California Medical License Law

Foreign Medical School Graduates and California Medical Board Licensing

California's Medical Board maintains a website www.mbc.ca.gov with a host of information, including a list of all approved medical schools, in the U.S. and Canada as well as throughout the world.  It is easy to check whether a particular medical school has received Board recognition: simply go to http://www.mbc.ca.gov/applicant/schools_recognized.html and the list will appear.

It is amazing to me then, that significant numbers of international medical school graduates end up frustrated, angry and desperate after completing the expensive, time-consuming and often grueling coursework leading to a foreign medical degree, only to find they cannot train postgraduate or become licensed in California because they attended a disapproved school.  The actual list of officially disapproved schools is rather small:

1. CETEC University, Santo Domingo (closed)	05-19-83
2. CIFAS University, Santo Domingo (closed)	11-16-84
3. UTESA University, Santo Domingo	07-13-85 disapproval reaffirmed 02-07-97
4. World University, Santo Domingo (closed)	12-01-89
5. Spartan Health Sciences University, St. Lucia	06-13-85
6. University of Health Sciences Antigua, St. John's	07-28-95
7. Universidad Eugenio Maria de Hostos (UNIREMHOS), Dom. Rep.	11-01-96
8. Universidad Federico Henriquez y Carvajal, Dom. Rep.	07-31-98
9. St. Matthew's University, Grand Cayman	02-18-05
10. Kigezi International School of Medicine, Cambridge, England and Uganda	11-02-07

On the other hand, the number of unrecognized yet not disapproved foreign medical schools may be significantly larger.  These medical schools may be approved at some time in the future but are not recognized at the time the graduate applies for a California license.  One such school I recently learned about from a Californian studying in Australia is Bond Medical School.  Because no Bond graduate had previously applied for a California license and the school has not yet undergone the approval process, Bond remains unrecognized, despite the fact that its faculty and curriculum more or less mirrors eleven Australian medical schools which are recognized.   Bond, once it applies, will probably be approved.  Until then, however, my hapless potential client remains out of luck.

To determine whether a foreign medical school is unrecognized (assuming it is not on the disapproved "short list") the Medical Board suggests you simply check the country and schools listed on its website roster of approved schools. If your school does not appear, it is either disapproved or yet unrecognized.

A few years ago the California Medical Board was informed that the Medical School of the Americas, an institution set up by Fidel Castro in Cuba as an "in your face" to the American medical school establishment was about to graduate its first Californian who would no doubt be seeking a California license.  This set in motion discussion among the Board's Licensing Division staff and counsel about the recognition process, policy, and a debate about how and whether an on-site visit to Cuba is required.

At any rate, if you are pursuing a medical education and there is a chance you may end up in a foreign medical school, it would behoove you to visit the California Medical Board's website and check its list of recognized medical schools if you wish to avoid heartache and aggravation later on when seeking a postgraduate training authorization letter (PTAL) or California Medical License.  Make sure the school you attend is recognized before investing the time, effort and money in a foreign medical education.

If  you have questions or need legal advice on foreign medical degrees and getting licensed or authorized to train in California, contact the author at: www.slotelaw.com

 

 

 

 

 

 

 

 

 

 

 

 

 

 

When Criminal Matters are Reportable for Medical Board License Applicants or Licensees

 Physicians, including recent medical school graduates and physicians from other states or countries seeking a California medical license must fill out a state application which includes pages L1C and L1D, each of which asks a question pertaining to criminal actions.  Question #23 on page L1C asks "Have you ever been convicted of, or pled guilty or nolo contendere to ANY offense in any state in the United States of foreign country?"  Question 24 on page L1D asks "Is any criminal action pending against you?"

These questions appear straight forward; however, it is amazing how often physician applicants are confused about what must be reported, or not reported, and end up receiving a letter from the Medical Board asking for a narrative explanation of an arrest and/or conviction and why the application "failed to disclose" the matter relative to questions 23 and 24.

For example, many people, including doctors, assume that if probation from a criminal conviction is completed and the matter is then officially "expunged" from their record under California Penal Code Section 1203.4, they need not report the conviction on the license application.  California, however, has a specific statute requiring such convictions to be reported on license applications notwithstanding expungement.  See California Business and Professions Code Section 480(a)(1).

