A Case Study of One Major University

The University of Utah and Third World Medical Students

The state of Utah has been likened to the "South 30 years ago. Every Black medical student I've spoken with who has had any contact with the state has gone elsewhere spreading the word about how racist the state is. Moromons and non-Mormons alike, joke about Utah being a theocracy and about Blacks not being "worthy" for the priesthood. Whites in other states dislike the parochial environment of Utah, they go as far as placing advertisement against the state. 45

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Into such an environment the University of Utah and its' College of Medicine recruit Third World medical students. One would venture to guess that the university administration being fully cognizant of the social, political and religious environment would be prepared to truly become the "alma mater", dear mother, of their non-white students; Protecting them whenever necessary, with whatever poser necessary, form the slings and arrows of probably hostile non-university community. Upon investigation, one finds a definitive policy statement, laudatory in definitive policy statement, laudatory in its' scope, insight and courage against negative outside pressures, (disseminated just 4 years after the acceptance of its first Black Student who actually attended.) 46

The policy statement spoke of many topics, among which were:

-a definite "minority program of the University of Utah College of Medicine" whose objective is to graduate Black, Chicano, Native American and poor whites in increased numbers;

-especially the above from Utah and WICHE states;

-the College acknowledges a special responsibility to

-provide programs that support their education

-make financial aid available to the full extent of the minority students' assessed financial needs;

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-the statement that in the past and in the foreseeable future, "complete financing has been possible using a combination of resources";

-individually tailored "special programs of academic support" arranged by, or through, the assistant dean for student affairs.

Noble words, indeed, but have these words translated themselves into actions and how effective have the actions been in definitively addressing the needs of Third World students enrolled at the UUMC.

In short, the words have remained words, This is not to vitiate the isolated attempts of some, or the feeble, misplaced attention of a great many others, but a direct denial of any elaborated program of the University to admit, retain, and graduate "increased numbers or not they reside in Utah or the WICHE states or elsewhere. This is a calling of the University to tasks, for the ruthless malicious manipulation of non-white students for its' own ends, or for blundering malfeasance in the administration of its' minority program in the face of long, continual and pertinent criticism of the "program" by its' Third World students.

In the area of financial aids, the University has never through its own efforts solely, provided "complete financing". It is an open secret that while some Third World students were forced to supplement their incomes in illegal ways in order to survive (basic bread and butter to mouth survival ) because of insufficient University aid, certain white students, some with parents on the College of Medicine faculty, were enjoying general grants and fellowship funds from the college while at the same time receiving substantial sums from parental
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sources. As late as November 2, 1973, the University placated its' financially hobbled Third World students with promises to bring them to 100% of their financial need; yet, in the "Third World Student Newsletter" of April 1974, we still find "Financial Aid is still an unsettled issue, but further developments will be reported...".

With reference to "the special responsibility" the University alleges it acknowledges, if such is true no formal avenue for the expression of that responsibility has been established. Yes, there is a self-appointed assistant to the dean for minority affairs whom the University legitimized by default, abut the incompetent handling of the job and the lack of initiative to come from that office has never been questioned or criticized by the University. Whatever, change in personnel, presently contemplated, is solely the result of long pressure from the Third World Medical Organization, in conjunction with in University's placation of the Chicano community through pressure from SOLIIC. Since there is no "one" to take responsibility in a formal sense, many times and many times inappropriately, individuals, such as Jane Hunt or Dr. Chaing have faced the brunt of criticism for University induced and maintained problems. Most often, though, the burden of proof and the recognition of problems is reflected back squarely on the shoulders of the problem the problem plagued Third World Medical student.

The result of (I will be generously euphemistic) the misplaced solutions, to ill-percieved problems, arising out of the University inability to give due respect to the problems and possible solutions brought to it by its' student caste, (let alone, Its THIRD World Student caste), has been sheer disaster. In many respects the University is no closer, now,

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than four years ago, in graduating even one Third World Student.

