis for disciplining a physician pursuant to section 458.331;
Is a graduate of a medical school or college maintaining a
standard and reputation approved by the board pursuant to section 458.331; and
Has been certified by licensure examination of the Federation of State Medical Boards of the United
States, Inc. (FLEX) or is certified by
the National Board of Medical Examiners as having completed its examination; provided that said examination
required shall have been so certified within the 10 years immediately preceding the filing of his application for licensure under this section.
Petitioner meets the requirements of Section 458.313(1), Florida Statutes, in that:
He is 33 years old.
He is of good moral character. The parties have stipulated to this with the exception that Respondent contends the errors or omissions on the application constitute fraud. Fraud, however, has not been estab- lished--only an error in judgment--and Petitioner has not committed an offense that would constitute the basis for disciplining a physician pursuant to Section 458.331, Florida Statutes.
He is a graduate of a medical school, and his credentials fall within the purview of Section 458.331(3), Florida Statutes, which states:
The board shall not reinstate the license of a physician, or cause a license to be issued to a person it has deemed unqualified, until such time as it is satisfied that he has
complied with all the terms and conditions set forth in the final order and
that such person is capable of safely engaging in the practice of medicine.
He not only passed the ECFMG examination and met that agency's requirements, and passed the New York State FLEX examination, he also:
Completed his undergraduate work in an accredited United States university (University of Florida).
Studied at a medical school which is recognized by the World Health Organization. (It is immaterial that the studies were not completed on the physical campus of Petitioner's medical school. His course of study in his last two years was approved by and under the auspices of his medical school, and he fulfilled all medical requirements for graduation except the community service.)
See (2) above. He has passed both Part I of the National Boards and the ECFMG examination.
He has completed the year of supervised clinical training in a hospital affiliated with an approved medical school and has passed both Part II of the National Boards and the ECFMG examination.
That the Florida Board of Medical Examiners issue Petitioner a license to practice medicine in Florida by endorsement.
RECOMMENDED this 22nd day of September, 1983, in Tallahassee, Florida.
ARNOLD H. POLLOCK, Hearing Officer Division of Administrative Hearings The Oakland Building
Filed with the Clerk of the Division of Administrative Hearings this 22nd day of September, 1983.
Edward F. Simpson, Jr., Esquire Post Office Box 305
John E. Griffin, Esquire Assistant Attorney General Department of Legal Affairs The Capitol
Ms. Dorothy Faircloth Executive Director
Mr. Fred Roche, Secretary Department of Professional
