House Committee Advances Medical Marijuana Bill to Expand Research
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On September 9, 2020, a U.S. House of Representatives committee advanced a bill to expand access to marijuana for research purposes. The House Committee on Energy and Commerce voted unanimously by voice vote in favor of HR 3797, the Medical Marijuana Research Act of 2019. The bill would: “amend the Controlled Substances Act to make marijuana accessible for use by qualified marijuana researchers for medical purposes, and for other purposes.”
HR 3797 – Medical Marijuana Research Act.
The amendment to existing federal law would allow researchers to use “marijuana products available through State-authorized marijuana programs” until there are federally-approved suppliers who can meet the demand of the federal researchers. More specifically, there will be no limit on the number of entities that could be federally approved to cultivate and distribute cannabis for research purposes. Additionally, the Secretary of Health and Human Services would be required to submit a report to Congress that includes a review of cannabis research and a note on whether cannabis should be rescheduled on the drug schedules that are used to decide what drugs are controlled substances.
The amendment also takes care of a problem in the law it amends to prevent government law enforcement officials from interfering with the sale or distribution of research marijuana.
Advancement in Cannabis Cultivation.
Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws, (NORML) said in a statement that the amendments to the law advanced by the bill were “necessary and long overdue.”
“Rather than compelling scientists to access marijuana products of questionable quality manufactured by a limited number of federally licensed producers, federal regulators should allow investigators to access the cannabis and cannabis-infused products that are currently being produced in the legal marketplace by the multitude of state-sanctioned growers and retailers,” Armentano said.
George F. Indest III, President and Managing Partner of The Health Law Firm also stated: “This is a law that is necessary and long overdue.” He urged everyone to contact their U.S. Representative and Senators and ask them to vote in favor of it.
The next step for the bill is a vote on the House floor; however, it is unclear whether this will happen and when it will happen, given everything that is occurring at present.
To read HR3797 in full, click here.
EVERYONE SHOULD WRITE THEIR U.S. CONGRESSIONAL REPRESENTATIVE AND THEIR TWO SENATORS AND REQUEST THAT THEY SUPPORT THIS BILL.
Click here to go to our Marijuana Law Blog page and read my prior blog on this subject to learn more.
Contact Experienced Health Law Attorneys for Medical and Recreational Marijuana Concerns.
The Health Law Firm attorneys can assist health care providers and facilities, such as doctors, pharmacists, and pharmacies, wanting to participate in the medical marijuana industry. We can properly draft and complete the applications for registration, permitting, and/or licensing while complying with Florida law. We can also represent doctors, pharmacies, and pharmacists facing proceedings brought by state regulators or agencies.
To contact The Health Law Firm please call (407) 331-6620 or Toll-Free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.
Sources:
Reisman, Sam. “House Committee Advances Medical Marijuana Research Bill.” Law360. (September 9, 2020).
Rashidian, Nushin. “Key House Committee Advances Cannabis Research Bill.” Cannabis Newswire. (September 9, 2020). Web.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.
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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.
How to Find the Right Attorney for Your Irregular Behavior Case Before the USMLE or ECFMG
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
If you have received a letter from the United States Medical Licensing Examination (USMLE) Secretariat or the Educational Commission for Foreign Medical Graduates (ECFMG) accusing you of “irregular behavior,” this is very serious stuff. You need an experienced lawyer to assist you. But how do you find one? This blog will provide several tips on how to locate an experienced effective attorney who will really provide the legal assistance you need.
You Don’t Need a Philadelphia Attorney to Represent You.
First, there are only a handful of attorneys in the United States who have handled more than one of these cases. Even if you find one, this does not mean he or she is really experienced and will really advocate your position before the Committee for Individualized Review (CIR) or the ad hoc committee which is appointed to hear your case. You don’t need an attorney who is actually in Philadelphia, Pennsylvania (where the USMLE and the ECFMG have offices and where such hearings are usually held), to represent you. Most of the work is actually done before the hearing.
What you do need is someone who is experienced and knows how to properly prepare you for the nerve-wracking hearing you will have. The attorneys of our firm routinely do this.
What to Look for in an Attorney Before You Select One.
1. First, make sure that the attorney you select actually has ample experience in actually appearing before the committee and representing individuals and has done this multiple times in the past. Ask how many hearings.
