1

Filed 4/2/24 Hoang v. Medical Board of California CA3

NOT TO BE PUBLISHED

California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for 

publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication 

or ordered published for purposes of rule 8.1115.

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

THIRD APPELLATE DISTRICT

(Sacramento)

----

LUCAS TRI HOANG,

Plaintiff and Appellant,

v.

MEDICAL BOARD OF CALIFORNIA,

Defendant and Respondent.

C098645

(Super. Ct. No. 34-2022-

80003828-CU-WM-GDS)

Following an administrative hearing, the Medical Board of California (the Medical 

Board) denied Lucas Tri Hoang’s application for a physician’s and surgeon’s license, 

finding he failed to demonstrate he was safe to practice medicine after having been 

disciplined by and then terminated from his internal medicine residency program. Hoang 

challenged the Medical Board’s decision by petition for writ of mandate. The trial court 

denied the petition, Hoang appeals, and we affirm.
2

FACTUAL AND PROCEDURAL BACKGROUND

Hoang graduated from medical school in May 2017. In July 2017, he began a 

residency program (also known as a postgraduate training program) in internal medicine 

at Louisiana State University Health Sciences Center in Shreveport (hereafter, the 

“residency program” or “the program”). A residency in internal medicine normally lasts 

three years. Hoang successfully completed the first year of the program, but in December 

2018 he was placed on probation and then suspended, and in February 2019 he was 

terminated.

In June 2019, Hoang applied for a physician’s and surgeon’s license with the 

Medical Board. He disclosed on his application that he had been “repeatedly disciplined” 

and terminated by the residency program, but he stated those actions were based on 

“unfounded accusations or false allegations.” He also submitted various documents to 

the Medical Board as part of the application process, including several performance 

evaluations from the residency program, at least two of the underlying disciplinary 

notices, and various other documents regarding the accusations against him. The 

documents submitted by Hoang show the following:

Dr. Karina Sulaiman, the director of the residency program, became aware of

concerns about Hoang’s performance during the first six or seven months of his 

residency. Concerns included: failing to comply with instructions, being rude and 

aggressive to nursing staff, receiving an extremely low score (2nd percentile) on an intraining examination, and making mistakes involving patient care.

On January 12, 2018, Dr. Lauren Beal, the associate director of the residency 

program, completed an evaluation of Hoang based on “feedback from attendings” that 

stated there were “several areas of concern,” including: “His patient care lacks attention 

to detail. Professionalism is an issue with regard to respectfulness of what attendings tell 

him. For example, he ordered an MRI on a patient after being explicitly told not to order 

it. Attendings recommend that he work on following instructions. He has not been
3

responsive to feedback and needs to work to be more open to suggestions.” Dr. Beal 

gave him a score of 1 out of 5 (remedial) in several areas, including interpersonal and 

communication skills and professionalism, as well as some areas of medical knowledge 

and patient care. Hoang acknowledged receiving a copy of the evaluation.

In July 2018, Hoang received an end-of-year summary evaluation. Although he 

received many positive comments, negative comments included: “There were . . . a few 

instances where he made a clinical decision that was inappropriate and acted on it without 

communicating with the resident first”; “He does not take responsibility for his 

mistakes”; and “not performing at the level of an intern with 6+ months of training.” His 

overall score was 3.01 (with a score of 3 signifying “competent”), but he was rated below 

3 in the areas of interpersonal/communication skills, medical knowledge, and patient 

care.

On December 11, 2018, Dr. Sulaiman provided written notice to Hoang that he 

was being placed on probation because his performance was “well below what is 

expected for a physician at your level of training.” The notice cited Hoang’s 

“deficiencies in medical knowledge” and “issues with communication and respect for 

authority.” It noted, “During your recent ward rotation assignment you were found to 

have made potentially life-threatening errors of judgment in terms of patient care and also 

failed to follow the direct orders of your supervising attending. These were discussed 

with you on December 5th 2018 and you did acknowledge your role in these decisions.” 

Hoang signed the notice on December 12, 2018, to acknowledge he had received it, but 

he also wrote on it that he intended to appeal.

On January 5, 2019, Dr. Vinh Nguyen completed an evaluation of Hoang for the 

period from December 1, 2018, through December 15, 2018. Dr. Nguyen gave Hoang a 

score of 1 out of 5 (remedial) in several areas, including medical knowledge, and gave 

the following two examples: (1) Hoang pushed 12 units of insulin IV in a type 1 diabetic 

patient with a high glucose level, and (2) Hoang failed to order an interventional 
4

radiology (IR) consult he (i.e., Dr. Nguyen) had repeatedly asked for, which delayed 

“IR’s evaluation and subsequently [led] to the patient not receiving the procedure and 

having to return to the hospital a week later.” Hoang reviewed and signed the evaluation 

on January 7, 2019, and wrote, “Thank you so much for your valued feedback.”

On February 12, 2019, Dr. Sulaiman provided written notice to Hoang that he was 

terminated from the program. The notice cited errors in medical judgment, including: 

inappropriate use of opioids in patient care, inappropriate use of IV insulin in diabetes,

inappropriate use of potassium in a patient with a rising potassium, and treating 

tachycardia without an EKG. It also cited Hoang’s failure to follow the direct orders of a 

supervisor on several occasions, including not removing a central line when instructed to 

do so. Finally, it cited inappropriate behavior toward interns, including instructing 

interns to withhold data from the supervising attending, calling an intern a “ ‘tattle tale,’ ” 

telling other residents and students this intern would kill or harm patients, and pushing 

this intern to tears.

