The Issue At issue in this proceeding is whether petitioner's application for a medical license by endorsement should be approved.
Findings Of Fact The Findings of the Facts of tbe Recommended Order are adopted by the Board of Medicine as being based on competent substantial evidence.
Recommendation Based on the foregoing findings of fact and conclusions of law, it is RECOMMENDED that a final order be entered certifying petitioner's application to the Department of Professional Regulation, for licensure by endorsement with, should the Board be persuaded that such is appropriate, placement of petitioner on probation for such term and subject to such conditions as the Board may reasonably specify. DONE AND ENTERED in Tallahassee, Leon County, Florida, this 24th day of April 1991. WILLIAM J. KENDRICK Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 24th day of April 1991.
The Issue Whether Petitioner's application for technologist license should be approved pursuant to Chapter 493, Florida Statutes. Petitioner appeared without counsel at the hearing and was advised of his rights in administrative proceedings. He acknowledged understanding such rights and elected to represent himself in this matter.
Findings Of Fact Petitioner Irving Zahler resides at Golden Beach, Florida. In September 1979, he submitted an application to Respondent for licensure as a clinical laboratory technologist in the specialties of serology, clinical chemistry, hematology, and immunohematology. His application reflected his education, laboratory training, and experience in the field. Specifically, it showed that he had been the director of a diagnostic laboratory for a period of 32 years. Prior to that period, from 1940 to 1949, he had been employed as a medical technician for the Veterans Administration, Bronx, New York. He has obtained 35 academic college credits in his field at accredited colleges or universities. (Testimony of Petitioner, Taylor, Exhibits 1-2). By letter of February 13, 1980, Respondent's director of Office of Laboratory Services advised Petitioner that his application had been denied because he did not have 60 semester hours of education as required under Section 10D-441.25(9), Florida Administrative Code. Petitioner informally requested review of the decision to determine if he met other qualification standards under the rule. By letter of arch 12, 1980, Respondent sent him another letter again informing him that his application had been denied for failure to show that he had achieved a satisfactory grade in the U.S Public Health Service approved proficiency examination in clinical laboratory technology, as specified in Section 10D-41.25(10), F.A.C. Petitioner thereafter requested an administrative hearing. (Exhibit 3). The U.S. Public Health Service proficiency examination was administered from 1975 to March 1979 when it was discontinued. Petitioner did not take the examination during that period and cannot do so at this time since it is not available to applicants. However, during the period 1967-1968, he passed qualifying examinations given by the Department of Health, Education and Welfare in General, microbiology, chemistry, mematology, serology, blood grouping and typing. These examinations qualified him to serve as the director of a clinical laboratory. In 1979 he was issued a license as a director of a clinical laboratory by the City of New York. (Testimony of Petitioner, Taylor, supplemented by Exhibit 4)
Recommendation That Petitioner Irving Zahler be issued a license as a clinical laboratory technologist in those specialties set forth in his application for licensure. DONE AND ENTERED this 10th day of June, 1980, in Tallahassee, Florida. THOMAS C. OLDHAM, Hearing Officer Division of Administrative Hearings 101 Collins Building Tallahassee, Florida 32301 (904) 488-9675 COPIES FURNISHED: Leonard Helfand, Esquire District 11 Legal Counsel 401 Northwest 2nd Avenue Room 1040 Miami, Florida 33128 Irving Zahler 100 Golden Beach Drive Golden Beach, Florida 33160 Department of Health and Rehabilitative Services Steven W. Huss, Staff Attorney Central Operations Services 1317 Winewood Boulevard Tallahassee, Florida 32301 ================================================================= AGENCY FINAL ORDER ================================================================= STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES IRVING ZAHLER, Petitioner, vs. CASE NO. 80-710 DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES, Respondent. /
The Issue The issue presented is whether Petitioner's application for licensure as a physician by examination pursuant to Section 458.311(8), Florida Statutes, should be granted.