2. Second, Look for an attorney who is board certified by their state bar association in the legal specialty of health law. Many states now have such certifications, including Florida, Pennsylvania, and Texas. Board certification in a legal specialty is like board certification in a medical specialty. It is the mark of attaining a higher degree of expertise and excellence. An attorney who is certified in health law will understand the medical issues involved in your case, the impact this can have on your future as a physician and other aspects a criminal law attorney or civil litigation attorney will not.
3. Third, check out the background of each attorney before you hire one. Google them and review everything you can find. Check with the state licensing board or state bar association for adverse actions.
4. Ask the attorney how the attorney exactly how the attorney will prepare you for the hearing. When we prepare an individual for a hearing, we review everything from the physical layout of the hearing room, to exactly how the actual hearing will be conducted, to whom the members of the hearing committee will be. We review how to speak and answer questions effectively and the types of questions that may be asked of you. All of this helps you to be better prepared and less nervous when appearing at the hearing.
5. Ask the attorney if the attorney uses expert witnesses in these cases. In many cases, no expert witness is required. However in some cases experts such as computer technicians, forensic document examiners or handwriting experts, polygraphers (lie detector analysts), statistics experts, or other experts should be hired to provide an expert report for the committee to consider.
6. Find out if the attorney will meet with you in person a week or two prior to the hearing to help prepare you. We always do this. If you cannot come to our office in the Orlando, Florida area (which most people do), we will meet with you via Zoom, Skype, video chat, or just telephonically if necessary.
7. We recommend that you select an attorney who is not a solo practitioner. An attorney who has several attorneys in his firm in the same area of specialty will have additional back up if it is needed. If you hire an attorney who is alone by himself, illness, accidents, family emergencies, and other unforeseen events can cause you to be without legal representation at the last minute.
8. Often the cheapest attorney is not the best one for you. Remember the old saying that “you get what you pay for.” Cheaper is not always better. However, paying the most may not ensure that you get the most effective legal counsel. You must do your homework, finding out the information above.
Contact Us for an Initial Consultation on Your Irregular Behavior Case.
Contact our firm and we will be happy to discuss your irregular behavior case with you before you decide on hiring an attorney.
Contact a Health Care Attorney Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education, and those being challenged by the National Board of Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG)
The Health Law Firm and its attorneys represent interns, residents, fellows and medical school students in disputes with their medical schools, supervisors, residency programs and in dismissal hearings. We have experience representing such individuals and those in graduate medical education programs in various disputes regarding their academic and clinical performance, allegations of substance abuse, failure to complete integral parts training, alleged false or incomplete statements on applications, allegations of impairment (because of abuse or addiction to drugs or alcohol or because of mental or physical issues), because of discrimination due to race, sex, national origin, sexual orientation and any other matters. We routinely help those who have disputes with the National Board fo Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG), including on hearings and appeals concerning “Irregular Behavior,” “unprofessionalism,” and “Irregular Conduct.”
To contact The Health Law Firm please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.
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“The Health Law Firm” is a registered fictitious business name and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.
Florida Department of Health Claims Orchid Nursery Has No Constitutional Protection In Pot Licenses
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On August 27, 2020, the Florida Department of Health (DOH) argued to the United States Eleventh Circuit Court of Appeals that a Florida nursery can’t claim the 14th Amendment to the U.S. Constitution protects its right to marijuana licenses. The DOH urged the appellate court to uphold the dismissal of Louis Del Favero Orchids’ suit because, it claimed, the U.S. Constitution doesn’t cover a property interest in a business that is illegal under federal law. This seems to be a rather hypocritical argument in that the counter-question could be “How can the state of Florida issue licenses for or control a business that is illegal under federal law?”
Is the Law Constitutionally Protected?
The would-be medical pot nursery operator has been fighting since 2016 to get one of the state’s few medical marijuana licenses. It has been involved in ongoing litigation in state court over Florida’s medical marijuana licensing process.
The nursery claims that the U.S. Constitution protects a property right to the licenses even if Congress has outlawed marijuana because the right itself is created by state law. In its suit, Louis Del Favero Orchids said that the property right itself originates in Florida state law, specifically, the law that legalized medical marijuana. Federal law can only determine “whether a given property interest rises to the level of a protected property interest,” the nursery argued in its brief.