On July 14, 2019, Dr. Sulaiman wrote a letter “To whom it may concern” stating

Hoang was terminated for “multiple issues concerning patient care and professionalism,” 

among other things. Dr. Sulaiman also stated Hoang had appealed his termination, but 

the appeal was denied. We have no other information regarding this appeal.

On October 31, 2019, Dr. Sulaiman signed an affidavit stating Hoang was 

terminated from the residency program “based on his lack of medical knowledge, patient 

care issues directly affecting patient safety, and his lack of professionalism.” Dr. Beal 

and Leisa Oglesby1signed similar affidavits.

In addition to the documents just described, which Hoang himself provided to the 

Medical Board, it appears the Medical Board also requested and obtained the residency 

1 Oglesby is the designated institutional official of the Louisiana State University 

Health Sciences Center-Shreveport Graduate Medical Education Department.
5

program’s file on Hoang (and we note that, as part of the application process, Hoang 

authorized the program “to release to the Medical Board of California . . . any 

information, files or records, including medical records[ and] educational records, . . . 

requested by the Board in connection with this application”). The Medical Board’s file in 

this case thus includes documents provided by both Hoang and by the residency 

program.2

On November 21, 2019, the Medical Board denied Hoang’s application due to his 

discipline by and termination from the residency program. Hoang requested a hearing to 

contest the denial, and the Medical Board issued a “statement of issues.”

3

 Under the 

heading “Jurisdiction,” the statement of issues identified Business and Professions Code 

sections 475, 480, 2221, and 2234. We will discuss these sections in more detail below. 

The statement of issues briefly described Hoang’s discipline and termination, and 

contained one cause for denial of the application titled “Unprofessional Conduct,” which 

stated, in full: “Applicant’s application for a physician and surgeon’s [license] is subject 

to denial under Business and Professions Code sections 2221, subdivision (a) (license 

may be denied for unprofessional conduct) and 2234 (general unprofessional conduct) for 

unprofessional conduct as demonstrated by Applicant’s inadequacies and deficiencies in 

his internship program, as described above.”

At the hearing, the Medical Board presented expert testimony from Dr. James 

Nuovo. Dr. Nuovo has been licensed to practice medicine in California since 1992, and 

is board certified in family medicine. He was responsible for residency programs at the 

University of California, Davis School of Medicine from 1992 through 2018. Hoang 

2 Many of the documents overlap (i.e., many of the documents Hoang provided 

were also provided by the residency program). 

3 A “statement of issues” is the name of the document that is filed to initiate “[a] 

hearing to determine whether a . . . license . . . should be granted.” (Gov. Code, § 11504.) 
6

does not challenge Dr. Nuovo’s qualifications as an expert. Dr. Nuovo reviewed Hoang’s 

application. He testified the application in and of itself raised concerns about Hoang’s 

ability to safely practice medicine because it disclosed he had been terminated from his

residency program, and it was “extremely unusual for a program to have to terminate a 

resident.” Dr. Nuovo also reviewed the documents provided to the Medical Board by 

both Hoang and the residency program. Based on his review of the documents, Dr. 

Nuovo opined Hoang was not capable of practicing competently and safely. He found 

some of Hoang’s errors in medical judgment were “shocking” and “dumbfound[ing],” 

and he testified “patients can die” from such errors. He acknowledged he did not 

interview Hoang, and he accepted all of the program’s allegations as true, and the 

Medical Board thus acknowledged Dr. Nuovo’s “review was based on hearsay and 

double hearsay.”

Hoang testified on his own behalf. He denied the most serious allegations against 

him. He did not present his own expert. He submitted letters of recommendation from 

classmates, supervisors, and a nurse. He presented testimony from Dr. Stephen H. 

Greenberg, who was the director of the residency program from April 2013 to July 2017. 

Dr. Greenberg was involved in the process of selecting Hoang for the residency program, 

but his last day as director of the program was the same day that Hoang started. Dr. 

Greenberg thus did not supervise or oversee Hoang during his residency program and had 

no personal knowledge about his performance in the program.

Following the hearing, the Medical Board issued a decision denying Hoang’s 

application based on its conclusion that Hoang “failed to demonstrate that he is safe to 

practice independently.”

Hoang filed a petition for writ of mandate pursuant to Code of Civil Procedure 

section 1094.5 challenging the Medical Board’s decision. The trial court denied the 

petition and entered judgment accordingly, and Hoang timely appealed.
7

STANDARD OF REVIEW

“In reviewing administrative proceedings under [Code of Civil Procedure] section 

1094.5 that do not affect a fundamental right, such as an attempt to obtain a license to 

engage in a profession or business, the trial court reviews the whole administrative record 

to determine whether the findings are supported by substantial evidence and whether the 

agency committed any errors of law. [Citations.] On appeal in such a case, we stand in 

the same shoes as the trial court and apply the same standard of review.” (Donley v. Davi

(2009) 180 Cal.App.4th 447, 455-456.) “Under the substantial evidence test, the 

agency’s findings are presumed to be supported by the administrative record and, in both 

the trial court and here on appeal, it is the petitioner/appellant’s burden to show they are 

not. [Citations.] We ‘ “do not reweigh the evidence; we indulge all presumptions and 

resolve all conflicts in favor of the [agency’s] decision. . . .” ’ [Citation.] When more 

than one inference can be reasonably deducted from the facts, we cannot substitute our 

own deductions for that of the agency.” (Id. at p. 456.) We decide issues of law de novo. 

