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He took six years to graduate from the university in Bethesda, Md., instead of the customary four, according to the school. The delays were due in part to the deaths of his father in 1998 and his mother in 2001. Yet the information about his academic probation and bad grades wasn't included in his military personnel file, leaving the impression he was ready for more intense instruction. In June 2003, Hasan started a four-year psychiatry internship and residency at Walter Reed Army Medical Center in Washington, D.C., and he was counseled frequently for deficiencies in his performance. Teachers and colleagues described him as a below average student. Between 2003 and 2007, Hasan's supervisors expressed their concerns with him in memos, meeting notes and counseling sessions. He needed steady monitoring, especially in the emergency room, had difficulty communicating and working with colleagues, his attendance was spotty and he saw few patients. In one incident already made public, a patient of Hasan's with suicidal and homicidal tendencies walked out of the hospital without permission. Still, Hasan's officer evaluation reports were consistently more positive, usually describing his performance as satisfactory and at least twice as outstanding. Known as "OERs," the reports are used to determine promotions and assignments. The Army promoted Hasan to captain in 2003 and to major in 2009. At Walter Reed, Hasan's conflict with his Islamic faith and his military service became more apparent to superiors and colleagues, according to the information. He made a pilgrimage to Mecca in Saudi Arabia, a trip expected of all Muslims at least once. But he was also cited for inappropriately engaging patients in discussions about religious issues. Early in 2007, Maj. Scott Moran became director of psychiatry residency and took a much firmer line with Hasan. Moran reprimanded him for not being reachable when he was supposed to be on-call, developed a plan to improve his performance, and informed him his research project about the internal conflicts of Muslim soldiers was inappropriate. Nonetheless, Hasan presented the project, entitled "Koranic World View as It Relates to Muslims in the U.S. Military," and it was approved as meeting a residency program requirement, according to the information. Hasan graduated from the Walter Reed residency program and began a two-year fellowship in preventive and disaster psychiatry. Despite his earlier reservations, Moran wrote a solid reference letter for Hasan that said he was a competent doctor. Reached by telephone, Moran declined to comment. Hasan completed the fellowship June 30, 2009. Two weeks later he was at Fort Hood.
[Associated
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