According to the nursery’s brief, it sought damages and an injunction requiring the state of Florida to grant the company a hearing on its application for a medical marijuana license. You can read the nursery’s brief here.
Property Right in the “Process of” the Issuance of a Medical Marijuana License?
The Florida nursery filed its case first in federal court in June 2019. But in November 2019, the federal judge threw out the suit, deciding that the company had a property interest in the pot license under state law, but not under the 14th Amendment to the U.S. Constitution. The lower court decided that if Congress has legislated that marijuana is against the law, then it can’t be property protected by the U.S. Constitution. As a result, this decision, the nursery quickly appealed the ruling to the Eleventh Circuit.
In the brief it filed in the Court of Appeals, the Florida DOH urged the Eleventh Circuit to uphold the district court’s decision. It argued that not only is the right to a medical pot license not protected by the 14th Amendment, but there’s no property right in the process of medical marijuana licensure, the DOH told the court.
Click here to read the Florida DOH’s brief in full.
What the case does not discuss is the fact the Florida Constitution contains a provision identical to the 14th Amendment of the U.S. Constitution, in its Article 1, Section 9, which states: “Due process.—No person shall be deprived of life, liberty or property without due process of law. . . .” However, if the federal court’s decision stands, then this would be a matter solely based on Florida law and not one for the federal courts.
To learn more about their ongoing litigation in Florida involving medical marijuana issues, click here.
Click here to go to our Marijuana Law Blog page and read my prior blog on this subject to learn more.
Contact Experienced Health Law Attorneys for Medical and Recreational Marijuana Concerns.
The Health Law Firm attorneys can assist health care providers and facilities, such as doctors, pharmacists, and pharmacies, wanting to participate in the medical marijuana industry. We can properly draft and complete the applications for registration, permitting, and/or licensing while complying with Florida law. We can also represent doctors, pharmacies, and pharmacists facing proceedings brought by state regulators or agencies.
To contact The Health Law Firm please call (407) 331-6620 or Toll-Free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.
Sources:
Jones, Diana. “No Constitutional Right To Pot Licenses, Fla. Tells 11th Circ.” Law360. (August 27, 2020). Web.
Jones, Diana. “Nursery Tells 11th Circ. Pot License Constitutionally Protected.” Law360. (June 29, 2020). Web.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.
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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.
Dentists, What Should You Do If You Or Your Staff Tests Positive For COVID-19 at Your Practice?
By Achal A. Aggarwal, M.B.A., J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
You or a member of your staff has a confirmed case of COVID-19. What now? Your primary concern is for the individual affected. However, as a health professional operating a professional practice, you also have a duty to your employees and to your other patients. You have to be concerned about any patients with whom your infected staff might have had contact. These steps and protocols, all from prominent government agencies, are meant to help guide you if you or someone in your practice tests positive for COVID-19.
Follow these steps below to help ensure the health and safety of others and to reduce the likelihood of additional transmissions:
• The Centers for Disease Control and Prevention (CDC) recommends that employees who were exposed to the infected staff member should be quarantined for 14 days, keep track of their symptoms, and contact their own healthcare provider if the symptoms progress.
• Your entire dental office and facility, especially the waiting areas, restrooms, and treatment areas, should receive a “deep cleaning.” These should be regularly cleaned and sanitized or sterilized as the case may be. Click here for additional information on the proper ways to do so.
• According to the CDC, the Dental Healthcare Provider (DHP) should ensure that environmental cleaning and disinfection procedures are followed consistently and correctly after each patient. However, according to the CDC, the DHP does not need to attempt to sterilize a dental operatory between each patient.
• Sterilization protocols do not vary for respiratory pathogens. According to the CDC, the dental professional should perform routine cleaning, disinfection, and sterilization protocols, and follow the recommendations for “Sterilization and Disinfection of Patient-Care Items” present in the Guidelines for Infection Control in Dental Healthcare Settings.
• The Dentists should have and implement sick leave policies for any infected staff. These should be flexible, non-punitive, and consistent with public health guidance.
• As part of routine practice, dentists should also monitor themselves for fever and symptoms consistent with COVID-19 regularly.