(Medical Board v. Superior Court (2001) 88 Cal.App.4th 1001, 1008.) 

DISCUSSION

We note at the outset that Hoang is representing himself on appeal,

4 and many of 

his arguments are difficult to understand. However, although “a party may choose to act 

as his or her own attorney,” “ ‘[s]uch a party is to be treated like any other party and is 

entitled to the same, but no greater consideration than other litigants and attorneys.’ ” 

(Nwosu v. Uba (2004) 122 Cal.App.4th 1229, 1246-1247.) 

4 He was represented by counsel at the administrative hearing and in the trial court. 
8

I

Amendments to Business and Professions Code Section 480 do not Affect the Medical 

Board’s Decision

Hoang’s first set of arguments are related, and deal with an amendment to 

Business and Professions Code section 4805that took effect during the pendency of the 

administrative proceedings in this case. He contends (1) the Medical Board’s decision 

must be reversed because it is based on a version of section 480 that no longer exists, and 

(2) the amendment to section 480 impliedly repealed the Medical Board’s authority to 

deny a license for unprofessional conduct. These arguments raise an issue of statutory 

construction, which we review de novo. (Medical Board v. Superior Court, supra, 

88 Cal.App.4th at p. 1008.) For the reasons explained below, we reject both arguments 

and find the amendment to section 480 does not affect the outcome in the case.

A. Sections 475, 480, 2221, and 2234

The Medical Board cited sections 475, 480, 2221, and 2234 in both the statement 

of issues and its decision as grounds for denying Hoang’s application. We begin by 

briefly examining those four sections and where they fit into the Business and 

Professions Code as a whole. 

As the name implies, the Business and Professions Code regulates businesses and 

professions. It establishes California’s Department of Consumers Affairs (§ 100), which

is comprised of numerous boards that license and regulate various trades and professions, 

including doctors, nurses, dentists, veterinarians, accountants, real estate appraisers, 

contractors, and barbers and cosmetologists (§ 101). The Medical Board is one such 

board, and it licenses and regulates physicians and surgeons. (§§ 101, subd. (b), 2000 et 

seq.) 

5 Undesignated statutory references are to the Business and Professions Code.
9

Sections 475 and 480 are in division 1.5 of the Business and Professions Code,

which deals with denial, suspension, and revocation of licenses. Division 1.5 “applies 

broadly” to all boards within the Department of Consumer Affairs and to the trades and 

professions those boards license and regulate. (Sulla v. Board of Registered Nursing

(2012) 205 Cal.App.4th 1195, 1205; see also Lone Star Security & Video, Inc. v. Bureau 

of Security & Investigative Services (2009) 176 Cal.App.4th 1249, 1256.) 

Section 475 provides, in relevant part: “(a) Notwithstanding any other provision 

of this code, the provisions of this division shall govern the denial of licenses on the 

grounds of: [¶] . . . [¶] (4) Commission of any act which, if done by a licentiate of the 

business or profession in question, would be grounds for suspension or revocation of 

license.”

Prior to July 1, 2020, section 480 provided in relevant part: “(a) Notwithstanding 

any other provision of this code, a board may deny a license regulated by this code on the 

grounds that the applicant has one of the following: [¶] . . . [¶] (3) (A) Done any act that 

if done by a licentiate of the business or profession in question, would be grounds for 

suspension or revocation of license.” We will refer to this as the prior version of section 

480. By its terms, it became “inoperative on July 1, 2020, and, as of January 1, 2021, is 

repealed.” (Former § 480, subd. (e).) 

Section 480 currently states (and has stated since July 1, 2020), in relevant part: 

“(a) Notwithstanding any other provision of this code, a board may deny a license 

regulated by this code on the grounds that the applicant has been convicted of a crime or 

has been subject to formal discipline only if” certain conditions are met. (§ 480, subd. 

(a).) As to formal discipline, the board may only deny a license on that ground if the 

“applicant has been subjected to formal discipline by a licensing board in or outside 

California within the preceding seven years from the date of application based on 

professional misconduct that would have been cause for discipline before the board for 

which the present application is made and that is substantially related to the 
10

qualifications, functions, or duties of the business or profession for which the present 

application is made.” (§ 480, subd. (a)(2).)6 Section 480 no longer authorizes a board to 

deny a license based on an act that would be grounds for suspension or revocation of a 

license. 

In addition to division 1.5, which applies to all boards within the Department of 

Consumer Affairs, the Business and Professions Code contains other divisions and 

sections that apply exclusively to particular boards and particular trades and professions. 

As relevant here, the Medical Practice Act, which is in chapter 5 of division 2 of the 

Business and Professions Code, regulates the Medical Board and the practice of 

medicine. (§ 2000 et seq.) Sections 2221 and 2234 are part of the Medical Practice Act 

and apply only to the Medical Board.

