Medical Education Law Blog

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Have You Received a Letter from the ECFMG or USMLE Accusing You of Irregular Behavior? All Is Not Lost; Legal Advice Is as Close as a Phone Call Away!

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Have you recently received a letter from the Educational Commission for Foreign Medical Graduates (ECFMG) or the United States Medical Licensing Examination (USMLE) Secretariat accusing you of “irregular behavior?” All is not lost. But you should seek advice from an attorney or law firm that has a lot of experience with such matters, before responding or doing anything else.

If You Are Innocent or Have a Believable Explanation to Justify What You Are Being Accused of Doing, You Need to Defend Yourself Against the Accusations of “Irregular Behavior.”

Yes, it is possible to successfully defend yourself against accusations of “irregular behavior.” However, we do not suggest that you should attempt to represent yourself or do this on your own. In any letter you receive on this will be advised of your rights to make a statement explaining your side, to have a hearing committee consider the matter, to appear in person before the hearing committee, and to have legal representation (an attorney) at the hearing with you to represent you. We recommend that you always ask for an exercise all of these rights.

It has been our experience that those individuals who think that they can just write a letter and explain what happened will usually not succeed. A full investigation has already been conducted by the USMLE or ECFMG and it will feel that it has already adequately explored and discovered all of the facts in your case.

It is our advice that you must always find out exactly what evidence or information the organization has against you and you must appear in person and testify under oath at a hearing at which the committee can ask you questions in order to show your honesty and innocence.

As Attorneys Experienced in Such Matters, We Know How to Prepare and Present Cases to Such Hearing Committees and to Successfully Convince Them of Your Position.

Our law firm and our attorneys have had a great deal of experience in dealing with the ECFMG and the USMLE on issues involving grading on the Step examinations, accusations of “irregular behavior,” testing and grading irregularities, and allegations regarding conduct which the organizations contends is “irregular behavior” (including mistakes in completing applications and affidavits). We haven’t represented many medical students and medical graduates in challenges, hearings before the committees, and on appeals.

Although, just as in medicine, in legal matters such as this one, we cannot guarantee any specific outcome or success in a case, we can advise you of our many successful cases. Finding any lawyer in the United States who has a great deal of prior experience with the USMLE or the ECFMG is very difficult. There are very, very few of us. Additionally, once you check out the backgrounds of any attorney whom you are considering, you may find that the particular attorney is not what you expect or would desire to hire. You want to hire attorneys that have a great deal of experience in this area, who know what they are doing, and who will not exaggerate or promise you that which they are not able to deliver.

Experience, Organization, and Knowledge are the Hallmarks of Our Legal Representation of You!

In our case, we tell the truth, we know what the “hot” issues are that are important to the ECFMG he and the USMLE, and we are aggressive advocates of your innocence or your position in the case. We prepare ahead of time and put together a comprehensive, detailed, and well organized presentation, through documents, which we deliver to the committee ahead of time for its consideration at your hearing. We always go to the hearing in Philadelphia, appearing with you in person at the hearing, and making the best presentation possible for you. We are by your side allo the way!

We do our best to prepare you ahead of time, going over potential questions that the committee might ask you and preparing your testimony in advance. We try not to leave anything to chance. If you are subject of a similar type of hearing, or court case, then you really do need experienced legal counsel to help you prepare. You should not try to do this alone.

Severe Consequences of Receiving a Label of “Irregular Behavior.”

There can be some very severe consequences of receiving a label of “irregular behavior,” if you do not adequately defend against such allegations. These can extend all the way from a stamp on the transcript of your Step examination scores stating “irregular behavior,” with a letter attached to it going into great detail about your “irregular behavior,” all the way to a complete ban (forever) from taking any further Step examinations, and everything in between. Even the stamp of “irregular behavior” alone can prevent you from successfully matching with residencies you are seeking or obtaining jobs you desire. This is similar to having a stamp of “Found Guilty of Cheating” on a transcript; the effect may be the same. You may find yourself being excluded from receiving interviews or invitations from residency program for which you apply.

Do not take a chance! Although legal representation may be expensive, you must consider the amount of time and money you have already spent to date to have a medical career and be willing to spend what it takes to continue that career. Don’t jeopardize it by trying to scrimp on legal fees. Remember that you usually get what you pay for.

View Our Other Blogs on Our Experience with the USMLE, ECFMG, and NBME, and Hearings on “Irregular Behavior.”

Our law firm is had a great deal of experience representing students and graduates in disputes with and defending charges of “irregular behavior” against the USMLE, ECFMG and he NBME. To review a few of these please see:
Limits on Number of Attempts and Time for Completion of USMLE Step Exams and
ECFMG Affidavit to Complete? Attending a Caribbean Medical School? Being Investigated for Irregular behavior by the ECFMG or USMLE? You need Legal Advice! Your Residency Matching Might Now Be at Issue, as Well!

