Calvin Au, DO
Emergency Medicine · San Jose
- Medicare standing
- Clear
- Enrolled, allowed to bill and order, not excluded
- Plans that list them
- Not verified
- Not the same as out of network.
- Office
- 1
Offices
1 location · Emergency Physicians Associates San Jose PC · 131 clinicians in this group
Looking this up.
Hospitals listed: Santa Clara Valley Medical Center. That is not proof they admit you there this week.
Plan participation
Not verified
We could not verify current plan participation for this doctor. This does not mean they are out of network. Call Dr. Au’s office at (408) 947-2500 to ask if they take your plan before you enroll.
Hospitals they work in
1 hospital
These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.
- Santa Clara Valley Medical CenterSan Jose, CAAcute Care Hospital · Government - Local · Has an emergency department · Birthing-friendlyPart of Santa Clara Valley Health and Hospital System, which runs 3 hospitalsPatients rate it 3 of 5 · 70% would definitely recommend itOverall rating: 2 of 5 starsWorse than the national rate — SSI - Colon Surgery: 2.572, Oct 2024 – Sep 2025Better than the national rate — Central Line Associated Bloodstream Infection (ICU + select Wards): 0.563, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.256, Oct 2024 – Sep 2025Better than the national rate — MRSA Bacteremia: 0.369, Oct 2024 – Sep 2025
See every measure and the patient survey for Santa Clara Valley Medical Center
Behind the star rating — Deaths: 2 better, 6 the same, 0 worse of 8 measures. Safety: 2 better, 5 the same, 1 worse of 8 measures. Readmissions: 0 better, 10 the same, 1 worse of 11 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.
| SSI - Colon SurgeryInfections | 2.572 | Worse | Oct 2024 – Sep 2025 |
| Central Line Associated Bloodstream Infection (ICU + select Wards)Infections | 0.563 | Better | Oct 2024 – Sep 2025 |
| Clostridium Difficile (C.Diff)Infections | 0.256 | Better | Oct 2024 – Sep 2025 |
| MRSA BacteremiaInfections | 0.369 | Better | Oct 2024 – Sep 2025 |
| Abdominopelvic accidental puncture or laceration rateComplications and deaths | 1.25 (0.3 to 2.2) · 1,535 cases | No different | Jul 2022 – Jun 2024 |
| CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths | 1.07 (0.76 to 1.38) | No different | Jul 2022 – Jun 2024 |
| Death rate among surgical inpatients with serious treatable complicationsComplications and deaths | 214.59 (167.38 to 261.8) · 108 cases | No different | Jul 2022 – Jun 2024 |
| Death rate for CABG surgery patientsComplications and deaths | 2.8 · 41 cases | None | Jul 2022 – Jun 2025 |
| Death rate for COPD patientsComplications and deaths | 6 · 141 cases | None | Jul 2022 – Jun 2025 |
| Death rate for heart attack patientsComplications and deaths | 10.2 · 124 cases | None | Jul 2022 – Jun 2025 |
| Death rate for heart failure patientsComplications and deaths | 8.3 · 501 cases | None | Jul 2022 – Jun 2025 |
| Death rate for pneumonia patientsComplications and deaths | 14.9 · 653 cases | None | Jul 2022 – Jun 2025 |
| Death rate for stroke patientsComplications and deaths | 10.1 · 348 cases | None | Jul 2023 – Jun 2025 |
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths | 3 · 4,502 cases | None | Jul 2024 – Jun 2025 |
| Iatrogenic pneumothorax rateComplications and deaths | 0.24 (0.04 to 0.43) · 9,014 cases | No different | Jul 2022 – Jun 2024 |
| In-hospital fall-associated fracture rateComplications and deaths | 0.34 (0.15 to 0.52) · 9,216 cases | No different | Jul 2022 – Jun 2024 |
| Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths | 4.54 (2.51 to 6.58) · 1,421 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative acute kidney injury requiring dialysis rateComplications and deaths | 1.54 (0 to 3.2) · 288 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative hemorrhage or hematoma rateComplications and deaths | 2.11 (0.66 to 3.56) · 1,446 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative respiratory failure rateComplications and deaths | 11.61 (4.09 to 19.14) · 294 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative sepsis rateComplications and deaths | 7.29 (3.39 to 11.2) · 299 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative wound dehiscence rateComplications and deaths | 1.9 (0.45 to 3.36) · 333 cases | No different | Jul 2022 – Jun 2024 |
