Vietnamese Medical Grads Fight for Doctor’s Licenses

After six years of medical studies at the University of Saigon, Le Dao fled her war-torn homeland in 1978, accepting a ride from the owner of a small boat who wanted a doctor aboard to care for his pregnant wife.

Since arriving in the United States a few weeks later, Dao, 36, has completed her medical training by working three years as an intern and resident at the University of California, Irvine Medical Center. She has passed each examination placed in the path of aspiring doctors.

But Dao is not licensed to practice medicine in California because she does not have her original college diploma or documentation that she completed the required course work. That, Dao said, is because she had only one day to prepare for her escape from Communist Vietnam three years after the fall of the South Vietnamese government.

Processing Stopped

Without such evidence, the California Board of Medical Quality Assurance will not give Dao or 30 other Vietnamese refugees who graduated from the University of Saigon after 1975 permission to work as doctors. The board stopped processing their applications more than a year ago. It since has renewed consideration of the applicants on a case-by-case basis, but advocates for the refugees say the board’s position amounts to a ban on new licenses for them.

“We are desperate,” Dao said.

A class-action lawsuit on behalf of the Vietnamese refugees and other graduates of foreign medical schools has been filed in federal court in San Francisco by the Center for Public Interest Law. The center, affiliated with the University of San Diego, contends that the Vietnamese are merely the clearest victims of a broader effort by the Board of Medical Quality Assurance to restrict the flow of foreign-educated doctors into California.

Sen. Edward R. Royce (R-Anaheim) has introduced legislation that would create a special committee of former University of Saigon faculty members who now live in the United States to rule on the validity of the 31 graduates’ claims. Decisions of this committee would be final unless overturned by the BMQA after public hearings.

“We have spent a great deal of time trying to resolve this without legislation,” Royce said. “But it’s clear now that legislation is necessary if we want to prevent a situation where these people are in limbo until the United States reconciles its differences with the government of Vietnam.”

Sensing a threat to its traditional authority over physician licensing, the board has strongly opposed the bill, which already has been approved by the Senate and is now before the Assembly.

“Special-interest bills are always a mistake, especially when the issue is medical training,” said Kenneth J. Wagstaff, executive director of the BMQA. “We can’t protect the public adequately if special-interest legislation shoots holes in our procedures.”

A committee of the kind Royce proposes is not unprecedented. A similar panel established in 1975 by the American Medical Assn. attested to the training of roughly 1,000 University of Saigon graduates who fled the country as the capital fell to the Communists. But that committee did not evaluate the credentials of any students who graduated after 1975, when the last of the committee’s members left the country.

Dr. Quynh Kieu, a Fountain Valley pediatrician who left Saigon aboard one of the last U.S. military planes out of the besieged city, was one of the doctors whose training was certified by the AMA-sponsored committee in 1975. Now Kieu is leading the fight for the second generation of refugees, all of whom, she says, enrolled at the university before 1975 and had graduated by 1980.

Kieu concedes that the new regime began to consider political affiliation along with academic performance as grounds for admission to the medical school after 1975. But she insists that students who were already enrolled in the school, which was renamed Ho Chi Minh University, were allowed to continue without a change in curriculum.

“The Communists did not have the means to take over the school,” Kieu said. “The school continued on, with the same staff, the same students, who were there from before, and the hospital continued to run. The medical students still had to study and work at the hospital as they were before.”

Le Dao was one of those students. She entered the medical school in 1971, one of 200 chosen from more than 5,000 applicants. She says she graduated in 1977 and worked for nearly a year at the Cho Ray Hospital in Saigon as a physician.

It was in the spring of 1978 that she fled with little more than the clothes on her back, pretending to be selling coconuts in order to get close to the beach where she was picked up. With about 35 other “boat people,” Dao headed for Malaysia, where the group landed three days later.

Resumed Her Training

Eventually, Dao was able to fly to the United States, and after settling in Garden Grove she resumed her medical training. In February, 1981, she took and passed an examination given to all graduates of foreign medical schools. In June, 1982, she passed the federal medical licensing examination, which is required before aspiring doctors can complete their training by working in a hospital.

Dao then spent three years at UC Irvine Medical Center. In January, 1986, she passed an oral examination given by the state, normally the final hurdle before a doctor is licensed to practice medicine. A month later, the BMQA asked Dao for a $200 license fee and a recent photograph.

But Dao never got her license. Instead, she was told in June, 1986, that the BMQA had stopped processing all applications from students who graduated from the Vietnamese medical school after 1975.

Err on Side of Safety

Current and former BMQA officials interviewed by The Times say they have chosen to err on the side of public safety in refusing to license Vietnamese medical students who lack official proof of training.

Applicants without such proof will be considered for licensing only if they complete remedial training at an approved hospital and their Vietnamese work is attested to by former faculty members with personal knowledge of their training.

The committee established by Royce’s bill would include five former University of Saigon faculty members and one staff member of the BMQA’s Division of Licensing. The education of any refugee certified by the committee would be considered adequate unless the BMQA found, after public hearings, that the decision was “not based on substantial evidence.”

Royce’s bill, on which 26 members of the Legislature now are listed as co-authors, is supported by the California Medical Assn. It was approved unanimously by the Senate on June 4 and has been approved by the Assembly Health Committee. It awaits a hearing in the Assembly Ways and Means Committee before moving to the full Assembly for final passage.

Royce contends that, without his bill, the BMQA will not allow the 31 refugees whose credentials are in question to practice even if they can document their training.

“The BMQA’s position is not based on whether or not these people graduated,” Royce said in an interview. “To them that’s not important. They’ve already made the decision that they’re not going to allow them to be physicians in this state, regardless of what information is brought forward, regardless of exam scores.

“These people (the Vietnamese) can spend the rest of their lives in limbo until another bureaucracy in another country decides to send their bureaucracy (the BMQA) a piece of paper they want,” Royce said. “Until they get that, it matters not one iota what other information is brought forward.”

Times staff writers Paul Jacobs and Jim Schachter contributed to this story.