Contact a Health Care Attorney Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education.

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.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 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

KeyWords: 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 © 2018 The Health Law Firm. All rights reserved.

Contracting 101: Medical Graduates Entering the Workforce, Follow These Tips!

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

This is part one, of a blog series that is intended to provide an introductory review of the basics of contracting for medical graduates entering the work force as residents and fellows, primarily by discussing employment agreements. We will highlight many of the common provisions found in employment contracts, along with many of the mistakes and pitfalls that we see in our day-to-day practice.

By the end of this informational blog, it is our hope that medical graduates will better understand the common language and terms found in employment contracts for health care professionals. The following tips are meant to assist new professionals in recognizing common mistakes made by physicians and health professionals when negotiating contract terms. We hope to help make both employers and employees more knowledgeable about employment contracts so they can avoid potential problem areas and legal entanglements.

Our comments here are meant to provide general rules we have learned from our experience. However, please remember, every situation is different and there are exceptions to every rule. These tips are not intended to constitute legal advice. We recommend contacting an experienced health attorney for questions or concerns regarding specific employment contracts, or to thoroughly review all of the contract terms prior to acceptance.

Tip 1 -“Standard” or “Routine” Physician Employment Agreements Do Not Exist.

No two employment agreements are identical. Each must be reviewed on its own terms. It is important to consult with a healthcare lawyer experienced in negotiating employment contracts and evaluating health care business transactions.

Tip 2 – Negotiation is Always an Option.

Even though an employer may have what appears to be a “standard” employment contract for all physician employees, this can have changes, amendments, schedules, exhibits or terms that are varied from physician to physician or professional to professional. Generally, large employers are less likely to change their form to accommodate the physician than small organizations, but they can and often will. Small employers are often willing to make more changes to their written agreements.

If there are any changes, additions or clarifications you need to make to the contract, then put them in writing, sign them, incorporate them into the contract and attach them to the contract.

Tip 3 – All Oral Agreements Should be Accurately Reflected in the Wording of the Contract.

If it is different or not specified, the language in the contract will govern in any future dispute.

For more information, please read one of my prior blogs on physician and employment contracts here.

In our future blogs, we will continue to provide tips on various issues to watch for in health care employment contracts.

Stay tunes for part two of this blog series.

Contact a Health Care Attorney that is Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education.

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 the following areas: 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), discrimination due to race, sex, national origin, sexual orientation and any other matters, reviewing and negotiating contracts, preparing contracts, helping employers and employees enforce contracts, advice on setting aside or voiding contracts, litigation of contracts (in start or federal court), business transactions, professional license defense, opinion letters, representation in investigations, fair hearing defense, representation in peer review and clinical privileges hearings, litigation of restrictive covenant (covenants not to compete).

To contact The Health Law Firm, please call (407) 331-6620 and visit our website at 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 the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: physician employment agreement, physician employment contract, health professional contracting, negotiating business transactions, physician contracts, contracting tips for medical graduates, contract attorney, business law attorney, business lawyer, contract lawyer, contract litigation, business litigation, employment contract terms, physician agreements, physicians entering the workforce, business transactions, restrictive covenants, noncompetition agreements, covenants not to compete, business ventures, residency and fellowship, medical graduate attorney, fellowship contract lawyer,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, health care professional representation, health care professional defense lawyer, Florida health care lawyer, The Health Law Firm reviews, reviews of The Health Law Firm attorneys

“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 © 2018 The Health Law Firm. All rights reserved.

ECFMG Affidavit to Complete? Attending a Caribbean Medical School? Being Investigated for Irregular behavior by the ECFMG or USMLE? You need Legal Advice! Your Residency Matching Might Now Be at Issue, as Well!

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Have you recently unexpectedly received an affidavit from the Educational Commission for Foreign Medical Graduates (ECFMG or the United States Medical Licensing Examination (USMLE) Secretariat? Are you attending or have you graduated from a Caribbean medical School such as the University of Science, Art and Technology (USAT), Faculty of Medicine, in Montserrat, or the Atlantic University School of Medicine (AUSOM) in St. Lucia? Then you are probably, unknowingly, being investigated for misconduct, improprieties in your medical school attendance or other “irregular behavior.” You need to consult with a lawyer and specifically a lawyer who knows and understands the processes followed by the ECFMG and the USMLE.

Large Number of Legal Inquiries Being Received from Current Students and Graduates of USAT.

