UCI Hospital Official’s Post in Jeopardy

UCI Medical Center’s top cardiologist could lose his position under rule changes state regulators proposed Wednesday, saying the exemption he received to get his job was not intended to be used that way.

Neither Dr. Jagat Narula, chairman of the medical center’s cardiology department, nor the associate chief, Dr. Mani Vannan, holds a California medical license or American board certifications.

They are the only cardiology chief and associate chief at the five UC hospitals lacking such credentials.

Narula and Vannan, who are from India, have been leading the cardiology department since 2003 under an exemption that allows visiting physicians to practice at teaching hospitals without a California medical license for as long as five years.

Both have licenses in Pennsylvania, which has more lenient requirements.

But officials with the Special Programs Committee of the Medical Board of California said the exemption was not intended to be used for doctors in senior positions, and the committee adopted language that would prohibit department chairs or division chiefs from using such an exemption.

The exemption, Dr. Richard Fantozzi, chairman of the medical board committee, said at a hearing, “was intended to be issued for faculty with special talent.” It was not intended “to be department chairs and department heads.”

Joyce Hadnot, chief of the medical board’s licensing program, said the UCI exemptions would be reviewed in an upcoming audit. She declined to say what action could be taken if the medical center in Orange is found to have abused it. UCI maintains it has complied with the law.

About 40 of the 4,000 doctors practicing in the UC system are working under licensing exemptions, according to Jennifer Ward, a spokeswoman for the UC system. Narula is the only department chairman.

Neither Narula nor Vannan spoke at the hearing, which was held in El Segundo. Neither could be reached for comment.

No one spoke in opposition to the proposed changes in the law.

Obtaining a state medical license is a years-long process that requires passing a three-part test, completing a residency at an accredited school within the U.S., and, for foreign-born doctors, passing an English proficiency exam. Board officials say experienced doctors are reluctant to get licenses as they become more specialized, because it requires returning to a vast amount of beginner-level material they no longer use.

The three-person committee is expected to recommend adoption of the new language to the full medical board, which will vote Friday. The change must be approved by the Legislature and the governor.

The licensing problem is the latest blow to an institution reeling from a series of revelations, including substandard performance in liver, kidney and bone-marrow transplant programs and questions about alleged favoritism in the awarding of a residency position to the son of a donor. They come after a string of controversies during the last 10 years that began when fertility doctors stole eggs and embryos from patients and implanted them in other women, and include the failure to properly handle human remains in a donated-cadaver program.

Narula and Vannan worked in hospitals in Philadelphia before they were recruited to UCI.

They have been controversial in their department, and doctors have chafed under their leadership. Five have left the department, and several criticized them before the medical board in August for not holding state licenses.

Several complaints have been lodged at UCI against Narula and Vannan, citing problems with hiring, research practices and clinical procedures, four cardiologists said.

UCI officials would not confirm whether any whistle-blower or Office of Equal Opportunity and Diversity complaints had been filed, citing privacy rules. They did confirm that a research complaint had been filed but declined to provide details.

“These guys wanted to get rid of everybody and bring in their own people,” said Dr. Michael Brodsky, a cardiologist who left shortly after the pair were hired and now practices in Hawaii.

UCI spokesman Tom Vasich said the medical center would abide by the board’s new rules.

The new language states: “The applicant shall not be appointed to a supervisory position at the level of a department chair or division chief.”

It also says they “will be accountable to the department chair in the appropriate specialty in which the applicant is practicing.”

It was not clear whether the new rules would apply to Vannan, as assistant chief.

To remain department chair, Narula must complete steps toward a state medical license before his exemption expires Jan. 23, 2007, although he could apply for two one-year extensions.

Vasich said Narula was working toward a license.

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Times staff writer Kimi Yoshino contributed to this report.