| Pressure ulcer rateComplications and deaths | 0.23 (0 to 0.78) · 7,538 cases | No different | Jul 2022 – Jun 2024 |
| Rate of complications for hip/knee replacement patientsComplications and deaths | 5.4 · 94 cases | None | Apr 2023 – Mar 2025 |
| Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections | 0.735 | No different | Oct 2024 – Sep 2025 |
| SSI - Abdominal HysterectomyInfections | 2.573 | No different | Oct 2024 – Sep 2025 |
| Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits | 14.6 · 185 cases | None | Jul 2023 – Jun 2025 |
| Heart failure (HF) 30-Day Readmission RateUnplanned return visits | 22.1 · 951 cases | None | Jul 2023 – Jun 2025 |
| Hospital return days for heart attack patientsUnplanned return visits | 56.3 · 128 cases | None | Jul 2022 – Jun 2025 |
| Hospital return days for heart failure patientsUnplanned return visits | 6.4 · 644 cases | None | Jul 2022 – Jun 2025 |
| Hospital return days for pneumonia patientsUnplanned return visits | 1.3 · 699 cases | None | Jul 2022 – Jun 2025 |
| Pneumonia (PN) 30-Day Readmission RateUnplanned return visits | 16.3 · 921 cases | None | Jul 2023 – Jun 2025 |
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapyUnplanned return visits | 5.7 (3.9 to 8.1) · 226 cases | No different | Jan 2024 – Dec 2024 |
| Rate of inpatient admissions for patients receiving outpatient chemotherapyUnplanned return visits | 12.6 (9.4 to 16.5) · 226 cases | No different | Jan 2024 – Dec 2024 |
| Rate of readmission after hip/knee replacementUnplanned return visits | 5.4 · 94 cases | None | Jul 2023 – Jun 2025 |
| Rate of readmission for CABGUnplanned return visits | 11.4 · 54 cases | None | Jul 2023 – Jun 2025 |
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits | 20.3 · 242 cases | None | Jul 2023 – Jun 2025 |
| Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits | 13.2 (9.9 to 17.4) · 702 cases | No different | Jan 2022 – Dec 2024 |
| Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits | 1 (0.7 to 1.4) · 195 cases | No different | Jan 2024 – Dec 2024 |
What patients said (4,032 patients answered, 29% of those asked)
| Cleanliness | 3 |
| Nurse communication | 3 |
| Doctor communication | 3 |
| Communication about medicines | 3 |
| Discharge information | 2 |
| Overall hospital rating | 3 |
| Quietness | 2 |
| Recommend hospital | 4 |
| Room was "always" clean | 70% |
| Nurses "always" communicated well | 73% |
| Doctors "always" communicated well | 76% |
| Staff "always" explained | 57% |
| Yes, staff "did" give patients this information | 82% |
| Yes, staff "did" give patients information about help after discharge | 82% |
| Doctors "always" explained things so they could understand | 71% |
| Doctors "always" listened carefully | 74% |
| Doctors "always" treated them with courtesy and respect | 82% |
| Patients who gave a rating of "9" or "10" (high) | 67% |
| Staff "always" explained new medications | 71% |
| Nurses "always" explained things so they could understand | 71% |
| Nurses "always" listened carefully | 69% |
| Nurses "always" treated them with courtesy and respect | 80% |
| "Always" quiet at night | 43% |
| "YES", patients would definitely recommend the hospital | 70% |
| Staff "always" explained possible side effects | 44% |
| Yes, staff "did" give patients information about possible symptoms | 83% |
Original Medicare doctor bills
$81,223
Medicare paid this office $81,223 for 525 people.
This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.
| Emergency department visit with high level of medical decision making | 307 | $45,149 | $141 |
| Critical care, first 30-74 minutes | 107 | $19,400 | $181 |
| Emergency department visit with moderate level of medical decision making | 107 | $10,828 | $97 |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 168 | $1,248 | $7 |
| X-ray of chest, 1 view | 12 | $92 | $8 |
Who their Medicare patients are
525 Original Medicare patients in 2024. Average age 75 · Under 65 13% · 85 and older 21% · Women 55% · Also on Medicaid 57% · Health risk score 2.40. Above the middle of the specialty; the typical emergency medicine clinician is at 2.01.