• The dentists should screen all staff at the beginning of their shift for fever and symptoms consistent with COVID-19. One person, such as the receptionist, might be assigned to this task. Equipment that does not require actual physical contact, such as an infrared thermometer, should be used. The dentists in the practice should be required to undergo this screening, as well.
For additional information, guidance, and resource documents on this topic, please visit our Health Law Articles and Documents page. Be sure to visit our blog page regularly to stay updated on the latest news, policies, and health law topics!
We continue to receive inquiries from healthcare practitioners requesting information regarding health law matters during this time of uncertainty. We are here for you! If you have additional questions in the COVID-19 crisis or any health law matter, please call our office at (407) 331-6620.
Additional Resources.
The following are additional resources dentists should consult on this issue:
- CDC Guidance for Dental Settings During the COVID-19 Response
- Interim U.S. Guidance for Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure to COVID-19
- Guidelines for Infection Control in Dental Healthcare Settings
- Guidelines for Sterilization and Disinfection of Dental Patient-Care Items
Contact Health Law Attorneys Experienced in Representing Dentists.
The attorneys of The Health Law Firm provide legal representation to dentists in the Department of Health (DOH) investigations, Department of Regulatory Affairs (DORA) investigations, Agency for Health Care Administration (AHCA) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Office of Civil Rights (OCR) HIPAA complaints and investigations, U.S. Department of Health and Human Services (HHS) subpoenas and investigations, state board of dentistry complaints and investigations and other types of investigations of health professionals and providers.
Our firm also routinely represents physicians, dentists, orthodontists, medical groups, clinics, pharmacies, home health care agencies, nursing homes and other health care providers in Department of Health (DOH), Department of Regulatory Affairs (DORA), and Agency for Health Care Administration (AHCA) inspections, audits, and recovery actions, as well as Medicare and Medicaid investigations, audits and recovery actions.
To contact The Health Law Firm, please call (407) 331-6620 or (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.
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About the Authors: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, and Achal A. Aggarwal, M.B.A., J.D. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com. The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620.
“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.
CVS Fined for Prescription Errors and Poor Staffing at Oklahoma Pharmacies
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On July 16, 2020, the Oklahoma State Board of Pharmacy fined CVS, the nationwide pharmacy chain, $125,000, after auditors found safety issues and “chaotic” scenes at four of its pharmacies. State regulators in Oklahoma cited and fined the nation’s largest retail pharmacy chain for conditions including inadequate staffing and errors made in filling prescriptions. Hopefully, this was isolated to the few stores involved.
Pharmacy Complaints.
In four separate administrative orders, the Oklahoma State Board of Pharmacy said that auditors responded to complaints at each of the pharmacies for issues including long waiting times, wrong information on prescription refills, and dosage mistakes. The state board inspected the four pharmacies from mid-2019 to early 2020. In one case, the complaint said the pharmacy had put someone on hold on multiple occasions, sometimes as long as an hour. In another case, a woman said that when she got her medication refilled, the name and other information on the bottle she received was for someone else.
The pharmacy chains have pushed back on customer and employees’ complaints, saying staffing is sufficient and errors are rare.
Pharmacy Audits.
On multiple occasions, state auditors visiting the pharmacies said they found understaffed facilities, with the phone continuously ringing, employees working around unopened (and, we assume, un-inventoried) delivery boxes, and long lines at the drive-through windows. According to the orders, one pharmacy stated that it was normal for them to be as much as two weeks behind in filling prescriptions as a result of understaffing. It should be noted that the audits took place predominantly before the COVID-19 crisis.
Additionally, in letters to state pharmacy boards and in interviews, pharmacists working for CVS allegedly admitted that they struggled to keep up with an increasing number of tasks including filling prescriptions, giving flu shots, tending the drive-through window, answering phones, and calling patients. According to the orders, many said they also struggled to meet corporate performance metrics that they characterized as excessive and unsafe.
As a routine customer of CVS Pharmacy (not in Oklahoma, of course), I can sympathize with the pharmacists, pharmacy technicians, and clerks. In many places, pharmacists are now being required to administer a laundry list of vaccinations (literally, ten different vaccinations), practice medicine to a limited scope, contact prescribing physicians, constantly order out-of-stock drugs, order diagnostic tests, and answer all sorts of customer questions. Now, with the COVID-19 pandemic, there is a steady flow of coronavirus tests to administer to customers at the drive-through window. I see first-hand how difficult it is for these front-line healthcare professionals to keep up on a daily basis.