The University, which admitted its' first Black student, only when faced with mounting threat of Federal allocation shutoff unless integrated, has been successful in "recycling" - asking "failing" Third World students to repeat years. This lends itself to self aggrandizement - since the University is being lenient and helping those it would have "in other circumstances (races)" expelled - even though many problems could have been avoided or corrected before critical moments, if the University had the motivation to fulfill its public relations statements and the ability to listen to its Third World Students. It also lends itself to excellent adverising copy, since the University can boast ever increasing numbers of "minority" students enrolled even though many of the names are used year after year. I cite, specifically, the not isolated example of the Robert A. Wolbach, M.D., Assistant to the Dean on Minority Student Affairs memo of March 20, 1974 to the Black Pre-Medical Society of the University of Maryland at College Park. 48

The University has failed to recognize its' responsibility to support the emotional- psychological well-being of its Third World students. Yet, the University has felt justified to freely bandy about the "psychological" diagnosis, with reference to its pathologic obssessive- compulsive, manic-depressive, drug abuser, without offering to or making adequate 3 provisions for, the treatment of those individuals so labeled.

The University has failed to formalize an impartial channel of input for new procedures or review of old policies, with regard to its Third World students.

Not only the "rabidly hostile, rebellious" Third World students hold a poor opinion of the University, such generally acknowledged "moderates" as Terri Hope, M.D. or J. R. Smith, M.D. are hard pressed to hide the bitter disappointment they found in Utah. Even "uncle Tom" negroes like Charles Nabors, PhD. are scurrilous about the conditions within the University, if he thinks he is beyond the earshot of "white folks".

The department of Infectious Disease, will never recruit the illustrious and certainly moderate, Wilbur C. Jordan, M.D., who, though he admits he is attracted by the program here, is adamant in his refusal to live in Utah because he is not use to police harassment of Black men. A harassment which is quite commonplace. 49

Such a broad spectrum of Black people reaching such a substantive consensus, especially in light of the ease with which Black people can find a topic over which to argue, is the strongest evidence of the validity of the charges.

Certainly, it should be evidence enough to the University that among the Third World Community there is strong widespread disbelief concerning the University's alleged policy toward "the Minorities" and that the University must address itself to the problem of Third World Students, in radically different ways than in the past, if it is truly sincere in the platitudes it disseminates.

The University of Utah and Tony Robinson

"Utah? Isn't that a state somewhere out west?", would have been my reply to question about this state before 1970. In those days I had not much reason to know anything about Utah. So when in late November of 1969, a letter stating in effect that if I were to apply to the University of Utah College of Medicine, I would be accepted, I was flabbergasted. Throughout my life I wanted to have a "service" career and about the beginning of junior high school had focused that career on medicine. With the closing days of college, I had a reckless hope of being accepted into medical school; I was Black and the fad of enrolling Blacks was just beginning, I had good grades, in everything but chemistry and math. On the other hand, I did not hide the fact I was deeply involved in radical politics50 to the extent I was a member of the Young Lords Party and the Health Revolutionary Unity Movement.

Therefore, when weighed in the balance of hope against reality, I considered a letter recruiting me to far off Utah a clerical error. I called the Dean of Students, Gary Maxwell, M.D. to verify its' validity. He assured me of the University's sincerity in recruiting me; told me that I had received some of the highest MCAT scores in the country and suggested I speak to a student named Barr Taylor, who would interview me in New York while he attended the National Black Science Student Organization Conference.

A few days after a pleasant interview with hard selling "obviously" liberal Barr Taylor, I received a plane ticket to Salt Lake City.

When I arrived in Salt Lake, I made the mental resolve to present myself in the most "militant" way to bring out any falsity in the University's offer to recruit me.

However, the most militant racial statements were applauded and encouraged. The University
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seemed to spare no expense in courting my enrollment
I even had dinner and wine at the Balsam Embers. I can still remember the ardent statements of encouragement, and the we-need-Negroes-like- yourself- to-change-the-racism-in-the Utah speeches of Kurt Fiedler, Sherman Dickman, Chuck Nabors, Gary Maxwell, in addition to Barr and Susan Taylor.

