Dr. Olushola J. Metiko is paid $201,000 a year as a top administrator at the state Central Prison Regional Medical Center, where he treats patients, oversees patient care and helps manage a facility that recently underwent a major expansion.

It is a full-time job with on-call duty and patients - convicted felons - who bring their own special challenges. But Metiko has found the time to perform a second state job, making roughly $50,000 a year reviewing thousands of cases to help determine whether North Carolina drivers should be taken off the road for health reasons that could make them a risk to themselves or other motorists.

Metiko is one of three doctors and an optometrist who review medical files on contract with the state Division of Motor Vehicles at a cost of $6 per file. In the last fiscal year alone, he reviewed 8,936 files and was paid $53,616.

Susan Stewart, manager of the DMV's Medical Review Branch, said at a minimum, Metiko and three other medical professionals should be spending five minutes per case, and she expects them to spend as much as 30 minutes on cases in which drivers show multiple health risks.

If Metiko spent just five minutes on each of those 8,936 files, he would have worked the equivalent of 93 eight-hour days in the 2010-2011 fiscal year, or more than 18 weeks of full-time work.

State Rep. Shirley Randleman, a Wilkesboro Republican, oversees prison spending as a budget writer. She said the workload from both jobs raises questions about how Metiko can perform them well without having one job overlap the other.

"It warrants inquiry," she said. "The two jobs would need to be separate and apart and so I would like to see how that is being done."

The other medical professionals have their own private practices. All but one have been carrying DMV caseloads that are roughly as high as Metiko's.

Officials with the DMV say they see no reason to take Metiko off the DMV reviews or reduce the number of cases he is handling.

"I think it is adequate for a screening process, and that's what it is," said DMV Commissioner Mike Robertson. He added that he is unaware of a single complaint from another medical professional about the recommendations Metiko and the others have made.

DOC officials did not respond to requests for an interview. In a written statement, Metiko's supervisor at the Department of Correction praised his work, but did not address questions about the time Metiko had spent on DMV work.

"His job duties and assignments at Central Prison have always been met with the highest level of professionalism and satisfaction," said Dr. Paula Smith, chief of health services for the Division of Prisons. "The division has been aware of his outside employment and has never felt that this interfered with his work duties at Central Prison."

Metiko, who has worked for the prison system since 1997, declined to comment about his DMV work; the others did not return phone messages requesting interviews.

Checking drivers' fitness

Metiko, Drs. Venkat L. Prasad and his wife, Mamatha Ramaswamy, and optometrist Roy Max Raynor Jr., are all veteran practitioners in good standing with their professions. All except Metiko have connections to Stewart: Prasad is Stewart's personal physician; Ramaswamy is Prasad's wife; and Raynor is Stewart's optometrist.

The contract doctors are an early step in the process of denying someone their driving privileges. The DMV first receives information from sources such as accident reports, family members or family doctors that raise questions about a driver's fitness behind the wheel. Those suffering from diabetes, sleep apnea or respiratory ailments, for example, could become liabilities on the road.

For each file, the contract doctors can recommend the drivers lose their privileges, keep them with or without restrictions, or request more medical information such as additional tests.

Work in the evenings

Metiko has been doing the work since at least 2001 and has received corrections officials' approval several times since then.

Stewart said it is difficult finding doctors willing to do the work at $6 per file. The DMV used to have doctors on staff to review them at greater expense, she said, adding that Metiko has been particularly diligent. When the caseload began to back up a few years ago, Stewart said, Metiko took on more files. "He said he was taking vacation so he could help out."

News researchers David Raynor and Teresa Leonard contributed to this report.