A year ago, our firm was receiving a large number of calls from students and graduates of the Atlantic University School of Medicine (AUSOM) concerning inquiries and letters they were receiving from the ECFMG and/or the USMLE. However, over the past several months, we have now received an even larger number of inquiries from students and alumni of the University of Arts, Technology and Sciences (USAT) Faculty of Medicine in Montserrat. We have now seen several different affidavits which the ECF image he has sent to students and graduates of USAT which request some very specific and detailed information about their course attendance and experience as students at USAT.

Each inquiry we have received from students and graduates of USAT has disclosed facts and circumstances that are slightly different from the other. From these we have been able to piece together a fairly comprehensive picture of what is probably going on. To summarize, it appears that you SAT is under investigation by the ECF image he for the various irregularities that our clients have disclosed have occurred in the past.

Affidavits from the ECFMG and the USMLE Should Be Taken Very Seriously. They Should Be Answered Truthfully and Must Be Returned Promptly.

The Handbook and Guidelines published by the ECFMG and the USMLE, require that any student or graduate who applies for their services must promptly respond to requests for information. This would include responding to the affidavits (which are really questionnaires to be completed under oath). Otherwise, the applicant can be charged by the ECFMG or the USMLE with “irregular behavior” in accordance with the Handbook and Guidelines that they previously agreed to follow when initially applying.

We hear from our callers, clients, and potential clients that they may have received instructions from their schools or from other sources that they do not have to do send these affidavits back in or respond to these requests for information. We do not believe that this is correct and vice. If confronted by having been sent such an inquiry or affidavit by the USEMLE or ECFMG, you should immediately contact competent, experienced, legal counsel to advise you on the exact issues and facts of the situation. You will only receive advice that takes your own personal interests into consideration from your own personal attorney; you are not likely to receive it from anyone else.

View Our Other Blogs on Our Experience with the USMLE, ECFMG, and NBME, and Hearings on “Irregular Behavior.”

Our law firm is had a great deal of experience representing students and graduates in disputes with and defending charges of “irregular behavior” against the USMLE, ECFMG and he NBME. To review a few of these please see:
What to Do If You Receive an Inquiry From the USMLE, ECFMG, or NBME
GOING TO TAKE THE USMLE STEP EXAMS? BEWARE OF ACTIONS THAT CAN BE CALLED “IRREGULAR BEHAVIOR”-PART 1, and
Accused of Irregular Behavior on the USMLE? Here’s What You Will Do Wrong.

Contact a Health Care Attorney Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education.

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.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 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

KeyWords: 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 © 2018 The Health Law Firm. All rights reserved.

What to Do If You Receive an Inquiry From the USMLE, ECFMG, or NBME

By Achal A. Aggarwal, J.D., M.B.A., Attorney, The Health Law Firm

The National Board of Medical Examiners (NBME) is an organization that sets certain standards for anyone seeking licensure in the U.S. It prepares and administers state recognized examinations for medical students and medical residents, to assure they meet certain requirements for clinical knowledge (CK) and ability to interact effectively with patient using the English language, the latter know as “clinical skills” (CK). The NBME’s mission is centered on the assessment of physicians. The NBME develops and manages the United States Medical Licensing Examination (USMLE) through the USMLE Secretariat.

The USMLE is a multi-part professional examination sponsored by the NBME and the Federation of State Medical Boards (FSMB). In order to obtain a license to practice medicine or to participate in medical specialty residency programs in the U.S., one must take and successfully pass all four parts of the USMLE. Each part of the USMLE is referred to as a “step.”

Foreign medical graduates must register with and be screened by the Educational Commission for Foreign Medical Graduates (ECFMG), in order to take the USMLE step examinations and become licensed in the U.S. They must also pass all of the steps of the USMLE.

The USMLE is administered in four parts: USMLE Step 1, USMLE Step 2 Clinical Knowledge (CK), USMLE Step 2 Clinical Skills (CS), and the USMLE Step 3.

When a medical student or medical resident is suspected of compromising the validity, integrity, or security of the examination process, the USMLE and the NBME will investigate. The investigation is to determine whether or not that student or resident obtained proprietary information or helped others to cheat on the USMLE.

The Consequences of Irregular Behavior Charges.

When the USMLE, NBME, or ECFMG has initially determined that a student, medical school graduate, resident or fellow, may have committed some act that may have violated the integrity of the examination, may have attempted to gain an unfair advantage over other test-takers, or may have violated the security of the test, then it will charge that student or resident with what is called “irregular behavior.” This term could probably be interchanged with the word “cheating” but is much broader than and may encompass far more than what you would normally think of as cheating.