Section 2221 provides, in relevant part, the Medical Board may deny a license “to 

an applicant guilty of unprofessional conduct or of any cause that would subject a 

licensee to revocation or suspension of their license.” (§ 2221, subd. (a).) And section 

2234 provides the Medical Board shall take action against a licensee who is charged with 

unprofessional conduct, and it defines unprofessional conduct as including certain 

enumerated acts like gross negligence, repeated negligent acts, and incompetence. 

(§ 2234.) Case law teaches that unprofessional conduct is not limited to the acts

enumerated in section 2234 and includes any “conduct which indicates an unfitness to 

practice medicine.”7 (Shea v. Board of Medical Examiners (1978) 81 Cal.App.3d 564, 

575; see id. at p. 575, fn. 5.) 

6

It appears undisputed for purposes of this appeal that Hoang has never been 

convicted of a crime or subject to formal discipline by another licensing board. 

7 Hoang does not seriously contend the conduct underlying his discipline and 

termination does not indicate an unfitness to practice medicine. Instead, he contends the 

Medical Board failed to prove the conduct actually occurred.
11

We note that, pursuant to these four sections of the Business and Professions Code, 

unprofessional conduct is grounds for denial of a license in two ways. The first and more 

direct way is pursuant to section 2221, which provides the Medical Board may deny a 

license to an applicant guilty of unprofessional conduct—period. The second way, which 

is more circuitous but which ends up at the same place, is pursuant to the prior version of 

section 480 and to section 2221, which both provide the Medical Board may deny a 

license based on an act or cause that would be grounds for suspension or revocation, and 

section 2234, which provides the Medical Board may suspend or revoke a license based 

on unprofessional conduct.

B. Hoang’s arguments regarding section 480

Hoang argues the Medical Board’s decision must be reversed because it is based 

on a version of section 480 that no longer exists. We disagree.

The statement of issues in this case was issued in March 2020, and the Medical 

Board thus cited the prior version of section 480 because that is the version that was in 

effect at the time. Again, the prior version authorized a board to deny a license on the 

ground the applicant had done an act that would be grounds for suspension or revocation 

of a license. By the time the administrative hearing was held (in April 2021) and the 

challenged decision was issued (in December 2021), section 480 had been amended to 

provide a board may deny a license based on conviction of a crime or formal discipline 

by a licensing board if certain conditions were met, and it no longer authorizes a board to 

deny a license based on an act that would be grounds for suspension or revocation of a 

license. The Medical Board nonetheless cited the prior version of section 480 in its 

decision as a ground for denying Hoang’s application. 

Hoang argues that, because the Medical Board cited the prior version of section 

480, which had been repealed by the time it issued its decision, it acted in excess of its 

jurisdiction in denying his application. We disagree. We might agree if the Medical 

Board had cited only the prior version of section 480 as a basis for denying Hoang’s 
12

application, because that version no longer exists. (See, e.g., Governing Board v. Mann

(1977) 18 Cal.3d 819, 826-828 [where the school district disciplined a teacher based on

conviction for possession of marijuana, and where law enacted during pendency of 

appeal prohibited public agencies from sanctioning an individual based on conviction for 

possession of marijuana, the district could no longer discipline the teacher based on 

conviction].) But the Medical Board also cited section 2221 as a basis for denying 

Hoang’s application. That section was in effect at all relevant times, and it authorizes the 

Medical Board to deny a license based on unprofessional conduct. Moreover, it is clear 

from both the statement of issues and the challenged decision that the Medical Board

denied Hoang a license because of unprofessional conduct. The Medical Board’s citation 

to the prior version of section 480 thus does not affect the validity of its decision.

Hoang also argues that when the Legislature amended section 480, it limited the 

Medical Board’s authority to deny a license to the two grounds specified therein (i.e., 

conviction of a crime or formal discipline by another licensing board), and thus impliedly

repealed the Medical Board’s authority to deny a license for unprofessional conduct 

pursuant to section 2221. Again, we disagree.

The Legislature “has opted to create a two-track system to make [licensure]

available under both section 4[8]0 and other [Business and Professions Code] sections 

addressing individual trades” and professions. (Lone Star Security & Video, Inc. v. 

Bureau of Security & Investigative Services, supra, 176 Cal.App.4th at pp. 1256-1257, 

italics added.) Thus, although section 480 specifies grounds for denying an application 

for licensure that apply to all boards within the Department of Consumer Affairs, it is not 

exclusive, and other provisions of the Business and Professions Code remain applicable 

to specific boards. As relevant here, section 2221, which is part of the Medical Practice 

Act, provides the Medical Board may deny an application for unprofessional conduct, 

and that is what the Medical Board did here.
13

We reject Hoang’s argument that the Legislature impliedly repealed section 2221 

when it amended section 480. When interpreting two statutes that “ ‘touch upon a 

common subject,’ we must construe them ‘in reference to each other, so as to “harmonize 

the two in such a way that no part of either becomes surplusage.” ’ ” (Garcia v. 

McCutchen (1997) 16 Cal.4th 469, 476.) We presume the Legislature intended “ ‘every 

word, phrase and provision’ ” in both statutes “ ‘to have meaning and to perform a useful 

function.’ ” (Ibid.) Finally, and critically, we do not lightly imply that the Legislature 

intended to repeal a statute. Instead, “ ‘[A]ll presumptions are against a repeal by 

implication. [Citations.]’ [Citation.] Absent an express declaration of legislative intent, 

we will find an implied repeal ‘only when there is no rational basis for harmonizing the 

two potentially conflicting statutes [citation], and the statutes are “irreconcilable, clearly 

repugnant, and so inconsistent that the two cannot have concurrent operation.” ’ ” (Id. at 

pp. 476-477.)