The Oklahoma Board said it “strongly recommended” that CVS follow through on nearly a dozen recommendations for all of its Oklahoma pharmacies, including increased training for technicians and changes to how staffing needs were determined. Additionally, the Oklahoma Board advised eliminating tasks that might overburden pharmacists and removing some metrics they are required to meet. For example, phone calls pharmacists often must make could be outsourced to a corporate call center.
In a statement, CVS Pharmacy said it agreed with the Board to settle the matter to avoid the lengthy and costly hearing process. The orders specify that CVS neither admits to nor denies the violations. The company agreed to pay the fines and to make other efforts to address the problems without contesting the allegations.
While the fine of $125,000 is relatively small for CVS, as it’s the country’s fifth-largest company, the move did validate the concerns raised at multiple drugstore chains by pharmacists who say workplaces are putting the public at risk.
You can read all four orders in this case here: CVS Order – Bartlesville, CVS Order – Choctaw, CVS Order – Moore, and CVS Order – Owasso.
Visit our Areas of Practice page on our website to learn more about Board of Pharmacy Representation and how we can assist Pharmacists and Pharmacies in these types of cases.
Consult With A Health Law Attorney Experienced in the Representation of Pharmacists and Pharmacies.
We routinely provide defense for pharmacists, pharmacies, and pharmacy technicians; defense to complaints filed against their licenses; defense to complaints filed by patients; defense in litigation against pharmacists, pharmacies, and technicians; legal representation and defense to DEA and Board of Pharmacy audits, investigations, and subpoenas; legal representation in depositions in criminal cases, negligence cases, civil cases, or disciplinary cases involving other health professionals. We have experience in dealing with HIPAA privacy complaints, audits, and investigations. We have experience in defending in Medicare, Medicaid, Tricare, and health insurance audits. We accept most professional liability insurance that pharmacists carry.
The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing physicians, physician assistants, and other health professionals in investigations and at Board of Pharmacy hearings. Call our office now at (407) 331-6620 or toll-free at (888) 331-6620 and visit our website www.TheHealthLawFirm.com.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, Florida 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.
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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.
New Policy Changes to USMLE Exams and How They Impact Medical Students, Graduates
By Achal A. Aggarwal, J.D. and Carole C. Schriefer, J.D.
The United States Medical Licensing Examination (“USMLE”) is a three-step examination required to obtain a medical license. It is written and administered by the USMLE Secretariat of the National Board of Medical Examiners (“NBME”) and is sponsored by the Federation of State Medical Boards (“FSMB”) and the USMLE.
Medical students desiring to practice in the U.S. are under immense pressure to not only pass the exams but to excel at them. Specifically, the USMLE Step 1 Examination, the USMLE Step 2 Clinical Knowledge (“CK”) Examination, and the USMLE Step 2 Clinical Skills (“CS”) Examination are the most significant deciding factors that residency programs use for selecting applicants to interview for residency positions. However, a lot is about to change.
Important Policy Changes.
On February 12, 2020, the FSMB and the NBME announced the following policy changes:
1. The Step 1 Exam will be changed to pass/fail grading;
2. The number of examination attempts for each exam will be reduced from six (6) to four (4); and
3. All examinees must pass the Step 1 Exam before taking the Step 2-CS Exam.
Changing the Step 1 Exam to Pass/Fail.
The USMLE has announced that it will change the Step 1 exam’s grading system from a three-digit score to a pass/fail grading system. This change will go into effect on January 1, 2022. A statement published on the website states that changing to pass/fail could help reduce some of the current overemphasis on USMLE performance while also retaining the ability of medical licensing authorities to use the exam for its primary purpose of medical licensure eligibility. Click here to visit the USMLE website and read the statement.
It appears that USMLE, FSMB, NBME, and the American Medical Association (AMA) are attempting to alleviate the stress and pressure the Step 1 exam puts on medical students. However, this change may cause issues for residency programs that are trying to screen for which students they want to interview.
In the current system, the Step 1 score is a three-digit score that is graded on a bell-curve. The minimum passing score for each Step 1 exam is different and depends on the performance of the total universe of the students who take that particular examination.