Conditions among them: High blood pressure 75% · Diabetes 52% · Coronary heart disease 40% · Chronic kidney disease 37% · Heart failure 32% · Atrial fibrillation 29% · Depression 27% · COPD 23% · Dementia 20% · Stroke 14% · Cancer 13%.
The office billed $708,259, Medicare allowed $107,464 and paid $81,223; for 790 services of 31 kinds.
Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.
Year by year
| 2024 | 525 | 790 | 75 | 2.40 | $708,259 | $81,223 |
| 2023 | 592 | 729 | 76 | 2.15 | $948,463 | $99,285 |
| 2022 | 579 | 691 | 76 | 2.20 | $973,473 | $102,093 |
| 2021 | 514 | 614 | 74 | 2.76 | $794,265 | $92,121 |
| 2020 | 247 | 342 | 73 | 2.48 | $324,886 | $39,974 |
| 2019 | 38 | 80 | 68 | 1.60 | $40,015 | $5,821 |
Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.
See the services billed each year
2023: 7 services
| Emergency department visit with high level of medical decision making | 322 | $49,761 | $149 |
| Critical care, first 30-74 minutes | 170 | $32,432 | $187 |
| Emergency department visit with moderate level of medical decision making | 89 | $8,862 | $98 |
| Emergent insertion of breathing tube into windpipe using an endoscope | 16 | $1,922 | $120 |
| Emergency department visit with low level of medical decision making | 20 | $1,237 | $62 |
| Insertion of non-tunneled central venous tube for infusion (5 years or older) | 12 | $872 | $73 |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 26 | $209 | $7 |
2022: 7 services
| Emergency department visit with high level of medical decision making | 365 | $58,319 | $153 |
| Critical care, first 30-74 minutes | 142 | $28,852 | $199 |
| Emergency department visit with moderate level of medical decision making | 63 | $6,447 | $102 |
| Emergent insertion of breathing tube into windpipe using an endoscope | 13 | $1,599 | $123 |
| Critical care, each additional 30 minutes | 11 | $1,170 | $98 |
| Emergency department visit with low level of medical decision making | 19 | $1,126 | $59 |
| Insertion of non-tunneled central venous tube for infusion (5 years or older) | 14 | $1,041 | $74 |
2021: 5 services
| Emergency department visit with high level of medical decision making | 352 | $57,947 | $155 |
| Critical care, first 30-74 minutes | 117 | $23,725 | $201 |
| Emergency department visit with moderate level of medical decision making | 43 | $4,562 | $101 |
| Insertion of non-tunneled central venous tube for infusion (5 years or older) | 16 | $1,278 | $75 |
| Emergency department visit with low level of medical decision making | 14 | $823 | $59 |
2020: 6 services
| Emergency department visit with high level of medical decision making | 163 | $25,352 | $152 |
| Critical care, first 30-74 minutes | 46 | $8,985 | $195 |
| Emergency department visit with moderate level of medical decision making | 21 | $2,040 | $97 |
| Emergency department visit with low level of medical decision making | 16 | $886 | $55 |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 37 | $262 | $7 |
| X-ray of chest, 1 view | 14 | $99 | $7 |
2019: 2 services
| Emergency department visit with high level of medical decision making | 23 | $3,209 | $140 |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 17 | $118 | $7 |
Medicaid work
$95,768 in 2024
Medicaid paid $95,768 for 2,831 billed services this clinician did in 2024, up to 144 people in a month for one service.
Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.