When it amended section 480, the Legislature did not mention section 2221, much 

less expressly repeal it,8 and we find the two statutes do not conflict. Instead, they 

provide separate and independent grounds for the Medical Board to deny a license. 

Section 480 authorizes any board within the Department of Consumer Affairs to deny a 

license based on commission of a crime or discipline by another licensing board, and 

section 2221 authorizes the Medical Board to deny a license based on unprofessional 

conduct. The statutes are not irreconcilable or inconsistent and both can operate 

concurrently.9 

8 Hoang notes the Legislature expressly repealed the prior version of section 480, 

which is true. But the Legislature did not also expressly repeal section 2221, and for the 

reasons explained herein, we find the Legislature did not impliedly repeal that section 

either. 

9 This fact also distinguishes this case from Pieri v. Fox (1979) 96 Cal.App.3d 802, 

a case cited by Hoang, albeit with almost no discussion of how it applies here. In Pieri, 
14

Our conclusion that the amendment to section 480 did not impliedly repeal section 

2221 is buttressed by the fact that the Medical Board (or its predecessor) has been 

authorized to deny a license based on unprofessional conduct for over a century. (See, 

e.g., Stats 1907, ch. 212, § 11, p. 255 [board of medical examiners “must refuse a 

certificate to any applicant guilty of unprofessional conduct”]; Stats 1945, ch. 896, § 1, 

p. 1660 [board “shall refuse a certificate to any applicant guilty of unprofessional 

conduct”]; Stats 1976, ch. 1185, § 46, p. 5302 [division of licensing “shall refuse a 

certificate to any applicant guilty of unprofessional conduct”]; Stats 1983, ch. 95, § 5, 

p. 200 [division “may deny a physician’s and surgeon’s certificate to an applicant guilty 

of unprofessional conduct or of any cause that would subject a licensee to revocation or 

suspension of license”].) Had the Legislature intended to repeal such long-standing 

authority, we would expect a very clear statement of such intent, but there is none.

II

The Medical Board Properly Relied on Section 2221

Hoang also makes two brief arguments about section 2221. First, he notes the 

Medical Board’s decision “did not even reference section 2221(a) as providing authority 

for denial” of his application. Hoang is incorrect. The decision states cause for denial 

exists “pursuant to Business and Professions Code sections 475, subdivision (a)(4), 480, 

subdivision (a)(3)(A), 2221 and 2234 (unprofessional conduct) and 2234, subdivision (d) 

(incompetence).” (Bolding and italics added.) Although the decision does not 

specifically cite subdivision (a) of section 2221, it clearly identifies unprofessional 

conduct as the cause of denial, and it is subdivision (a) that provides the Medical Board 

“may deny a physician’s and surgeon’s certificate to an applicant guilty of unprofessional 

conduct.” 

the two statutes at issue—sections 480 and 10177—actually conflicted and could not both 

operate at the same time. Here, there is no such conflict. 
15

Second, Hoang notes section 2221 uses the term “guilty”—i.e., “The board may 

deny a physician’s and surgeon’s certificate to an applicant guilty of unprofessional 

conduct” (§ 2221, subd. (a), italics added)—and he appears to argue that by using this 

term, the Legislature intended to limit the phrase “unprofessional conduct” to criminal 

acts. He cites no authority to support this argument, and we are aware of none. 

Moreover, we note that section 2234 defines the phrase “unprofessional conduct” as 

including “[i]ncompetence,” which is not a crime. (§ 2234, subd. (d).) We also note that 

case law has long held unprofessional conduct includes any conduct “which indicates an 

unfitness to practice medicine” (Shea v. Board of Medical Examiners, supra, 

81 Cal.App.3d at p. 575), and unfitness to practice medicine is also not a crime. We thus 

find the term “unprofessional conduct” is not limited to criminal acts. 

III

The Admission and Use of Hearsay Was Proper

Hoang’s final series of arguments deals with the admission and use of hearsay at 

the administrative hearing. By hearsay, he refers to the documents about him from the 

residency program’s file. Although these arguments are underdeveloped and sometimes 

difficult to understand, his point appears to be that the Medical Board’s decision denying 

him a license must be reversed because (1) it is based on a finding that he is not safe to 

practice medicine, and (2) that finding is not supported by substantial evidence because it 

is based solely on hearsay. As we explain below, we disagree. 

We note at the outset that the “rules of evidence do not apply to administrative 

hearings,” and that includes the rules governing the admission of hearsay. (Big Boy 

Liquors, Ltd. v. Alcoholic Beverage Control Appeals Bd. (1969) 71 Cal.2d 1226, 1230.) 

The admission of evidence is governed by Government Code section 11513, which 

provides, “The hearing need not be conducted according to technical rules relating to 

evidence and witnesses, except as hereinafter provided. Any relevant evidence shall be 

admitted if it is the sort of evidence on which responsible persons are accustomed to rely 
16

in the conduct of serious affairs, regardless of the existence of any common law or 

statutory rule which might make improper the admission of the evidence over objection 

in civil actions.” (Gov. Code, § 11513, subd. (c).) “Thus even ‘hearsay evidence is 

admissible in an administrative hearing if (1) it is relevant, and (2) it is of the character or 

quality on which “responsible persons are accustomed to rely in the conduct of serious 

affairs.” ’ ” (McCoy v. Board of Retirement (1986) 183 Cal.App.3d 1044, 1053-1054, 

italics omitted; see also Gregory v. State Bd. of Control (1999) 73 Cal.App.4th 584, 596 

[same].) 