Findings Of Fact Petitioner attended medical school in Cuba from September 1978 through July 1984. In that country, the academic year commences in September and ends in July. The medical school program in Cuba is a six-year curriculum which is divided into three phases, with each phase lasting two years. Phase I involves the study of normal structures and functions of the human body (basic science courses); Phase II involves the study of pathological structures and functions (clinical rotations in hospitals); and Phase III involves integral medical care. Clinical rotations continue through the first half of Phase III, the student's fifth year in medical school. During the second half of Phase III, the medical student undertakes a rotating internship in four disciplines or a vertical internship in an individual discipline. The four disciplines are internal medicine, pediatrics, obstetrics and gynecology, and surgery. The student must pass a theoretical and practical examination in each discipline in order to proceed to the next rotation. After the medical student successfully completes each Phase, including the internship, the student is awarded the degree of Doctor en Medicina. During Phase III, instruction is given in the form of lectures, small group seminars, individual instruction, practical training, and problem-oriented instruction. Students rotate to different teaching hospitals and polyclinics. At the teaching hospitals, students review clinical records with the principal professors and discuss, as a group, patient symptoms, diagnoses, and treatment. The polyclinics are neighborhood clinics emphasizing preventative medicine. While students are working at the polyclinics, they are not members of the staff; rather, the staff doctors supervise and consult with the medical students rotating through the various polyclinics. A medical student graduates after completion of the sixth year's curriculum without the necessity of taking a written examination. To practice medicine in Cuba, however, it is necessary for the medical school graduate to obtain a license and register with the national health registry. Upon registering, the physician receives a medical card, which carries the picture and signature of the physician. Petitioner completed a rotating internship from September 1983 through July 1984 as part of her medical education. She was assigned to a physician/specialist in each field of study during her internship rotation. She examined patients in front of her fellow students and/or the professor. She participated in discussions regarding pathology or symptoms, particular diagnoses, and appropriate treatments. She interviewed patients, performed physical examinations, and ordered laboratory tests if indicated. She did not participate in surgical procedures during the surgical rotation of her internship. Although Petitioner completed her medical school curriculum in July 1984, she did not receive a diploma. She did not register with the national registry and, therefore, did not receive a medical card. In September 1984 Petitioner left Cuba and went to Venezuela. Petitioner offered no evidence as to her activities from July 1984 when she completed her medical school curriculum until September 1984 when she left Cuba. Petitioner has taken the examination offered by the Educational Commission for Foreign Medical Graduates once, but she did not receive a passing grade on that examination.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that a Final Order be entered denying Petitioner's application for licensure pursuant to Section 458.311(8), Florida Statutes. DONE and ENTERED this 22nd day of June, 1995, at Tallahassee, Florida. LINDA M. RIGOT, Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 22nd day of June, 1995. APPENDIX TO RECOMMENDED ORDER Petitioner's proposed findings of fact numbered 1, 4, 5, and 5 [sic] have been adopted either verbatim or in substance in this Recommended Order. Petitioner's proposed finding of fact numbered 2 has been rejected as not constituting a finding of fact but rather as constituting a conclusion of law. Petitioner's proposed finding of fact numbered 3 has been rejected as not being supported by the evidence in this cause. Respondent's proposed findings of fact numbered 2-9 have been adopted either verbatim or in substance in this Recommended Order. Respondent's proposed findings of fact numbered 1 and 10 have been rejected as not constituting findings of fact but rather as constituting conclusions of law. COPIES FURNISHED: Frank Valladares, Esquire 2955 Southwest 8th Street Suite 204 Miami, Florida 33135 Gregory A. Chaires, Esquire Christopher E. Butler, Legal Intern Office of the Attorney General Suite PL01, The Capitol Tallahassee, Florida 32399-1050 Dr. Marm Harris, Executive Director Agency for Health Care Administration Board of Medicine 1940 North Monroe Street Tallahassee, FL 32399-0770 Tom Wallace, Assistant Director Agency for Health Care Administration 2727 Mahan Drive Fort Knox Building 3, Suite 3431 Tallahassee, Florida 32308-5403 Sam Power, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive Fort Knox Building 3, Suite 3431 Tallahassee, Florida 32308-5403