Returning to New York, I could barely wait out the formality of waiting for the letter of acceptance to come, that I might return my $100 tuition deposit. Why I reasoned should I risk losing this opportunity by waiting for acceptance in other schools where I'd be just another token in the crowd, when at Utah I would be an individual accepted not only for the racial characteristics the school desperately needed but also as a person with certain insights which would be valuable in rendering feedback to white liberals ardently, sincerely seeking to change their racial attitudes. At Utah, I was offered financial aid guaranteed to be 100% of what I would need. I was offered constant academic monitoring and the promise of effective tutorial aid at the first sign of academic difficulty. It was a place to graduate into the socially-politically conscious physician I dreamed of becoming.

"Gee, Jane, could I see Dr. Maxwell? I've been looking for an apartment for 6 weeks now, I didn't know housing discrimination was so bad, but we are already two weeks into the beginning of the quarter, I'm missing classes to look for an apartment and Barr's landlady says she'll put him out if he keeps letting a nigger stay at his place."

"Oh! Dr. Ruoff's the new Dean of Students."

"No, Dr. Ruoff. I don't think getting a room at

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the Y.M.C.A. and not making "waves" as you put it will solve the problem."

Thus occurred the initial courtship and disillusion of one Tony Robinson at the hands of the U.U.M.C. and the first of many "hostile" incidents which I, and the other Third World Students to come after me would be accused of.

The myriad interactions between myself and the society of Utah resulted in true cultural shock on both our parts and culminates today, four years later, in my petition for graduation and plea for justice.

The reasons for my petition are fairly straight forward:

The requirements for the Class of '75 to graduate are clearly delineated in a memo from Jane J. Hunt, Assistant to the Dean, Student Affairs Administration, dated December 10, 1973. In part the memo states "the above requirements are to become effective for the graduating class of 1975." There is no statement of requirements for graduation for classes before and including the class of '74. The sole and nearest explanation of requirements for graduation for the Class of 74 is found in the Student Information Handbook, dated January, 1974 which says on page 8, "All seniors are required to take a total of 42 weeks of electives which are offered by all departments and run generally in two to four week blocks." In addition, on page 10, paragraph 7:

Each medical student is required to take Part I of National Boards as a candidate upon or after completion of preclinical work. All medical students are required to take Part II
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of National Boards as candidates prior to graduation, but not before completion of the third year clinical clerkships. Passing Parts I and II of National Boards is not required for promotion or graduation. This precludes the use of any portion of National Boards Parts I or II to determine whether a student should or should not be promoted or graduated.

To return to the more clearly defined requirements for graduation for the Class of 1975, we find as pertinent to the present argument:

1. Seniors must satisfactorily complete 42 weeks of elective time prior to graduation.

2. A minimum of 24 weeks must be spent at the University of Utah College of Medicine or its affiliated hospitals except when specific approval to do otherwise comes from the Dean of Student Affairs.

3. A minimum of 12 weeks must be spent in clinical electives except upon specific approval by the Assistant Dean for Student Affairs to do otherwise. The Assistant Dean will have authority to define clinical electives.

I petition that I should be allowed to graduate from the University of Utah, with the degree of Doctor of Medicine, on June 8, 1974, with the Class of '74, the class I initially enrolled with, because I believe that:

1) I will have completed by that date the spirit, if not the letter, of the academic requirements for that degree.

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As of June 8, I will have spent 32 weeks at the University of Utah College of Medicine or its affiliated hospitals in the following Senior electives:

Pediatric Externship 8 weeks
Perinatal Externship 4
Pediatric Radiology 3
Obstetrical Preceptorship 8
Infectious Disease Fellow 4
Anesthesiology Clerkship 3
Clinical Child Psychiatry 1

Thus, by the criteria for the Class of '75, requirement #2 is fulfilled.

At that time in clinical electives, if clinical electives means "primary" patient care responsibility on the wards, writing orders, dictating discharge summaries, op reports, etc. I will have completed 18 weeks in the following:

Pediatric Externship 9 weeks
Obstetrical Preceptorship 8
Clinical Child Psychiatry 1

Thus fulfilling class of '75 requirement #3.

I have taken parts I and II of the National Boards.