We easily conclude a residency program’s file regarding its discipline and 

termination of a resident is both relevant and the sort of evidence that a responsible 

medical licensing board would rely on in deciding whether to grant that person a license 

to practice medicine. Our conclusion is buttressed by Dr. Nuovo’s uncontradicted 

testimony that he reviewed the residency program’s file on Hoang, that it contained the 

types of materials he would expect to see in a resident’s file, and that a program director 

(or any physician) would reasonably rely on such materials when evaluating a resident’s 

competency and qualifications. As Dr. Nuovo also explained (again without 

contradiction), the purpose of a residency program “is to transform medical school 

graduates into physicians capable of independent practice by ensuring that a resident can 

translate medical knowledge into safe clinical practice.” In recognition of the importance 

of residency programs to ensuring the safe practice of medicine, the Legislature has 

provided that, in order to obtain a physician’s and surgeon’s license, the applicant must 

have received credit for at least 12 months of postgraduate training. (§ 2096.) It has also 

provided that licenses must be renewed every two years (§ 2423), and that before a 

license may be renewed for the first time, the physician must have received credit for at 

least 36 months of postgraduate training (§ 2097). The Legislature has also declared, 

“Protection of the public shall be the highest priority for the Medical Board of California 

in exercising its licensing, regulatory, and disciplinary functions. Whenever the 
17

protection of the public is inconsistent with other interests sought to be promoted, the 

protection of the public shall be paramount.” (§ 2001.1.) Given how important 

postgraduate training is to both (1) protecting the public by ensuring physicians are safe 

to practice, and (2) obtaining and maintaining a license, we do not see how a responsible 

licensing board could fail to consider a residency program’s file on an applicant, 

especially an applicant who was terminated from the program for reasons demonstrating 

an unfitness to practice medicine. We thus find no error in admitting the residency 

program’s file on Hoang into evidence even though the file contains hearsay.

That the files were properly admitted does not end the analysis, however, because 

Government Code section 11513 also provides, “Hearsay evidence may be used for the 

purpose of supplementing or explaining other evidence but over timely objection [and we 

note there was a timely objection in this case] shall not be sufficient in itself to support a 

finding unless it would be admissible over objection in civil actions.” (Gov. Code,

§ 11513, subd. (d).) Thus, hearsay “is perfectly acceptable evidence to rely upon in an 

administrative proceeding to supplement or explain other admissible evidence,” but it “is 

insufficient to support a point itself.” (Malaga County Water Dist. v. State Water 

Resources Control Bd. (2020) 58 Cal.App.5th 447, 480.) We agree with the Medical 

Board’s argument that, although the residency program files contain hearsay, that hearsay 

could properly be used to supplement or explain the admissions Hoang made as part of 

the application process and at the hearing. Hoang is a party to this proceeding, and 

Evidence Code section 1220 provides that the admission of a party “is not made 

inadmissible by the hearsay rule.” Hoang’s application was admitted into evidence 

without objection, and as part of that application, he admitted he was disciplined and 

terminated by the residency program. He also provided the Medical Board with copies of 

the probation and termination notices, which, on their face, show he was disciplined and 

terminated for reasons that demonstrate an unfitness to practice medicine. Although we 

acknowledge that Hoang insists the reasons for his discipline and termination are false 
18

and/or unfounded, he nonetheless admitted that those reasons are why he was disciplined 

and terminated. Hoang’s admissions would thus be admissible over objection in a civil 

action pursuant to Evidence Code section 1220, and the program files were admissible to 

supplement and explain those admissions. 

IV

Sufficient Evidence Supports the Medical Board’s Decision

Although the program files were admissible, Hoang is correct when he argues that

hearsay standing alone is not sufficient in itself to support a finding.

10

 Hoang then argues 

the Medical Board failed to present any nonhearsay evidence to support its finding that he 

is not safe to practice medicine. This argument demonstrates a misunderstanding of both 

the burden of proof and the Medical Board’s ultimate conclusion in this case. 

“[T]here is a clear distinction between proceedings involving the revocation of an 

existing license and proceedings involving the denial of an application for a license.” 

(Martin v. Alcoholic Bev. etc. Appeals Bd. (1959) 52 Cal.2d 259, 264, italics added.) 

Courts “often have recognized that an individual, having obtained the license required to 

engage in a particular profession or vocation, has a ‘fundamental vested right’ to continue 

in that activity.” (Hughes v. Board of Architectural Examiners (1998) 17 Cal.4th 763, 

788-789.) “A licensee, having obtained such a fundamental vested right, is entitled to 

certain procedural protections greater than those accorded an applicant.” (Id. at p. 789.) 

Thus, “ ‘When an administrative agency initiates an action to suspend or revoke a license, 

the burden of proving the facts necessary to support the action rests with the agency 

making the allegation. Until the agency has met its burden of going forward with the 

evidence necessary to sustain a finding, the licensee has no duty to rebut the allegations 

10 Unless, of course, it would be admissible over objection in a civil action, but, as 

Hoang notes, the Medical Board has never claimed everything in the program’s files 

would be admissible over objection in a civil action. 
19

or otherwise respond.’ ” (Kruger v. Department of Motor Vehicles (1993) 13 Cal.App.4th 

541, 547.) 

This case, however, is not a license revocation case. It is a license application 

case. And in a license application case, the burden of proof is on the applicant to show he 

or she is qualified for licensure. (Martin v. Alcoholic Bev. etc. Appeals Bd., supra, 

52 Cal.2d at p. 265 [“the burden of proof may properly be placed upon the applicant in 

application proceedings”]; Bode v. Los Angeles Metropolitan Medical Center (2009) 

174 Cal.App.4th 1224, 1233 [applicant for hospital staff privileges has burden of proof of 

qualifications].) It was thus not the Medical Board’s burden to prove Hoang was not safe 

to practice medicine; it was Hoang’s burden to prove he was safe.11 (See Pick v. Santa 

Ana-Tustin Community Hospital (1982) 130 Cal.App.3d 970, 984.) 

Moreover, Hoang’s burden of proof was necessarily affected by what he disclosed 

to the Medical Board as part of his application. As described above, he admitted in his 

application he was disciplined and terminated, and he submitted numerous documents to 

the Medical Board that show, on their face, he was disciplined and terminated for reasons 

having to do with his unfitness to practice medicine. Hoang cites no authority (and we 

are aware of none) that holds a licensing board may not rely on documents submitted to it 

by an applicant in deciding whether to issue a license. Indeed, it is difficult to see how a 

licensing board could function properly if it could not rely on such documents. In order 

11 Hoang’s citation to discipline cases like Ashford v. Culver City Unified School 

Dist. (2005) 130 Cal.App.4th 344, disapproved on other grounds in Voices of the 

Wetlands v. State Water Resources Control Bd. (2011) 52 Cal.4th 499, 535, and Martin v. 

State Personnel Bd. (1972) 26 Cal.App.3d 573 is thus not apt because the burden in those 

cases is flipped. In Ashford, for example, an employee was able to successfully challenge 

his termination even though “[h]e did not testify at the hearing but instead relied on his 

right to require [the employer] to present admissible evidence in support of the charges 

against him.” (Ashford, at p. 347.) Here, it is the Medical Board that could rely on its 

right to require Hoang to present admissible evidence sufficient to demonstrate he is safe 

to practice. 
20

to meet his burden of proving he was safe to practice medicine, Hoang had to produce 

sufficient evidence to overcome the concerns about his fitness to practice medicine that 

he himself disclosed. We thus agree with the Medical Board’s related argument that it 

was not its burden to prove Hoang’s discipline and termination were justified; it was 

effectively Hoang’s burden to prove they were not.

The Medical Board found Hoang did not meet his burden of proof, and he gives us 

no reason to reject this finding. Based on his argument headings, he appears to argue the 

Medical Board’s finding that he is not safe to practice is not supported by substantial 

evidence because it is based solely on hearsay. That argument takes too narrow a view of 

what the Medical Board actually found. It is true that the Medical Board noted Dr. 

Nuovo’s opinion that Hoang was not safe to practice, and also noted Dr. Nuovo’s opinion 

was based largely on hearsay. However, its ultimate finding was that Hoang failed to 

meet his burden of proof to establish he is safe to practice. As the Medical Board 

correctly recognized, “The burden of proof is on the Applicant to establish that he meets 

the requirements for licensure and is safe to practice.” And it found, “Applicant failed to 

demonstrate that he is safe to practice independently.” Hoang never mentions this 

finding, much less convinces us it is based solely on hearsay or is otherwise not 

supported by substantial evidence. (See Cameron v. Sacramento County Employees’ 

Retirement System (2016) 4 Cal.App.5th 1266, 1278 [“factual findings not contested must 

be accepted as true”]; Von Durjais v. Board of Trustees (1978) 83 Cal.App.3d 681, 687 

[any finding not specifically attacked is to be accepted as true].) 

As the Medical Board notes, Hoang’s only evidence that he is safe to practice is 

his own testimony,12 and much of that testimony is difficult to understand and not 

12 As noted above, the only witness Hoang called—Dr. Greenberg—did not 

supervise him during his residency program and thus has no personal knowledge of why 

he was disciplined or terminated. 
21

convincing. He testified about much (but not all) of the underlying conduct for which he 

was disciplined and terminated and gave his version of events, the gist of which is that he 

did not do what he was charged with doing, or others were “confused,” or the charges 

were based on “a misunderstanding” or “a mix up,” or he “did not do anything 

inappropriate.” The Medical Board was not required to credit Hoang’s self-serving 

version of events. “The trier of the fact is the exclusive judge of the credibility of 

witnesses and may reject in toto even uncontradicted evidence by taking into 

consideration the bias and motive of the person testifying.” (Akopiantz v. Board of 

Medical Examiners (1961) 190 Cal.App.2d 81, 90; see also In re Marriage of Hofer

(2012) 208 Cal.App.4th 454, 460 [“The trier of fact may reject even uncontradicted 

evidence as not credible”].) “In reviewing factual determinations for substantial 

evidence, a reviewing court should ‘not reweigh the evidence, evaluate the credibility of 

witnesses, or resolve evidentiary conflicts.’ [Citation.] The determinations should ‘be 

upheld if . . . supported by substantial evidence, even though substantial evidence to the 

contrary also exists and the [fact finder] might have reached a different result had it 

believed other evidence.’ [Citations.] Uncontradicted testimony rejected by the [fact 

finder] ‘ “cannot be credited on appeal unless, in view of the whole record, it is clear, 

positive, and of such a nature that it cannot rationally be disbelieved.” ’ ” (In re Caden C.

(2021) 11 Cal.5th 614, 640.) Hoang fails to convince us his self-serving testimony 

“cannot rationally be disbelieved,” and he thus gives us no reason to reject the Medical 

Board’s finding that he failed to meet his burden of proof.

Hoang appears to believe that all he had to do to meet his burden of proof was to 

state the residency program’s reasons for disciplining and terminating him were false or 

unfounded, and once he did that, the burden then shifted to the Medical Board to prove 

the residency program’s reasons were founded. He cites no authority for this proposition, 

and we are aware of none. Again, it was his burden to prove he was safe, and the 

Medical Board found he failed to meet his burden.
22

Hoang argues one document in the record definitively disproves the residency 

program’s reasons for disciplining and terminating him and establishes he is fit to 

practice. The document is a Medical Board form titled “Certificate of Completion of 

ACGME/RCPSC Postgraduate Training,” and it is to be completed by every postgraduate 

training program the applicant attends. The form contains the following, preprinted 

certification: “The program director signing this form is formally certifying and 

documenting under penalty of perjury that the applicant received instruction appropriate 

for the particular postgraduate level and that he/she satisfactorily completed periods of 

training in accordance with the accepted standards and the criteria defined as equating to 

satisfactory performance. The program director is attesting to the fact that the applicant 

has acquired the skill and qualifications necessary to safely assume the unrestricted 

practice of medicine in this state.” (Italics added.) Dr. Sulaiman signed the form on 

September 6, 2019. Hoang argues the italicized language conclusively demonstrates he is 

safe to practice medicine. We disagree, because Hoang completely ignores that portion 

of the form that asks the program director about “unusual circumstances.” In this portion 

of the form, Dr. Sulaiman answered “yes” to the following questions: (1) “Did the 

applicant receive partial or no credit during his/her postgraduate training?” (2) “Was the 

applicant ever terminated, dismissed or expelled?” (3) “Was the applicant ever placed on 

probation?” (4) “Was the applicant ever disciplined or placed under investigation?” And 

(5) “Were any limitations or special requirements placed upon the applicant for clinical 

performance, professionalism, medical knowledge, discipline, or for any other reason?” 

Given these answers, and contrary to Hoang’s argument, this form did not conclusively 

establish he was fit to practice medicine and entitled to a license, particularly in light of 

the numerous documents Hoang provided to the Medical Board that demonstrate his 

unfitness. 

Hoang also argues issuance of a license should have been “automatic” because he 

met all three requirements for licensure in California—he graduated from medical school, 
23

he completed 12 months of postgraduate training, and he passed all steps of the United 

States Medical Licensing Examination. (See §§ 2082 [application for licensure shall 

include diploma and official transcript from approved medical school; proof of passage of 

required written examinations; and satisfactory completion of postgraduate training 

required by § 2096], 2096 [before license may be issued applicant must receive at least 

12 months of board-approved postgraduate training].) We disagree. When an applicant 

informs the Medical Board he was disciplined and terminated by a residency program for 

reasons demonstrating he is unfit to safely practice medicine, licensure is not automatic, 

and the burden is on the applicant to prove he is fit.

The burden of proof in this case also answers Hoang’s complaint that the Medical 

Board failed to call any of the individuals who witnessed or had personal knowledge of 

the conduct for which he was disciplined and terminated, which deprived him of the 

opportunity to question them. He fails to convince us the Medical Board was required to 

call these individuals. Again, it was Hoang’s burden to prove he was safe to practice 

medicine, not the Medical Board’s burden to prove he was not. Hoang could have called 

these individuals himself, deposed them, or obtained affidavits from them and introduced 

the affidavits into evidence. (See Gov. Code, §§ 11513, subd. (b) [each party to 

administrative hearing “shall have [the] right . . . to call and examine witnesses”], 11511 

[“On verified petition of any party, an administrative law judge or . . . an agency may 

order that the testimony of any material witness residing within or without the state be 

taken by deposition . . . . Where the witness resides outside the state and where the 

administrative law judge or agency has ordered the taking of the testimony by deposition, 

the agency shall obtain an order of court to that effect by filing a petition therefor in the 

superior court in Sacramento County”], 11514, subd. (a) [outlining procedure for 

introducing affidavits at administrative hearing].) He did none of these things. 

For all the reasons stated above, we find the Medical Board’s decision is supported 

by substantial evidence. 
24

DISPOSITION

The judgment is affirmed and, as the prevailing party, the Medical Board shall 

recover its costs on appeal. (Cal. Rules of Court, rule 8.278(a)(1), (2).)

 /s/

EARL, P. J.

We concur:

 /s/

HULL, J.

 /s/

WISEMAN, J.*

* Retired Associate Justice of the Court of Appeal, Fifth Appellate District, assigned 

by the Chief Justice pursuant to article VI, section 6 of the California Constitution.