The three-digit score helps residency programs assess which students were more likely to excel in their program and which students would not. By changing the exam to a pass/fail scoring system, residency programs will be forced to rely more heavily on the Step 2-CK scores, medical school performance, and overall curriculum vitae.
Greater Emphasis to Be Placed on Step 2-CK Exam.
Currently, the Step 2-CK exam is only the fourth-most deciding factor in how residency programs select applicants for interviews. Approximately 80% of residency program directors stated that it was an important factor, but not the most.
On the other hand, the Step 2-CS exam score is a less influential factor, with only 56% of residency program directors saying that it was essential to their decision. Students should anticipate that the Step 2-CK and Step 2-CS will become more important as program directors shift their attention to the scores of those exams.
For more information click here.
What remains to be seen is how these changes will impact international medical graduates (“IMG”), commonly referred to as “foreign medical graduates.” To distinguish themselves, IMGs often tried to get the highest possible USMLE score, as this was the most objective way for them to be compared to other U.S. medical school students.
Since each domestic and international medical school has its own unique clinical grading system, the USMLE Step 1 was one of the most objective ways to compare residency applicants. Now that Step 1 scoring has been eliminated, it might be harder for IMGs to make themselves attractive to competitive residency programs.
Reducing Overall Exam Attempts from Six to Four.
Additionally, the USMLE is changing the limit on the total number of times an examinee may take the same Step exam from six (6) attempts to four (4) attempts. This means that after the policy is implemented, it will be ineligible to take a Step exam if the examinee has made four (4) prior attempts on that Step exam, including incomplete attempts.
The policy is set to be implemented on July 1, 2021. Learn more about the policy here.
Examinees Must Pass Step 1 Before Taking Step 2-CS.
Although the USMLE has suspended the Step 2-CS exam administration at the present time because of the COVID-19 pandemic, it is set to implement a rule requiring all examinees to pass the Step 1 exam before qualifying to take the Step 2-CS exam.
Implementing such a rule would reduce the USMLE’s burden of administering the Step 2-CS exam multiple times since students will be required to qualify for the exam. Students can currently take the Step 1 exam, Step 2-CS exam, and Step 2-CK exam in any order they choose, depending on the requirements of their medical school. This new rule seeks to shift that burden by funneling students through the Step 1 exam.
The impact of such a change remains to be seen, however, we anticipate that this policy will reduce the testing burden on the USMLE while also maintaining the importance of the Step 1 exam despite changing its scoring to pass/fail.
It does represent a complete shake-up in how the system of testing has previously been administered.
Tips for the New Rules.
The following are suggestions we have concerning the new rules:
1. Take the Step 1 Exam as soon as you can, and begin preparing for the others.
2. Always treat every test administration extremely seriously, as though your future life and career depend on it; they do!
3. Take maximum advantage of commercial preparation courses and always try to take one of the recommended live ones before you take your examination.
4. Take off several weeks prior to the examination and find a hotel within walking distance of the test site where you will take the examination to study. Get rid of all distractions while studying for and immediately prior to taking the examination.
5. Never solicit actual test content or offer to share it with someone else.
For additional common-sense tips on preparing for and taking the USMLE Step exams, see another blog on this subject here.
Contact a Health Care Attorney Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education, and those being challenged by the National Board fo Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG)
The Health Law Firm and its attorneys represent interns, residents, fellows, and medical school students in disputes with their medical schools, supervisors, residency programs, and in dismissal hearings. We have experience representing such individuals and those in graduate medical education programs in various disputes regarding their academic and clinical performance, allegations of substance abuse, failure to complete integral parts training, alleged false or incomplete statements on applications, allegations of impairment (because of abuse or addiction to drugs or alcohol or because of mental or physical issues), because of discrimination due to race, sex, national origin, sexual orientation, and any other matters. We routinely help those who have disputes with the National Board fo Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG), including on hearings and appeals concerning “Irregular Behavior,” “unprofessionalism,” and “Irregular Conduct.”
To contact The Health Law Firm please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.