| EMERGENCY DEPT VISIT MOD MDM | 1,327 | $45,682 |
| EMERGENCY DEPARTMENT VISIT HIGH MDM | 764 | $40,686 |
| Service | 77 | $2,843 |
| EMERGENCY DEPT VISIT LOW MDM | 98 | $1,947 |
| Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes | 26 | $1,792 |
| Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 260 | $1,378 |
| Service | 91 | $1,063 |
| Service | 41 | $169 |
| Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 19 | $60 |
| COMPREHENSIVE METABOLIC PANEL | 28 | $53 |
| Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) | 42 | $52 |
| ASSAY OF LIPASE | 16 | $28 |
| 2024 | 2,831 | 15 | 144 | $95,768 |
| 2023 | 10,279 | 35 | 204 | $211,089 |
| 2022 | 7,573 | 22 | 329 | $226,874 |
| 2021 | 4,666 | 23 | 120 | $365,548 |
| 2020 | 1,253 | 13 | 102 | $43,568 |
| 2019 | 141 | 6 | 38 | $5,702 |
See the largest Medicaid services in earlier years
2023
| EMERGENCY DEPT VISIT MOD MDM | 2,026 | $69,889 |
| EMERGENCY DEPARTMENT VISIT HIGH MDM | 985 | $45,317 |
| EMERGENCY DEPT VISIT LOW MDM | 846 | $18,347 |
| Service | 665 | $14,705 |
| Service | 744 | $13,606 |
| Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes | 273 | $11,582 |
| Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug | 182 | $4,757 |
| Service | 113 | $4,046 |
| Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 430 | $3,529 |
| COLLECTION VENOUS BLOOD VENIPUNCTURE | 28 | $3,450 |
| Unclassified drugs | 18 | $2,661 |
| COMPREHENSIVE METABOLIC PANEL | 541 | $2,070 |
2022
| EMERGENCY DEPT VISIT MOD MDM | 1,879 | $66,697 |
| EMERGENCY DEPARTMENT VISIT HIGH MDM | 1,218 | $60,319 |
| EMERGENCY DEPT VISIT LOW MDM | 1,683 | $38,681 |
| Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes | 220 | $11,958 |
| Service | 359 | $11,845 |
| Service | 312 | $7,124 |
| Unlisted special service, procedure or report | 110 | $5,746 |
| COLLECTION VENOUS BLOOD VENIPUNCTURE | 41 | $3,851 |
| Service | 96 | $3,568 |
| Unclassified drugs | 22 | $3,245 |
| Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 217 | $3,067 |
| Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug | 40 | $1,939 |
2021
| EMERGENCY DEPT VISIT MOD MDM | 1,004 | $242,830 |
| EMERGENCY DEPARTMENT VISIT HIGH MDM | 1,132 | $63,197 |
| EMERGENCY DEPT VISIT LOW MDM | 922 | $23,799 |
| Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes | 159 | $10,982 |
| Service | 246 | $8,937 |
| Service | 93 | $3,450 |
| Unlisted special service, procedure or report | 50 | $2,655 |
| Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 134 | $1,790 |
| Service | 106 | $1,768 |
| Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug | 33 | $1,450 |
| COMPREHENSIVE METABOLIC PANEL | 179 | $1,267 |
| Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) | 247 | $845 |
2020
| EMERGENCY DEPARTMENT VISIT HIGH MDM | 304 | $17,046 |
| EMERGENCY DEPT VISIT LOW MDM | 310 | $8,831 |
| EMERGENCY DEPT VISIT MOD MDM | 189 | $7,099 |
| Service | 117 | $4,458 |
| Service | 92 | $3,583 |
| Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes | 28 | $1,565 |
| COMPREHENSIVE METABOLIC PANEL | 46 | $310 |
| Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) | 69 | $223 |
| Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 14 | $166 |
| Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | 15 | $119 |
| ASSAY OF LIPASE | 28 | $112 |
| Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count | 14 | $56 |
2019
| EMERGENCY DEPT VISIT MOD MDM | 28 | $1,772 |
| EMERGENCY DEPT VISIT LOW MDM | 38 | $1,602 |
| EMERGENCY DEPARTMENT VISIT HIGH MDM | 12 | $1,177 |
| Service | 25 | $946 |
| Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count | 21 | $110 |
| Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium (84132) Sodium (84295) Urea nitrogen (BUN) (84520) | 17 | $96 |
Drugs they prescribed that Part D paid
$7,995
Pharmacies billed $7,995 in 2024.
This is pharmacy cost, not the office bill, and not what patients paid.
Opioids were 10% of their Part D prescriptions (30 of 306) in 2024. At or below the middle of the specialty; the typical emergency medicine clinician is at 12%.
266 generic and fewer than 11 brand-name prescriptions · $7,995 in drug cost · 83 antibiotic prescriptions to 79 people.
