In New Jersey, every bus driver must have a special license, sometimes known as a passenger-carrying endorsement to a commercial driver's license. Additionally, "every holder of a special license . . . shall furnish to the Director satisfactory evidence of continuing physical fitness, good character and experience at the time of application renewal or such other time as the Director may require, and in such form as the Director may require." N.J.S.A. 39:3-10.1. Regulations require all bus drivers to submit proof of continuing physical fitness every twenty-four months by providing a "satisfactory medical report submitted by a New Jersey licensed physician." N.J.A.C. 13:21-14.5(c)6. Moreover, the Director may revoke or suspend a bus driver's endorsement whenever an individual has "failed to meet the medical and physical qualifications set forth in the regulations of United States Department of Transportation, Bureau of Motor Carrier Safety, 49 C.F.R. 391.41, effective January 1, 1971, and as thereafter amended." N.J.A.C. 13:21-14.5(c)11. Those USDOT regulations state: A person is physically qualified to drive a commercial motor vehicle if that person- (4) Has no current clinical diagnosis of myocardial infarction, angina pectoris, coronary insufficiency, thrombosis, or any other cardiovascular disease of a variety known to be accompanied by syncope, dyspnea, collapse, or congestive cardiac failure. 49 C.F.R. 91.41(b)(4).