Findings Of Fact Petitioner applied for licensure as a physician through endorsement by application dated May 20, 1986. On October 9, 1986, Petitioner appeared before the Board of Medical Examiners, Foreign Graduate Committee regarding his application for licensure. The Board of Medical Examiners (hereinafter "Board") at its meeting of October 11, 1986, voted to deny his application for licensure by endorsement. The Board stated as grounds for the denial that Petitioner had failed to document that he was a legitimate graduate of a foreign medical school. The Petitioner attended the National Autonomous University of Nicaragua in the country of Nicaragua. The National Autonomous University of Nicaragua requires, under Nicaraguan law, the completion of "social service" prior to receipt of a medical school diploma. The social service requirement involves between 1 and 3 full years of medical service in Nicaragua, usually at or very near to, the war zone. The Petitioner completed all course work required for the Diploma of Doctor in Medicine and Surgery from the National Autonomous University of Nicaragua but completed only eleven months of the social service requirement. The Petitioner left Nicaragua and came to the United States in April 1981. The Petitioner was not awarded his medical diploma because he failed to complete the social service requirement. The Petitioner testified at the final hearing that he failed to complete the social service requirement and fled his native country because of political persecution. The Petitioner stated that he was in fear for his life when he left Nicaragua. In order to take the Federation of State Medical Board's licensure examination (FLEX), Petitioner needed a medical school diploma. While in this country, the Petitioner searched for a medical school that would award him a diploma for his work in Nicaragua. The Petitioner's search included schools in Mexico, Honduras, Puerto Rico and the Dominican Republic. The Petitioner received a favorable response from CIFAS University in the Dominican Republic. CIFAS reviewed the Petitioner's transcripts of completed course work from the National Autonomous University of Nicaragua. Petitioner did not do any additional course work or training through CIFAS. Upon completion of its review of the Petitioner's medical education and training, CIFAS awarded Petitioner a medical degree on January 10, 1983. On February 17, 1983, Petitioner was issued a certificate from the Education Commission for Foreign Medical Graduates. The Petitioner took and passed the FLEX in June of 1983 and received a medical license in the State of Georgia. At the time of filing his application, Petitioner was a permanent resident of the United States.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Board of Medicine enter a Final Order granting Petitioner's application for licensure by endorsement. DONE and ORDERED this 25th day of May, 1988 in Tallahassee, Leon County, Florida. W. MATTHEW STEVENSON Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 25th day of May, 1988. APPENDIX TO RECOMMENDED ORDER, CASE NO. 87-0979 The following constitutes my specific rulings pursuant to Section 120.59(2), Florida Statutes, on all of the Proposed Findings of Fact submitted by the parties to this case. Rulings on Proposed Findings of Fact Submitted by the Petitioner: (None submitted). Rulings on Proposed Findings of Fact Submitted by the Respondent: 1. Adopted in substance in Finding of Fact 1. 2. Adopted in substance in Finding of Fact 2. 3. Adopted in substance in Finding of Fact 3. 4. Adopted in substance in Finding of Fact 4. 5. Adopted in substance in Finding of Fact 7. 6. Adopted in substance in Finding of Fact 9. 7. Adopted in substance in Finding of Fact 6. 8. Adopted in substance in Finding of Fact 6. 9. Adopted in substance in Finding of Fact 7. 10. Adopted in substance in Finding of Fact 7. 11. Adopted in substance in Finding of Fact 13. 12. Adopted in substance in Finding of Fact 10. 13. Adopted in substance in Finding of Fact 11. 14. Adopted in substance in Finding of Fact 12. 15. Adopted In substance in Finding of Fact 12. 16. Adopted in substance in Finding of Fact 14. 17. Adopted in substance in Finding of Fact 15. COPIES FURNISHED: Alfonso Oviedo-Reyes, Esquire 2100 Coral Way, Suite 403 Miami, Florida 33145 Allen R. Grossman, Esquire Department of Legal Affairs The Capitol LL04 Tallahassee, Florida 32399-1050 William O'Neil, Esquire Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750 Ms. Dorothy Faircloth Executive Director Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750
Findings Of Fact By application dated July 20, 1995, Petitioner applied to Respondent for a Clinical Laboratory Supervisor's license. Petitioner has not earned a doctoral degree in clinical laboratory science, one of the specialty areas, or one of the chemical or biological sciences. Petitioner does not have a masters degree in clinical laboratory science, one of the specialty areas, or one of the chemical or biological sciences. Petitioner does not have a baccalaureate degree in medical technology, one of the specialty areas, or one of the chemical or biological sciences. Petitioner does have a baccalaureate degree in business administration and has taken college level courses in biology, human anatomy and chemistry. Petitioner has demonstrated that she has five years of pertinent experience following receipt of the degree. Accompanying her application for licensure, Petitioner presented documentation that she completed an advanced clinical practicum as a Specialist in Blood Bank Technology in 1995 and has been certified by the national Board of Registry in Chicago, Illinois. Petitioner did submit an evaluation of her college transcript by a qualified staff member of the Board of Registry, Chicago, Illinois. Petitioner did not submit an evaluation of her college transcript by a Chairperson of a chemical or biological science department of a regionally accredited U. S. college or university. Petitioner did not file a motion for an extension of time in which to submit an evaluation of her college transcript prior to the expiration of the thirty day extension period.
