Recently, we have seen an uptick of physicians experiencing problems obtaining licensure by the Medical Board of California (“Board”) for perceived “unusual circumstances” during residency. As is the case for all physicians seeking licensure in California, the Board requires the physician to provide all records from their respective residency program(s). These records include all reviews and evaluations for each rotation the physician participated in and successfully completed. The problem lies when the physician is asked to remediate a rotation and/or fails any step of the United States Medical Licensing Exam(“USMLE”). This is what has happened to a recent client whom we’ll call Dr. Jones.

The Residency Issues

Dr. Jones is a foreign trained physician completing his residency here in California. According to Dr. Jones’ program director, it is not terribly uncommon for foreign trained physicians to have to remediate a month or two of rotations because the non-US school they attended failed to adequately prepare them to take on the level of responsibility US residency programs require. Dr. Jones was no different and was required to remediate a month of rotations during his first year of residency. Dr. Jones accepted the criticism with open arms and bettered himself by doing everything that was required of him to successfully complete the remediated rotation(s). During this time, Dr. Jones also failed Step 3 of the USMLE. Dr. Jones persevered, however, and successfully passed Step 3 of the USMLE and is in line to successfully complete and graduate from his residency program. Still, the Board is refusing to issue him an unfettered license.

Medical Board Probation?

In response to Dr. Jones’ application for licensure, the Board sent a letter to Dr. Jones indicating that the Board would offer him a license placing him on probation for three years due to “incompetency.” If Dr. Jones, did not accept these terms, his license would be denied and he would have to proceed to a hearing.

The Board’s rationale for denying Dr. Jones an unrestricted license was based on Business and Professions Codes sections 480 and 2234. Section 480(a) states “the Board may deny a license on the grounds that the applicant has one of the following: done any act that would be grounds for suspension or revocation of a license.” Section 2234 states “that the Board may take action for unprofessional conduct including, but not limited to: incompetence.”

 

What to Watch

As you can see, the Board is trying to preclude physicians from obtaining unfettered licenses if they have either (1) failed any part of the USMLE or (2) were required to remediate any rotation during their residency. It is somewhat ironic that the Board is claiming Dr. Jones is incompetent when he successfully completed and passed a rotation during his first year of residency. One could argue that all physicians are becoming more “competent” during their first year of residency as it is a highly supervised and learning environment. And as the program director stated, honest critique and feedback is essential to getting residents prepared to practice medicine.

The Board’s position would be similar to the State Bar of California refusing to grant an attorney an unfettered license because he/she failed their evidence course during law school and later passed it, even when the attorney passed the bar exam.

 

Conclusion

Dr. Jones (and all similarly situated physicians) still must pass all phases of the USMLE and successfully complete their respective residency programs. Dr. Jones has passed each step of the USMLE and a number of program and attending physicians have confirmed he will successfully complete his residency program later this year.

Unfortunately, the Board has complete discretion whether or not to grant a license application. And in a case like this, it appears the Board is overreaching and abusing its discretion.

If you find yourself facing Board restrictions on your license due to “unusual circumstances” that arise during your residency, please give our experienced team a call.