In response, [Richard Carmona] said he initially thought his work as a trauma surgeon would earn him credit hours for certification as an emergency physician. As for twice failing the surgeon exam - a potentially embarrassing fact for a man who wants to be US surgeon general, even though there is no requirement that he be a surgeon - Carmona said his work experience proves he is qualified.

The image of a physician also acting as a police officer, gunning down a suspect, has disturbed some of Carmona's colleagues. Dr. Charles Putnam of the University of Arizona, who worked with Carmona at a medical center, wrote a letter to [Edward M. Kennedy] that said, "Could not a physician have recognized the behavior of a mentally-ill individual and responded in kind?" But the senators did not question Carmona about the shooting.

The harshest criticism about Carmona came from Dr. Sidney Wolfe, the director of Public Citizen's Health Research Group, which is affiliated with the Ralph Nader organization. Wolfe said there are "very serious questions about his integrity." "Knowing what is already known about Dr. Carmona raises so many questions about his integrity that when more people become aware of this, as they inevitably will, it will be difficult if not impossible for many people to believe the pronouncements he makes as surgeon general," Wolfe wrote in a letter to Kennedy.