Recommendation Based on the foregoing, it is hereby RECOMMENDED that a Final Order be entered denying Petitioner's application for licensure as a Clinical Laboratory Supervisor. DONE AND ENTERED this 27th day of August, 1996, in Tallahassee, Florida. DANIEL M. KILBRIDE, Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 27th day of August, 1996. APPENDIX TO RECOMMENDED ORDER, CASE NO. 96-2187 Petitioner's proposed findings of fact. Petitioner did not submit proposed findings. Respondent's proposed findings of fact. Accepted in substance: paragraphs 1,4,5,6,7,8,9,10. Rejected as subsumed or irrelevant and immaterial: Paragraphs 2 (see Preliminary Statement) and 3 (see preliminary statement). COPIES FURNISHED: Lealand L. McCharen Assistant Attorney General Office of the Attorney General The Capitol, PL-01 Tallahassee, Florida 32399-1050 Diane Orcutt, Executive Director Board of Clinical Laboratory Personnel Agency for Health Care Administration Northwood Centre 1940 North Monroe Street Tallahassee, Florida 32399-0792 Jerome W. Hoffman, General Counsel Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 Douglas M. Cook, Director Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 Mary Donna Lee, pro se 2544 Robert Trent Jones Drive Apartment Number 816 Orlando, Florida 32835
The Issue Whether disciplinary action should be taken against Respondent's license to practice medicine and surgery based on the violations of Section 458.331(1), Florida Statutes, alleged in the Administrative Complaint filed in this proceeding.
Findings Of Fact The following paragraphs of the findings of fact submitted by the Respondent have been accepted and included in the findings of fact in this Recommended Order at least in substance and in most instances in their entirety. Editorial modifications have been made in some instances in the interests of accuracy and clarity; as well as when consolidating similar proposals submitted by both parties: 1, 2, 3, 4, 15, and 17. Paragraph 5 is rejected as constituting argument rather than proposed findings of fact. Paragraph 6 is rejected as constituting primarily argument about the credibility of witnesses rather than proposed findings of fact. To the extent findings are proposed in this paragraph, they are rejected as subordinate. The first two sentences of paragraph 7 are rejected as constituting argument about the credibility of witnesses rather than proposed findings of fact. The last sentence of paragraph 7 is accepted. The first five sentences of paragraph 8 are accepted. The last two sentences of paragraph 8 are rejected as constituting legal argument and/or subordinate facts. Paragraphs 9 and 10 are rejected as constituting argument about the credibility of witnesses rather than proposed findings of fact. The substance of the first three sentences of paragraph 11 is accepted. The last two sentences of paragraph 11 are rejected as constituting argument about the credibility of witnesses rather than proposed findings of fact. Paragraph 12 is rejected as for the most part constituting argument rather than proposed findings of fact. To the extent findings are proposed; they are rejected as subordinate. With the exception of the last sentence; all of paragraph 13 is rejected as for the most part constituting argument rather than proposed findings of fact. The substance of the last sentence of paragraph 13 is accepted. The fourth sentence of paragraph 14 is accepted with the deletion of the last clause. The remainder of paragraph 14 is rejected as constituting argument or as proposing irrelevant and/or subordinate facts. Paragraph 16 is accepted in substance, but only as to when and where the Respondent and Vicente met and as to what Vicente told the Respondent he was doing. Paragraph 18 is rejected as constituting argument about the credibility of some of the evidence rather than constituting proposed findings. Paragraph 19 is rejected as constituting argument about the credibility of some of the evidence rather than constituting proposed findings. Further, the implications of the arguments are rejected as being contrary to my resolution of credibility issues. The substance of the first two sentences of paragraph 20 is accepted. The remainder of paragraph 20 is rejected as irrelevant commentary about testimony rather than proposed findings on a material issue. Paragraphs 21, 22, and 23 are rejected as constituting argument rather than proposed findings of fact.