About the Authors: Carole C. Schriefer J.D., and Achal A. Aggarwal, M.B.A., J.D. practice health law with The Health Law Firm, which has a national practice. Its main office in the Orlando, Florida area. 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714
Phone: (407) 331-6620 or Toll-Free: (888) 331-6620. Its regional office is in the Northern Colorado, area. 155 East Boardwalk Drive, Fort Collins, Colorado 80525. Phone: (970) 416-7456. www.TheHealthLawFirm.com
KeyWords: Irregular behavior defense lawyer, irregular conduct legal representation, graduate medical education (GME) defense attorney, international medical graduate attorney, graduate medical education defense lawyer, lawyer for medical students, medical resident physician attorney, residency program legal dispute, residency program litigation, medical school litigation, legal representation for medical residents, legal dispute with medical school, medical students legal counsel, disruptive physician attorney, impaired medical student legal counsel, impaired resident legal defense attorney, United States Medical Licensing Examination (USMLE) defense lawyer, USMLE defense attorney, National Board of Medical Examiners (NBME) defense counsel, Educational Commission for Foreign Medical Graduates (ECFMG) defense lawyer, ECFMG defense attorney, legal representation for USMLE investigations, legal representation for NBME investigations, legal representation for irregular behavior, irregular behavior defense attorney, irregular behavior defense counsel, health law attorney, The Health Law Firm reviews, reviews of The Health Law Firm attorneys, Philadelphia attorney for ECFMG hearing, Philadelphia lawyer for NBME hearing, Philadelphia legal counsel for USMLE hearing
“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.
Significant Changes to USMLE Exams and What They Mean for Medical Students and Graduates
By Achal A. Aggarwal, M.B.A., J.D., and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
The United States Medical Licensing Examination (“USMLE”) is a three-step examination required to obtain a medical license. It is written and administered by the USMLE Secretariat of the National Board of Medical Examiners (“NBME”) and is sponsored by the Federation of State Medical Boards (“FSMB”) and the USMLE.
Medical students desiring to practice in the U.S. are under immense pressure to not only pass the exams but to excel at them. Specifically, the USMLE Step 1 Examination, the USMLE Step 2 Clinical Knowledge (“CK”) Examination, and the USMLE Step 2 Clinical Skills (“CS”) Examination are the most significant deciding factors that residency programs use for selecting applicants to interview for residency positions. However, a lot is about to change.
Important Policy Changes.
On February 12, 2020, the FSMB and the NBME announced the following policy changes:
1. The Step 1 Exam will be changed to pass/fail grading;
2. The number of examination attempts for each exam will be reduced from six (6) to four (4); and
3. All examinees must pass the Step 1 Exam before taking the Step 2-CS Exam.
Changing the Step 1 Exam to Pass/Fail.
The USMLE has announced that it will change the Step 1 exam’s grading system from a three-digit score to a pass/fail grading system. This change will go into effect on January 1, 2022. A statement published on the website states that changing to pass/fail could help reduce some of the current overemphasis on USMLE performance while also retaining the ability of medical licensing authorities to use the exam for its primary purpose of medical licensure eligibility. Click here to visit the USMLE website and read the statement.
It appears that USMLE, FSMB, NBME, and the American Medical Association (AMA) are attempting to alleviate the stress and pressure the Step 1 exam puts on medical students. However, this change may cause issues for residency programs that are trying to screen for which students they want to interview.
In the current system, the Step 1 score is a three-digit score that is graded on a bell-curve. The minimum passing score for each Step 1 exam is different and depends on the performance of the total universe of the students who take that particular examination.
The three-digit score helps residency programs assess which students were more likely to excel in their program and which students would not. By changing the exam to a pass/fail scoring system, residency programs will be forced to rely more heavily on the Step 2-CK scores, medical school performance, and overall curriculum vitae.
Greater Emphasis to Be Placed on Step 2-CK Exam.
Currently, the Step 2-CK exam is only the fourth-most deciding factor in how residency programs select applicants for interviews. Approximately 80% of residency program directors stated that it was an important factor, but not the most.
On the other hand, the Step 2-CS exam score is a less influential factor, with only 56% of residency program directors saying that it was essential to their decision. Students should anticipate that the Step 2-CK and Step 2-CS will become more important as program directors shift their attention to the scores of those exams.
For more information click here.
What remains to be seen is how these changes will impact international medical graduates (“IMG”), commonly referred to as “foreign medical graduates.” To distinguish themselves, IMGs often tried to get the highest possible USMLE score, as this was the most objective way for them to be compared to other U.S. medical school students.