The issue of discussion, then, is the absolute value of 10 weeks of elective time. Since academic credit is often received based upon research papers or written reports. It is may contention that I should be granted 10 weeks academic credit as recognition for the services I have rendered to the University, that the University might more efficiently fulfill its' own policy desires as
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delineated, for example, in the "Letter to Concerned Medical Students", by Dr. J.A. Dixon dated January 9, 1974.

During my four year attendance, I have continually taught, by action, by lecturing, by publication, about the peculiar educational barriers to Third World, especially Black Students, to obtain their level of goal success in a white middle class oriented medical institution. I have tried to refrain from pointless argumentation, but have tried to make necessary criticisms stressing the dynamics of the counter-productive psychology whites create when faced by non-whites. I, thus have brought creative constructive change to the medical institution of the University of Utah, which has resulted in benefit for all Third World students and the University, at large. Yet, I have not previously been compensated.

- It was I, who originated the idea, created the name Medical Organization,51 when the entire minority enrollment at the U.U.M.C. was George Woods, Fred Barbero and myself. This single action has evolved into the vehicle through which most other advances and communication between the university and the Third World students. This single action provided the nidus to create a minimal atmosphere which has kept every Third World Student whoever enrolled retained; has prevented suicide among Third World Students, when there has been suicide among white students faced with a lot less provocation; has provided sufficient financial aid to students lest they be forced to pimp, among other illegal things, to supplement the less than subsistence
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financial aid provided by the University. By the University's own statements the Third World Medical Organization "has been effective in expanding academic support programs, initiating elective courses of special interest to minority students, as well as improvements in financial aid arrangements."52 This single action alone is worth 10 weeks academic credit.

-It was I, who originated the idea that the Third World Medical Organization fight for membership on the admissions committee and the financial aids committee at both the levels of student and faculty input. Today, the University boasts "The College of Medicine now has three Black faculty members, one of whom sits on the Admissions Committee and its Minority subcommittee".53

-It was I who nurtured the embryonic concept of "critical mass of Third World students" out of the torture of my isolated Freshman year. A concept, for which I pushed and prodded the Third World Medical Organization to fight for at Admissions Committee meetings. This has resulted in a present Freshman class having Third World students who have a lot more unity and a lot less problems.

-It has been I who has kept the University informed of every national Black convention which has occurred since my initial enrollment. Where I did not personally attend the convention and deliver extensive reports,54 the University had no representation and thus lost valuable information. Of conventions or seminars, I
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did not know of, the University did not make use of its information gathering ability and thus prolonged correctable problems affecting its' Third World Students.

I have spiritually paid more than the price customarily paid for by whites to obtain the M.D. degree.

My own peers, Black medical students, from around the country, presented me an award in recognition of their own incredulousness that any group of Black students, let alone, one or two Blacks, could survive in a medical school in the most racist state in the country." I accepted the award as a tribute to the tenacity of purpose demonstrated most by Roger Greyeyes, George Woods and myself in facing without surrender the worst obstacles the society could impose.

All too often, for we three especially, the burden of proof, the recognition of problems, the delineation and implementation of novel solutions to precedent setting problems facing the medical school has rested solely on us as individuals.

Two examples immediately call themselves to mind. In the pathology course I took, I was almost daily from the first day of the course pleading with the department chairman for tutorial help. The chairman side-stepped and shuffled for almost two full quarters until about three weeks prior to the final examination when he "discovered" Josiah Taylor, M.D. to whom I'm eternally indebted for pulling through that course. Of course to add insult to injury the chairman
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performed the dual behaviors of

1) informing the rest of the class that "pass along to Tony, that he's going to fail the final" - an opinion they gleefully informed me of as I was preparing to take my microbiology final. (There's nothing more calming); and

2)sending me a deprecatory letter, couched in words which seemed disappointed that I had passed the final examination.55

The other incident, involves the specific train of abuses, misinformation and misguided solutions that finds me presently 10 weeks short of "attendance" toward graduation;
out well.

The situation in Pharmacology was no better and the pleas for tutorial help was continually acknowledged concurrent with numerous promises of immediate action. Needless to say, the immediate action took the greatest part of tow quarters to initiate. Despite the obvious appearance of the circumstances as too little, too late, I had unfounded faith that somehow all would work out well.

Exemplary, of the common symptom of poor self-image was my behavior in choosing the start of my junior year. Though eminence of choice was decided by lottery number and although I held a high value lottery (#6, I believe) I deliberately choose the latest possible starting date because I anticipated

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using my "vacation" time making up whatever delinquencies I might incur the sophomore year,with the specific thought of retaking the National Board, part I.

My negative anticipation was not frustrated. Identification with the Aggressor).

Dr. Cecil had been my preceptor through two quarters of physical diagnosis. On the day following the last class he called me at home to inform me he was going to give me a poor grade. A week later, I was informed he'd actually given me a failure! Inquiring further into the criteria which led to my evaluation, Dr. Cecil admitted he had never formally told me that my behavior and attitude did not meet his standards as acceptable or passing. He stated that it should have been obvious to me through inference by his behavior and attitude that I had been doing poorly.

The rest of that summer was spent under the tutelage of Dr. Kuida learning physical diagnosis - or rather, as I was told point blank, to rehabilitate my unprofessional attitude. Anyway, about 9 weeks into my 24 week "vacation", Dr. Kuida casually asked me if I was planning to re-take the National Boards to pass my pharmacology course. Panic! Two questions "Didn't I pass pharmacology and didn't I pass N.B. Part I" Answer, well there must have been an misunderstanding somewhere I still had approximately 15 weeks to make-up the pharmacology grade. I went immediately to the chairman asked for a mechanism to be tutored and retested; I even suggested a detailed tutorial-test procedure. He said he

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would take it under advisement but to keep in touch. Once more the shuffling about the low priority problem concerning my grade make-up dragged out. Weeks became months and soon all 24 weeks of my "vacation" had been spent in physical diagnosis classes or preparing to retake N.B. Part I; still no definite mechanism had been proposed to me how I might complete my pharmacology requirement. Finally, 8 months after the pharmacology department decided I had failed their requirements and 16 months after I initially asked for tutorial aid, Dr. Woodbury presented a marvelous tutorial-test procedure he had thought of - that's right - the very same plan I had presented him with 14 months earlier. Anyway, I was required to interrupt my junior clerkship and devote my full time in pursuing Woodbury - Robinson's plan for completing pharmacology. It took me 10 weeks to complete at a solidly acceptable level, 25-30 weeks of pharmacology. The very same 10 weeks that could have been spent during the balance 15 weeks of my vacation; the very same 10 weeks of attendance the University say I owe it now.

I will refrain from the litany of any more "atrocities" I feel I have suffered at the hands of the University and its supporting community. Let it suffice to say that almost every obstacle that a Black student has encountered nationally - from being called a "nigger" by the Dean of the College (Ebaugh) to isolation by "fellow" classmates to police harassment - I have suffered at Utah; every emotional problem a Black student has had nationally - from constantly falling asleep during lectures as somatizaion of depression
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to cross familial sexual involvement with displaced aggression (that means having one's girlfriend stolen by a fellow student and then threatening to kill that student for more details ask George Woods) - I have suffered while in Utah.

I have invested in the strictly pecuniary sense as much, and probably much more, than that which is required for the white student.

I presently have a long term debt in excess of $12,000 and a short term debt (repayable within 1 year) of $1650. My bank account is overdrawn $110 but I managed to borrow enough money against my Walker Bankcard to pay debts on my Mastercharge card.