Recommendation For all of the foregoing reasons, it is recommended that the Board of Medical Examiners enter a Final Order in this case dismissing all charges against the Respondent, Roberto Cuesta, M.D. DONE AND ORDERED this 12th day of March, 1986, at Tallahassee, Florida. MICHAEL M. PARRISH, Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 12th day of March, 1986. COPIES FURNISHED: Leonard Sussman, Esquire 7195 S.W. 47th Street Suite #101 Miami, Florida 33155 Stephanie A. Daniel, Esquire Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301 Dorothy Faircloth, Executive Director Board of Medical Examiners Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301 Fred Roche, Secretary Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301 Salvatore A. Carpino, Esquire General Counsel Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301 APPENDIX The following are my specific rulings on each of the proposed findings of fact submitted by each of the parties. By way of preface to the specific rulings which follow, I feel constrained to make the following observations regarding three of the principal witnesses in order that the parties may more clearly understand the basis for certain of the findings of fact. With regard to conflicts between the testimony of the Respondent and the witness Carlos Ramirez, I have generally tended to credit the testimony of the Respondent, largely on the grounds that the Respondent's version was more consistent with other evidence. Further, I found the Respondent to be sincere, candid, accurate, and honest in his testimony. Accordingly, I have given a great deal of weight to the Respondent's testimony. I found the witness Armando R. Vicente to be otherwise. Accordingly; I have given very little weight to Mr. Vicente's testimony except to the extent that it was corroborated by other reliable evidence or constituted admissions against interest.
Findings Of Fact After the hearing was called to order in the above styled cause, the parties submitted the following stipulation: Sometime in December of 1978, the Petitioner, MARY KANNER applied tot he DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES, Clinical Laboratory Registra- tion and Licensure Program, for a Clinical Laboratory Technologist License. After reviewing the petitioner's application and supporting documents, the DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES discovered that she did not have the sixty (60) semester hours required by Section 10D-41.25(9). MRS. KANNER was notified of her failure to qualify for the requested Technologist license by letter from the Department dated January 30, 1979. Subsequently, MRS. KANNER requested an Administrative hearing. Pursuant to her inquires, Mrs. Kanner received several communications from the Respondent Department. One letter dated January 30, 1979, from Nathan B. Schneider, Director of the Office of Laboratory Services, stated that it was the finding of the Respondent Department that Mrs. Kanner might be eligible for licensure as a clinical laboratory technician, and the letter authorized her to work in that capacity until the next scheduled examination, or no later than July 1, 1979. The letter stated that Mrs. Kanner would be notified in advance of the time and place of the examination. A second letter dated January 30, 1979, to Mrs. Kanner from Nathan B. Schneider, acknowledged the receipt of her application for licensure as a technologist but informed her that she was apparently ineligible because she did not have the required sixty (60) semester hours, but also advised her of her entitlement to an administrative hearing. Petitioner submitted letters as follows: a letter to Dr. Schneider from Alice Browner, Registrar of the Canadian Sociaety of Laboratory Technologist. The letter stated in pat that Petitioner had trained for a period of six (6) months, mainly September, 1966, to March of 1967, in a training program in the hematology department. The training was listed as follows: Bacteriology 1 evening a week February - May Biochemistry Sunday afternoons March - June Histology Saturday mornings March - Middle of May Blood Bank One evening a week January, February & March Hematology 6 months formal training Experience - 23 months (excluding formal training) (Resume in Hematology written previously) A letter dated March 29, 1979, to Dr. Schneider from Arthur Rosenberg, Chief of the Department of Hematology at the Sir Mortimer B. Davis - Jewish General Hospital, stated in part that Petitioner started her course in medical technology in 1966, and that in 1969, she wrote the hematology subject examination and received her Canadian registration. She worked as a hematology technologist until 1971, and as a department supervisor from 1971, to 1974. The letter stated that the preparation time prior to writing her examination subject would be the "equivalent of 60-plus semester hours of study." A letter was submitted to Counsel for the Respondent Department dated July 16, 1979, in which John V. Briscoe, Director of Hospital Services for the Sir Mortimer B. Davis - Jewish General Hospital, supplied a document which stated that the Jewish General Hospital is "an affiliated teaching hospital with McGill University, Montreal, Quebec, and is fully accredited by the Canadian Council on Hospital Accreditation, the date of the last accreditation survey being September 26, 1977." In answer to the statement by the Respondent Department that the Petitioner did not have documented evidence of the required sixty (60) semester hours direct from a university, Petitioner explained that in Montreal, Canada, in 1966, all English-speaking schools for nursing and technology took place in various accredited hospitals, using the same format as would be used at a university. In a separate section of the hospital was the school of nursing and the school of technology, but in recent years all of the schools were at the universities. Dr. Howard R. Rarick, Chief of the Clinical Laboratory Improvement Program for the Respondent Department, reviewed Petitioners application and supporting documents and did not find a transcript showing completion of sixty (60) hours credit or its equivalent as required by the State statute and rule promulgated thereunder. The Respondent Department does not evaluate the credits from foreign schools or institutions but forwards the credits to the International Education Research Foundation, which evaluates and determines the equivalent American credits that should be allowed. The Petitioner had no certified transcript from the hospital or university in which the foreign credits were earned and, therefore, was unable to send this to the Research Foundation to convert the foreign credits. The letters submitted by Petitioner are insufficient to substitute for a certified transcript for evaluation purposes. Both parties submitted a stipulation of facts, and the Respondent Department submitted a memorandum of law. These instruments were considered in the writing of this Order. To the extent the proposed findings of fact have not been adopted in, or are inconsistent with, factual findings in this Order they have been specifically rejected as being irrelevant or not having been supported by the evidence.
Recommendation Based upon the foregoing Findings of Fact and conclusions of Law, the Hearing Officer recommends that the application of the Petitioner, Mary Kanner, to sit for examination as a technologist be denied. DONE and ORDERED this 30th day of August, 1979, in Tallahassee, Leon County, Florida. DELPHIAN C. STRICKLAND Hearing Officer Division of Administrative Hearings Room 101, Collins Building Tallahassee, Florida 32301 (904) 488-9675 COPIES FURNISHED: Harold L. Braynon, Esquire Department of HRS 201 West Broward Boulevard Fort Lauderdale, Florida 33301 Mrs. Mary Kanner 1901 North 51st Avenue Hollywood, Florida 33021
Findings Of Fact 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.
Recommendation Based on the foregoing, it is RECOMMENDED: 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 2009 Apalachee Parkway Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 22nd day of September, 1983. COPIES FURNISHED: Edward F. Simpson, Jr., Esquire Post Office Box 305 Ormond Beach, Florida 32075 John E. Griffin, Esquire Assistant Attorney General Department of Legal Affairs The Capitol Tallahassee, Florida 32301 Ms. Dorothy Faircloth Executive Director Board of Medical Examiners Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301 Mr. Fred Roche, Secretary Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301
The Issue Whether the Petitioner meets the requirements for licensure as a medical doctor set forth in Section 458.311(1)(c), Florida Statutes (1985), as required by Section 458.313(1), Florida Statutes (1985)?
Findings Of Fact In July of 1984, the Petitioner applied for licensure as a medical doctor by endorsement. The Petitioner's application was denied by the predecessor of the Respondent on June 17, 1985, for the following reason: The applicant has not completed an approved internship of at least one year or at least five years of licensed practice as required by Section 458.311(1)(c), Florida Statutes and Section 458.313(1), Florida Statutes. The Petitioner began postgraduate training at the University of Alberta on August 1, 1960, as a "Straight Intern - Division of Internal Medicine." The training program the Petitioner participated in was part of a four year program at the University of Alberta. The portion of the program which the Petitioner began started on July 1, 1960 and ended on June 30, 1961. Most of the students in the program began on July 1, 1960. The Petitioner was not able to begin on July 1, 1960 because of visa problems. Based upon a form filed with the Respondent by Dr. L. M. Anholt, Assistant Dean, Director, Division of Postgraduate Medical Education, at the University of Alberta, the Petitioner began the program on August 1, 1980, and ". . . continued in that program until 30 June 1981 at which time he did further two months (until 31 August 1981 in Paediatrics) at his request." [Emphasis added]. According to Dr Anholt, the Petitioner requested pediatrics training "because he was leaving the Department of Medicine and desired the additional experience prior to returning to the United Kingdom and continuing training." Based upon a letter from the Petitioner to the Respondent, dated November 13, 1984, the Petitioner took the two months of pediatrics training in order to obtain a license to practice medicine in Canada where he had passed the licensing exam. The Petitioner gave the following explanation for why he took the two months of pediatrics training: For an unrestricted license to practice medicine here in Alberta I had taken to complete a second post graduation year to include at least 2 months paediatrics, 2 months surgery and 2 months obstetrics. Dr. Anholt's predecessor as Director of Post Graduate Training assisted in arranging for me 2 months paediatrics but was unable to arrange the surgery or obstetrics. The University of Alberta subsequently issued a certificate to the Petitioner indicating that the Petitioner had satisfactorily performed the duties of "Straight Intern - Division of Internal Medicine" from August 1, 1980 until July 31, 1981. Based upon the foregoing the Petitioner completed 11 months of a program as a Straight Intern in the Division of Internal Medicine and two months of training in pediatrics as part of a second year of post graduate training.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Board of Medical Examiners enter an order denying the application of James McDonald for licensure by endorsement. DONE and ORDERED this 29th day of October, 1986, in Tallahassee, Florida. LARRY J. SARTIN Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 29th day of October, 1986. APPENDIX TO RECOMMENDED ORDER, CASE NO. 86-0811 The parties have submitted proposed findings of fact. It has been noted below which proposed findings of fact have been generally accepted and the paragraph number(s) in the Recommended Order where they were accepted. Those proposed findings of fact which have been rejected and the reasons for their rejection have also been noted. Paragraph numbers in the Recommended Order are referred to as "RO Petitioner's Proposed Findings of Fact First Sentence: First Sentence: The first sentence of the Petitioner's proposed recommended order is a final recommendation and not a finding of fact. Second Sentence: The second sentence is accepted in RO 7. Third Sentence: The alleged steps followed before issuing "Statements of Training" are not supported by the record of the hearing in this case and are therefore rejected. Fourth Sentence: The fourth sentence is not supported by the record of the hearing in this case and is therefore rejected. Fifth Sentence: The fifth sentence is not a finding of fact and is therefore rejected. Sixth Sentence: The sixth sentence is not a finding of fact and is therefore rejected. Respondent's Proposed Findings of Fact Paragraph Number: Accepted in RO 1 and 2. Accepted in RO 3 and 4. Accepted in RO 5 and 6. Accepted in RO 7. Accepted in RO 8. COPIES FURNISHED: M. Catherine Lannon, Esquire Assistant General Counsel Administrative Law Section Department of Legal Affairs Room LL-04 - The Capitol Tallahassee, Florida 32399-1050 James McDonald Box 400 Leduc T9E2Y2 Alberta, Canada Ms. Dorothy Faircloth, Executive Director Board of Medical Examiners 130 North Monroe Street Tallahassee, Florida 32301