Part D prescriptions only. The opioid rate is opioid prescriptions as a share of all this clinician's Part D prescriptions; surgeons and pain specialists run higher than others, so it is shown against the same specialty.
| Albuterol Sulfate Hfa | 13 | $332 | $22 |
| Cephalexin | 32 | $111 | $3 |
| Doxycycline Hyclate | 12 | $103 | $8 |
| Ondansetron | 23 | $94 | $4 |
| Hydrocodone-Acetaminophen | 27 | $76 | $3 |
See all 7 drugs
| Albuterol Sulfate Hfa | 13 | $332 | $22 |
| Cephalexin | 32 | $111 | $3 |
| Doxycycline Hyclate | 12 | $103 | $8 |
| Ondansetron | 23 | $94 | $4 |
| Hydrocodone-Acetaminophen | 27 | $76 | $3 |
| Ibuprofen | 15 | $27 | $2 |
| Prednisone | 12 | $19 | $2 |
Year by year
| 2024 | 306 | 230 | 10% (30) | None | $7,995 |
| 2023 | 329 | 248 | 9% (28) | None | $6,636 |
| 2022 | 287 | 206 | 11% (32) | None | $3,674 |
| 2021 | 185 | 140 | 13% (24) | 6% | $2,616 |
| 2020 | 185 | 139 | 13% (24) | 7% | $3,711 |
| 2019 | 121 | 95 | 12% (14) | 9% | $1,640 |
| 2018 | 42 | 33 | 0% (0) | 26% | $1,824 |
| 2017 | 23 | 16 | 0% (0) | None | $1,181 |
Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.
See the drugs prescribed each year
2023: 9 drugs
| Cephalexin | 45 | $338 | $8 |
| Ondansetron Odt | 21 | $144 | $7 |
| Amoxicillin-Clavulanate Potass | 11 | $107 | $10 |
| Dicyclomine | 16 | $83 | $5 |
| Hydrocodone-Acetaminophen | 25 | $80 | $3 |
| Naproxen | 18 | $67 | $4 |
| Meclizine | 20 | $63 | $3 |
| Cyclobenzaprine | 12 | $52 | $4 |
| Prednisone | 11 | $20 | $2 |
2022: 7 drugs
| Albuterol Sulfate Hfa | 11 | $407 | $37 |
| Cephalexin | 38 | $222 | $6 |
| Hydrocodone-Acetaminophen | 31 | $131 | $4 |
| Naproxen | 33 | $119 | $4 |
| Ondansetron Odt | 13 | $111 | $9 |
| Dicyclomine | 20 | $102 | $5 |
| Cyclobenzaprine | 18 | $85 | $5 |
2021: 4 drugs
| Cephalexin | 29 | $115 | $4 |
| Hydrocodone-Acetaminophen | 23 | $92 | $4 |
| Dicyclomine | 15 | $88 | $6 |
| Cyclobenzaprine | 11 | $38 | $3 |
2020: 6 drugs
| Hydrocodone-Acetaminophen | 22 | $90 | $4 |
| Dicyclomine | 12 | $79 | $7 |
| Azithromycin | 13 | $74 | $6 |
| Cephalexin | 14 | $61 | $4 |
| Ibuprofen | 11 | $61 | $6 |
| Prednisone | 11 | $30 | $3 |
2019: 3 drugs
| Ibuprofen | 17 | $114 | $7 |
| Cephalexin | 11 | $80 | $7 |
| Hydrocodone-Acetaminophen | 12 | $49 | $4 |
Checkups this office reported
1 measures · 2023
Medicare asked this office to report how often certain checkups happened in 2023. This is not a grade for the doctor. A specialist’s patients may not need every screening.
- Medicare’s overall office score
- 100.0 / 100
- Scores the office’s reporting and systems. It is not a grade for how the doctor treats you.
| Ultrasound Determination of Pregnancy Location for Pregnant Patients with Abdominal PainAs Medicare defines this measure | 100% | 25 |
What the office says it does
Boxes the office ticked on its Medicare worksheet for 2023. Nobody checks these.
- Create and Implement an Anti-Racism Plan
- Promoting Clinician Well-Being
Professional record
- NPI
- 1972957678
- Licence
- CA 20A16955
- Gender
- Male
More record details
- Sole proprietor
- Yes
- Taxonomy
- Federal specialty code 207P00000X (207P00000X); Student in a training program (390200000X)
- Mailing address
- 1150 N Indian Canyon Dr, Palm Springs, CA, 92262
- NPI first listed
- 2016-04-19
- NPI last updated
- 2020-03-25
- NPI record certified
- 2020-03-25
This is when the NPI record was last certified, not a medical board exam.