A charge of irregular behavior can have many unforeseen adverse consequences. Not only can these be adverse actions taken by the NBME, USMLE, or ECFMG, they may extend even wider.
The NBME, USMLE, or ECFMG may, for example void test scores, prohibit you from taking a test exam for a number of years, ban you from ever taking the step exams again, or may simply mark your transcript of test scores with the finding of “Irregular Behavior” (think of a big red stamp on your transcript that says “Irregular Behavior” or “Cheated”). However, such a finding may also result in the student’s being expelled from their medical school, not receiving a medical degree, or prevented from applying in the match program.

However, before the medical student or resident is officially charged with committing irregular behavior, the USMLE, NBME, or ECFMG sends a letter informing the individual of the charge and giving the person ceratin rights. The letter also offers the student or resident an opportunity to defend the allegation and attend a hearing in front of a committee (usually called the “Committee for Individualized Review” or CIR) in Philadelphia, Pennsylvania.

What to Do If You Receive a Letter from the USMLE Accusing You of Irregular Behavior.

The letter will usually include certain information and analysis including: the number of times the student or resident took the particular Step examination previously, the percentage of actual test questions to which the student was exposed, how well other test-takers did on the same individual questions, the time spent on the questions, the actions the person allegedly committed which violated the organization’s guidelines, and other information that may be relevant regarding the alleged “Irregular Behavior.”

Details on the rights the individual has to retake the tests or to challenge the findings by requesting a hearing is also included. These are contained in a section of the letter or in a separate attachment called “Policies and Procedures.”

If requested in writing in a timely manner, the CIR will schedule a time to review the facts surrounding the allegations (a hearing) and to hear from the individual. The person may just submit an explanation in writing without requesting an in-person hearing, but we recommend strongly against this. The student or resident may request and attend a hearing before the committee, in person or with an attorney (which we strongly recommend), if he or she so desires. The hearing takes place in Philadelphia.

Evidence may be submitted by the student, including his or her own testimony. The student may have legal representation (an attorney) with him or her at the hearing. Hearings have resulted in students having their test scores validated and being allowed to progress with their professional careers unfettered. They have also resulted in bans from ever retaking the step exams (in the most egregious cases).

Important Factors to Consider for a Hearing Before the Committee for Individualized Review.

Attending a hearing before the CIR is not a process that should be taken lightly, not is it a procedure that you should attempt without experienced counsel. We do not recommend attending such a hearing without an attorney and plenty of advance preparation.

When deciding whether or not to hire an attorney to represent you in this matter, consider the cost and time you expended in preparing for and taking these examinations. In addition, consider the time you will lose from your medical education, residency, internship, or future career if your passing scores are not validated and your studies and career are delayed. It seems illogical not to retain the services of an attorney experienced with this type of matter and this type of hearing, given the high stakes at issue. Even if you have some knowledge of law, evidence, and civil procedure, it is difficult to represent yourself while also being your own witness. Those who are not experienced in such matters will make fundamental mistakes that will harm their case.

Procedural guidelines furnished by the committee need to be followed regarding how evidence is given to the committee and presented at the hearing. Preparation for the hearing would include meetings in advance, preparation of questions and answers and other matters to help ensure a proper presentation. One who is not familiar with such proceedings may overlook key issues and concentrate on issues that are not relevant to the committee’s determination. Any presentation of documents for consideration at the hearing must include excellent organization and a professional presentation. This must be done well in advance of the hearing. In certain cases, it may be necessary to hire an expert witness if the issues and facts require it; however, live witnesses, other than the individual charged, are not allowed at the hearing. It is important to note that the CIR will have its own attorney present at the hearing and there are several attorneys who may be on the committee itself.

Finally, anyone with a charge of irregular behavior should remember that the CIR is not comprised of individuals who are “on your side.” The CIR’s purpose is to ensure that the USMLE policies and procedures are strictly enforced and will enforce them if it does not find your case convincing. The best way to make your strongest argument is to hire someone who has experience with CIR hearings and has won cases in front of it.

Everyone needs someone on their side and we strongly encourage you to hire someone who knows the process associated with Irregular Behavior and the CIR and who will fight for your right to defend yourself.

Contact a Health Care Attorney Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education.

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.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: Achal A. Aggarwal is an attorney with 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 Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: 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 © 2018 The Health Law Firm. All rights reserved.

 

Always Be Certain Your Correspondence Is Professional. Don’t Detract From Your Professional Reputation: 30 Tips (Part 2 of 3)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

This is Part 2 of a 3 part series on this issue.

I continue with my tips for preparing good, professional correspondence:

5.    Use titles or honorifics.  In the “business address” of your correspondence, always use the complete name of the person to whom you are writing (if known) together with that person’s honorific or professional title (e.g., Mr., