Dr. Arthur B. Boyd Jr., fired from the Maryland Shock Trauma Center two weeks ago, wanted to be a surgeon in the worst way.
The gregarious North Carolina native, who graduated from medical school in 1978, repeatedly flunked a basic medical licensing exam, the kind that all physicians are required to pass. So he tried unsuccessfully to persuade at least one state licensing board to let him combine scores on different portions of the exam, taken at different times, to produce a passing grade.
At St. Luke's Hospital in Cleveland, Dr. Boyd didn't satisfactorily complete his surgical residency, an official said, calling his skill ratings "mediocre, at best." But that didn't discourage Dr. Boyd from applying, unsuccessfully, for sought-after surgical jobs at places such as New England Deaconess, a Harvard-affiliated hospital in Boston.
A recent Who's Who in the Midwest listing said that Dr. Boyd was a "fellow" in the prestigious organ transplant program at the University of Pittsburgh in 1985. But a university spokeswoman said he "was kind of hanging out" at the program and was not admitted to any official fellowship.
He was so eager to wield a scalpel that he tried in 1984 to pay a Michigan state licensing official to slip him an advance copy of an exam. Dr. Boyd was arrested and pleaded no contest to bribery. He was sentenced to 30 days in the Ingham County, Mich., jail and fined $450.
After eight years of pestering licensing boards and academic medical centers, Dr. Boyd finally succeeded in July 1993 in landing a surgical job in a U.S. hospital -- at Shock Trauma in Baltimore.
The trauma center was undergoing a wrenching reorganization when Dr. Boyd arrived, and its officials failed to check his credentials. But he was required to fill out a form that calls for a Maryland physician's license number. No problem. He wrote down a bogus one, consisting of 15 numbers and letters, a hospital official alleged.
Maryland licenses have five numbers.
For two years, Dr. Boyd worked at Shock Trauma and, under an agreement with the Baltimore hospital, in the trauma center at Prince George's Hospital Center in Cheverly. Altogether, he helped treat about 950 patients in this state, many of them critically injured, before he was fired Oct. 3.
At Shock Trauma, he participated in 125 operations, hospital officials estimated, adding that he always worked under the supervision of a senior surgeon.
Arthur Bernette Boyd Jr. is, according to friends and acquaintances, a very agreeable fellow. The 48-year-old father of two likes dogs, has "well-behaved" children and is eager to pitch in when someone asks for his help. He seems to lack the arrogance that afflicts many surgeons, specialists notorious among their colleagues for having Everest-sized egos.
But Arthur Bernette Boyd Jr. also can be as relentless as a lava flow. He has taken, and flunked, the licensing exam 15 times. He traipsed to state after state trying to wangle a license, and at one point appeared before a dubious medical board in Ketchikan, Alaska.
To support himself in this seemingly quixotic quest, the Durham, N.C., native has doubled as an entrepreneur. According to Who's Who and to acquaintances, he helped run a soft-drink distributing firm in Cleveland and worked with a Cleveland-based surgical supply business. (He invented a wheelchair with a seat that could raise and lower the left and right buttocks separately, presumably to help shift the weight of immobile patients.)
Neither business is currently listed in the Cleveland phone book or Ohio state corporation records.
Today, he owns the rights to the formula for a line of soft drinks, called Motown beverages, that he's trying to peddle in the Washington area. Who's Who reports that he has been Motown's "chief surgeon" for the past seven years.
Neighbors say he lives on a tree-lined boulevard of $80,000 to $150,000 brick and frame houses in Shaker Heights, Ohio. Dr. Boyd would fly home to Cleveland on weekends to spend time with his wife, a dietitian at a Cleveland hospital, and children.
The physician has not responded to many messages left at various locations, including his home, requesting an interview.
But Peter Lawson Jones, a Cleveland lawyer who has represented Dr. Boyd in the past, called him "earnest and sincere, with a tremendous interest in serving the public with the skills that he has as a medical doctor."
"He happens to be very capable," said Mr. Jones, who has known the physician about six years. "Nobody criticizes his surgical skills. I'm sure that whatever patients he provided trauma services to, they were very well served. He's able, he's capable, he has the necessary acumen."
And, Mr. Jones claimed, Dr. Boyd hasn't done anything wrong. "At worst," he said, "we have a case of somebody who has had some difficulty with the licensure exam."
Maryland regulators don't see it that way.
At worst, they say, Dr. Boyd may have violated state law, which bars anyone from practicing medicine here without a license, a misdemeanor punishable by a fine of up to $5,000 and five years in jail.
Dr. John M. Parry, a Baltimore-area surgeon who knew Dr. Boyd, called him a "friendly, helpful kind of guy." But the surgeon said he was shocked to learn that Dr. Boyd had "bamboozled" Shock Trauma into appointing him as a surgical fellow.
"I'm sorry to hear all this is happening to him," Dr. Parry said. "On the other hand, it is kind of scary, in the sense that the system can break down like that."
Shock Trauma officials say they were "deceived" by Dr. Boyd: that they thought he had a medical license, that they weren't told he repeatedly had flunked the licensing test and that they knew nothing of his bribery conviction.
They also acknowledge that they did not check many of the claims he made on his resume.
"Apparently there was a significant failure here in the credentialing process for him," said Shock Trauma spokesman Joel Lee.
Internal reviews have revealed no similar cases, so hospital officials see Dr. Boyd's as a fluke. "This looks like it's a pure anomaly," Mr. Lee said.
He has said Dr. Boyd "capitalized" on the turmoil and change that swept Shock Trauma in 1993. Its director, Dr. Kimball I. Maull, had been fired and its administration taken over by the University of Maryland Medical System Inc.
The credentialing process when Dr. Boyd was hired later was taken over and strengthened by the university, officials said. Unfortunately, "all the changes made in the process were essentially made for those people coming into the system, or who were required to be renewed. He [Boyd] didn't meet either of those criteria," Mr. Lee said.
Employees who maintained his file repeatedly asked him to produce his license and in March 1994 noted in his records that he had hired an attorney to help him obtain it.
The problem did not reach top administrators until 18 months later -- four days before Dr. Boyd was fired from his $50,000-a-year job, Mr. Lee said.
"We had the nag part of this right," Mr. Lee said. "We just didn't have the follow-though."
Had they checked, officials might have learned a great deal.
In the final months of Dr. Boyd's surgical residency at St. Luke's Hospital, in the spring of 1984, the aspiring surgeon's supervisors were troubled. On the one hand, they appreciated what one called his "pleasing personality" and were impressed by his scores on written tests. He did so well, in fact, that a senior physician commented on his "photographic memory."
But they also said he seemed overconfident, lacked critical judgment, could be "overbearing" to subordinates and needed, in their view, another year of tutoring and surgical training.
He was, a hospital official said, "not considered to have satisfactorily completed a graduate training in surgery."
At the same time, Dr. Boyd was under pressure from another quarter. He had taken a standard multiday medical licensing exam, called the FLEX examination, numerous times since 1978. Each time, he flunked. In August 1984, he arranged to meet a Michigan state employee, a FLEX test proctor, and offered him a $20,000 bribe for an advance copy of the exam.
State police videotaped the meeting. Dr. Boyd was convicted of bribery in October 1985. He appealed, alleging entrapment. The Michigan Court of Appeals ruled against him.
He evidently was undaunted by his arrest. In fall 1984 and spring 1985, he hobnobbed with liver transplant specialists at the University of Pittsburgh.
"Arthur Boyd never really served an official fellowship here," said Lisa Rossi, a university spokeswoman. "He was kind of hanging out, as often-times surgeons do from other centers. He was never here in an official capacity."
Mr. Lee said he has seen "no evidence" that Shock Trauma sought verification or evaluations of Dr. Boyd's work at St. Luke's or the University of Pittsburgh. Such checks now are done routinely, he said.
Tried to make name for self
At Shock Trauma, Dr. Boyd finally had his chance to work as a surgeon in the United States. He quickly tried to make a name for himself in Baltimore's medical community.
Randy J. Smith, an instructor in Emergency Health Services at the University of Maryland at Baltimore County, met Dr. Boyd two years ago, and the two became friends. Dr. Boyd gave lectures to paramedics and emergency medical technicians in Mr. Smith's courses. Dr. Boyd was paid as much as $100 per talk.
Until recently, Mr. Smith and Dr. Boyd were collaborating as co-editors on a textbook called "Advanced Trauma Skills." Dr. Boyd helped recruit many of the 40-odd contributors. But after his dismissal, the physician withdrew from the project.
He also took Advanced Trauma Life Support training courses, aimed at physicians. Later, he qualified as an instructor in the program, earning between $50 and $100 per lecture.
Dr. Aurelio Rodriguez, chairman of the state Committee on Trauma for American College of Surgeons, said that Dr. Boyd was always eager to volunteer his services. "Many times, we have trouble getting instructors," he said.
No one with the program asked to see Dr. Boyd's medical license.
"He came to our course through the University of Maryland," he said. "Being a fellow there, the assumption is that he was licensed."
Arthur Bernette Boyd Jr.
* June 29, 1947: Born in Durham, N.C.
* 1969: Earns bachelor's degree from Florida A & M University.
* 1970: Spends a year as a postgraduate at New York University.
* May 1978: Receives medical degree from Meharry Medical College, Nashville, Tenn.
* June 1978: Dr. Boyd takes his first Federation of State Medical Boards' licensing exam (FLEX), and fails. In all, he will fail it 15 times.
* 1978-1980: Intern in surgery at Howard University Hospital, Washington.
* 1981-1984: Resident in surgery, St. Luke's Hospital, Cleveland. Hospital officials say he does not complete the residency satisfactorily.
* June 1984: Fails another FLEX exam.
* August 1984: Offers money to a Michigan state licensing official for an advance copy of the next FLEX exam. Is arrested on bribery charges.
* 1984-1985: His Who's Who listing claims he is a fellow in liver transplant surgery at the University of Pittsburgh. University officials say he was "just hanging out."
* Oct. 23, 1985: Pleads no contest in Michigan bribery case.
* 1985-1987: Dr. Boyd works for the Cleveland Medical Group, according to a resume submitted to Shock Trauma. There is no current phone listing in Cleveland for the group.
* 1986: Tries to get a medical license in Alaska.
* 1988 to present: Who's Who calls him "chief surgeon" of Motown Beverage Co. of Ohio. Directory also calls him a consulting surgeon to other hospitals and physicians."
* Late 1980s: Dr. Boyd practices medicine in the Caribbean, according to a Cleveland lawyer.
* July 1, 1993: Dr. Boyd becomes a fellow in trauma surgery at Maryland Shock Trauma Center.
* July 1, 1994: Dr. Boyd begins working at Prince George's Hospital Center under an arrangement with Shock Trauma. He helps treat about 300 patients there.
* Oct. 3, 1995: Dr. Boyd is fired by Shock Trauma.