On the other hand, California has a Penal Code provision, Section 1000, that allows a court to impose "Deferred Entry of Judgment" for first offenders charged with certain drug offenses, including:

Possession of Controlled Substances/Solvents/Marijuana/Concentrated Cannabis – Health and Safety Code sections 11350, 11357 and 11377, Penal Code section 381, and Business and Professions Code section 4060;

-       Possession of Drug – Paraphernalia Health and Safety Code section 11364

-       Aiding and Abetting in the Use of Certain Drugs – Health and Safety Code section 11365

-       Being Under the Influence of Illegal Drugs – Health and Safety Code section 11550  and Penal Code section 647(f);

-       Cultivation of Marjuana – Health and Safety Code section 11358 (only if the marijuana planted, cultivated, harvested, dried, or processed is for personal use);

-       Forging or Using a Forged Prescription to Obtain Drugs – Health and Safety Code section 11368 (only if the drugs were for personal use);

-       Driving While Possessing Marijuana – Vehicle Code section 23222(b);

-       Soliciting Drug-Related Acts – Penal Code section 653f(d) (only if the acts were directed at personal use).

When a defendant is given deferred entry of judgment, he or she must plead guilty, but the conviction is "deferred" from eighteen months to three years, while the defendant undergoes a treatment program and supervision.  Once the specified period and treatment is completed, the matter is deemed a nullity and it is as if the arrest and plea of guilty never occurred.

That is, unless you are a physician or nurse or other medical professional.  Then Business and Professions Code Section 492 pops up to say:

"Notwithstanding any other provision of law, successful completion of any diversion program under the Penal Code, or successful completion of an alcohol and drug problem assessment program under Article 5 (commencing with Section 23249.50) of Chapter 12 of Division 11 of the Vehicle Code, shall not prohibit any agency established under Division 2 (commencing with Section 500) of this code, or any initiative act referred to in that division, from taking disciplinary action against a licensee or from denying a license for professional misconduct, notwithstanding that evidence of that misconduct may be recorded in a record pertaining to an arrest. This section shall not be construed to apply to any drug diversion program operated by any agency established under Division 2 (commencing with Section 500) of this code, or any initiative act referred to in that division."

The California Department of Justice reports arrests to state licensing agencies like the Medical Board, including case disposition, so the hapless physician can anticipate some sort of Medical Board disciplinary action despite a Penal Code Section 1000 deferred entry of judgment program completion.

In New York State (and at least one other, Alabama) there is a provision for something called Adjournment in Contemplation of Dismissal (ACD) of criminal charges.  See New York Criminal Procedure Law, Section 170.55. This first offender program for generally non-violent offenses offers the defendant the chance to complete certain terms or conditions such as community service, and if he or she faces no new charges or arrests and the prosecutor does not refile based on failure to complete a term or condition, after six months the matter is deemed a nullity.  The arrest and court record are sealed. California law does not address this procedure, so after the six months has run from the court appearance where ACD was offered, a California physician or license applicant need not report this matter or answer "Yes" regarding convictions.  During the six months of adjournment prior to dismissal, however, he or she must answer "Yes" to questions about pending criminal actions. (See Question 24 on the California Physician's license application).

When in doubt about whether to answer "Yes" or "No" to license questions pertaining to convictions or pending criminal actions, medical license applicants would do well to consult an attorney familiar with Medical Board policy and these provisions.  In addition, currently licensed California physicians must still report any felony charges (indictments or filed information) and any felony or misdemeanor convictions to the Medical Board in writing within thirty (30) days under Bus. and Prof. Code Section 802.1.

If  you have questions or would like legal representation, please visit our website at www.slotelaw.com.

Criminal Actions and your California Medical License

When a California physician faces a criminal prosecution of any kind, it is a life changing event.  One thing the physician might not realize is that criminal conviction is not their only immediate concern.  Failure to notify the Medical Board of California of certain charges and all convictions may result in license discipline and even additional criminal charges and fines under Medical Board law and policy.

California Businesss and Professions Code Section 802.1 requires physicians to report to the Medical Board any indictment or information charging a felony, and any conviction, whether misdemeanor or felony, to which the physician pleads guilty, no contest, or is found guilty by verdict.  Failure to do so in writing within thirty (30) days is a public offense, subject to a five thousand ($5,000) fine.