It matters little to the University, that even fulfilling 100% of the need of an individual minority student, as "need" is legislated to barely adequate to keep a thin sparrow alive. What does matter is that every penny the University considers its due is to be paid. The only spontaneous review of University policy I ever knew about was a letter I received on September 10, 1973 from Cordell Allen, Income Supervisor for the University. The letter politely explained that an oversight had been made twice previously; it seemed I owed the university $200 in back medical tuition. Would I be so kind as to pay the University $200, lump sum, immediately. Thank-you. This letter was received the very week I was pleading with the University to extend the repayment date on a $500 emergency loan I had drawn to supplement the shortcomings in aid received the year I "squandered" the extra $200 I
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didn't pay in tuition.56

The ramifications of the minor problem of housing discrimination meant I had to pay $100 a month for rent (The University grants $50/month "need" for rent) in a shack in Central City. I was surrounded by two families of professional thieves in a high crime neighborhood. Subsequently, I have had over $800 value in necessities stolen from my house (such things as "the Suit" I owned, blood pressure cuff, opthalmoscope, tape recorder, records, books). Things stolen were such that they had to be replace3d at inflated prices. The purchase and maintanence of the rolling junk heaps I have been forced to use for transportation have been a major expense. I have actually spent $2000 over 4 years on various autos, not one of which runs today. This amount of money could easily have purchased a brand new car 4 years ago. However, because of a unified long-range program of financial aids, such a long term investment was never possible. Many students find themselves in similar transportation shape, some mechanism must be provided by the university to help those students without the benefit of "handdown" cars from parents, etc. to obtain financing for transportation.

When I muse on the total loan debt I carry when viewed against the backdrop of financial aid I was promised or should have received, I feel that I should be granted by the appropriate University departments and officers, renumberation to the $2000 level. Perhaps this could be by cash grant or perhaps by loan forgiveness either directly or through a program of loan forgiveness in

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exchange for services in a physician needed community, or some combination thereof. This request is especially crucial in view of the fact that as a further spin-off of my misadventures at the University, I must defer the initiation of my internship and whatever loan repayment ability I might have. Thus increasing total debt due to interest accrual.

Of course on the other hand, if the Promotions committee denies my request for graduation now, the University will want more tuition, my landlord will want more rent, etc., etc; Since there has been no formal review of financial aid correction in the past nor any indicated in future. The problem of how I will finance the completion of my medical school career is a clear example of a problem on which the responsibility of the burden of proof, the recognition of problems and the delineation and implementation of a solution rests solely with me.

I am willing to entertain the concept that there might exist valid reasons for denial of my petition for graduation. These would be:

1) Sufficient evidence by the University that I have not completed a training program and rendered service to the University at a level nominally expected of all (read white) students; or that

2) the University, whether or not acknowledging the validity of the
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foregoing, can offer concrete evidence that 10 weeks more attendance will result in producing me into a better physician than if graduated now.

As I mentioned previously, some believe that the single most reliable prognosticator of a student's potential for success is the MCAT-science score. Coincidentally the University's National Board's Policy states:57

It is rational to expect any comparison of the National Board Examinations scores, either Part I or Part II, to reflect the general proficiency of any given class in individual departments, both compared to other departments in this institution and similar departments throughout the nation. The use of National Board Examinations, Parts I and II, may help the medical school and curriculum committee to evaluate each department within the school, and to be of aid in determining if any deficiencies exist within these departments.

The year I took the MCAT, the average science score for Black students was 425, the average score
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for white students was 540.58 My score was 585.59 I think that is highly indicative, if not proof, that with all circumstances equal I should easily be in the 10% of any medical school class academically, especially if I put a great deal of effort into studying. On the other hand, the majority of Black students consider it extremely difficult for any Black student to do well given the degree of cross- cultural obstacles present in even the most liberal, long-experianced with minorities, in the middle of a ghetto medical school.

Since the University of Utah College of Medicine has none of the advantageous features the majority of Black students demand they need to perform even minimally well and all of the features Black students claim to be disadvantageous, I feel that a comparison of my excellent MCAT science score with my dismal National Board Part I and II scores is proof that this University has failed to give me in the past, and will fail to give me in the future, the quality of instruction to produce the quality physician we are mutually seeking to create despite enormous effort on my part. I feel that the controversial 10 weeks, could better be spent by me in a professional learning - through-doing setting, for example, at the Montefiore-Martin Luther King Health center in the Bronx, than the wards of the University of Utah as a student in Salt Lake City.

I feel I should be graduated now.

Thank-you for your considerable and extend consideration of this document and petition,

William A. "Tony" Robinson, M.S. IV