Since each domestic and international medical school has its own unique clinical grading system, the USMLE Step 1 was one of the most objective ways to compare residency applicants. Now that Step 1 scoring has been eliminated, it might be harder for IMGs to make themselves attractive to competitive residency programs.
Reducing Overall Exam Attempts from Six to Four.
Additionally, the USMLE is changing the limit on the total number of times an examinee may take the same Step exam from six (6) attempts to four (4) attempts. This means that after the policy is implemented, it will be ineligible to take a Step exam if the examinee has made four (4) prior attempts on that Step exam, including incomplete attempts.
The policy is set to be implemented on July 1, 2021. Learn more about the policy here.
Examinees Must Pass Step 1 Before Taking Step 2-CS.
Although the USMLE has suspended the Step 2-CS exam administration at the present time because of the COVID-19 pandemic, it is set to implement a rule requiring all examinees to pass the Step 1 exam before qualifying to take the Step 2-CS exam.
Implementing such a rule would reduce the USMLE’s burden of administering the Step 2-CS exam multiple times since students will be required to qualify for the exam. Students can currently take the Step 1 exam, Step 2-CS exam, and Step 2-CK exam in any order they choose, depending on the requirements of their medical school. This new rule seeks to shift that burden by funneling students through the Step 1 exam.
The impact of such a change remains to be seen, however, we anticipate that this policy will reduce the testing burden on the USMLE while also maintaining the importance of the Step 1 exam despite changing its scoring to pass/fail.
It does represent a complete shake-up in how the system of testing has previously been administered.
Tips for the New Rules.
The following are suggestions we have concerning the new rules:
1. Take the Step 1 Exam as soon as you can, and begin preparing for the others.
2. Always treat every test administration extremely seriously, as though your future life and career depend on it; they do!
3. Take maximum advantage of commercial preparation courses and always try to take one of the recommended live ones before you take your examination.
4. Take off several weeks prior to the examination and find a hotel within walking distance of the test site where you will take the examination to study. Get rid of all distractions while studying for and immediately prior to taking the examination.
5. Never solicit actual test content or offer to share it with someone else.
For additional common-sense tips on preparing for and taking the USMLE Step exams, see another blog on this subject here.
Contact a Health Care Attorney Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education, and those being challenged by the National Board fo Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG)
The Health Law Firm and its attorneys represent interns, residents, fellows, and medical school students in disputes with their medical schools, supervisors, residency programs, and in dismissal hearings. We have experience representing such individuals and those in graduate medical education programs in various disputes regarding their academic and clinical performance, allegations of substance abuse, failure to complete integral parts training, alleged false or incomplete statements on applications, allegations of impairment (because of abuse or addiction to drugs or alcohol or because of mental or physical issues), because of discrimination due to race, sex, national origin, sexual orientation, and any other matters. We routinely help those who have disputes with the National Board fo Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG), including on hearings and appeals concerning “Irregular Behavior,” “unprofessionalism,” and “Irregular Conduct.”
To contact The Health Law Firm please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.
About the Authors: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law; he is the President and Managing Partner of The Health Law Firm, and Achal A. Aggarwal, M.B.A., J.D. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com. The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620, Toll-Free: (888) 331-662.
KeyWords: Irregular behavior defense lawyer, irregular conduct legal representation, graduate medical education (GME) defense attorney, international medical graduate attorney, graduate medical education defense lawyer, lawyer for medical students, medical resident physician attorney, residency program legal dispute, residency program litigation, medical school litigation, legal representation for medical residents, legal dispute with medical school, medical students legal counsel, disruptive physician attorney, impaired medical student legal counsel, impaired resident legal defense attorney, United States Medical Licensing Examination (USMLE) defense lawyer, USMLE defense attorney, National Board of Medical Examiners (NBME) defense counsel, Educational Commission for Foreign Medical Graduates (ECFMG) defense lawyer, ECFMG defense attorney, legal representation for USMLE investigations, legal representation for NBME investigations, legal representation for irregular behavior, irregular behavior defense attorney, irregular behavior defense counsel, health law attorney, The Health Law Firm reviews, reviews of The Health Law Firm attorneys, Philadelphia attorney for ECFMG hearing, Philadelphia lawyer for NBME hearing, Philadelphia legal counsel for USMLE hearing
“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.