So while finding a criminal attorney and preparing to address criminal charges may preoccupy the physician facing felony charges, or when convicted by plea or verdict of any felony or misdemeanor, remembering to notify the Medical Board in writing within thirty days can mean the difference between facing licensing discipline and potential fine and not.

This Medical Board notification issue is separate from the fact that a conviction for a crime "substantially related to the qualifications, functions or duties of a physician and surgeon" is grounds for license discipline under Section 2236 of the California Business and Professions Code.

If you have questions or would like legal advice, www.slotelaw.com

 

Applying for Your California Medical License: Medical Board Law & Policy

The CA Medical Board issues licenses.  It can deny, offer probationary licenses, or allow a physician to withdraw an application.  Without preparation the process can be daunting.

Physicians must have a state license to practice in California.  Allowing sufficient time and providing a complete application with full documentation to the Medical Board can make a difference.  Failure to do so may result in delay, denial or the filing of a Statement of Issues and an administrative hearing. Lately (2012) the process has been taking about seven or eight months.

1. How Are California Medical License Applications Processed?

When the Medical Board initially reviews an application, an analyst reads the application and supporting documents to ensure that basic qualifications have been met, including education, board examinations, training, and experience.  The application also asks whether the applicant has any criminal convictions, terminations from training programs, or out-of-state discipline.  For a criminal conviction to result in license denial, it must be “substantially related to the duties, functions or qualifications of a physician and surgeon”.  This requirement has been broadly interpreted by the courts.  For example, DUI convictions have been deemed substantially related to virtually all California licenses, as are tax violations and crimes of dishonesty.  Criminal assault or domestic violence may also be disqualifying.

When the Board intends to deny an application, it issues a letter advising the applicant and the reasons for denial.  Denial usually follows prior informational requests or phone inquiries. The applicant is most often afforded an opportunity to provide information demonstrating that the deficiency or conviction cited is erroneous or mitigated.   An exception may be a serious a criminal conviction or dishonesty in the application itself.  In many instances of license denial the applicant is given the opportunity to withdraw.  Withdrawal means there will be no permanent record of denial in California or reported to the National Practitioner's Data Bank. The board might also offer a probationary license if it has concerns about the applicant's abilities or background and it appears the applicant might benefit from supervised education, counseling, additional training or monitoring.

2. How Long Does the Process Take?

The Medical Board’s website previously claimed that applications would be reviewed within ninety days and the applicant then advised of any problems or requests for additional information, so that the process could be completed on a relatively timely basis.  Those timelines, however, have changed drastically in recent years.  Since 2008-2009, the Board has advised applicants to expect at least six to nine months to process a license application.   When medical program appointments or job offers are at stake, these delays can be devastating.  It is best, therefore, to prepare for an extended process and, again, to make sure the initial submission is complete as well as accurate. 

3. What If My Application Is Denied?    

Ir your application for a California medical license is denied and decide not to withdraw or accept a probationary license if offered, you may request that a Statement of Issues be filed with the Office of Administrative Law and an administrative hearing held to determine whether the license should be issued.  A Statement of Issues is a document prepared by a Deputy Attorney General. It describes the application, includes supporting documents, and alleges the reasons for denial.  A hearing is scheduled before an Administrative Law Judge (ALJ). The ALJ will write a proposed decision that the Medical Board may adopt, modify or reject.

4.  Common reasons for denial: Criminal record; criminal conviction or pending matter not reported on application (questions # 23 and 24); out of state disciplinary history; program or education deficiencies, including a medical degree from an institution not recognized by California's Board.

4. Can I Appeal After Losing at an Administrative Hearing?

Yes. The applicant may accept the Board’s final decision, or file a Writ of Mandate in Superior Court to overturn the decision.  The applicant must demonstrate that the Board engaged in an “abuse of discretion” in denying the application—a relatively steep burden.  If the court affirms the Board’s decision, an appeal can still be made to the California Courts of Appeal or even the State Supreme Court.  However, the Board may also appeal an adverse Superior Court decision. Conclusion: A physician applicant should submit his or her license application to the California Medical Board as far in advance of any appointment or employment as possible.  Completeness and accuracy help avoid inordinate delays. Even if everything is submitted on a thorough and timely basis, however, government bureaucracy can still make the process a long and difficult one.  Many applicants find having licensing counsel helpful.

For additional information or inquiries, you can visit slotelaw.com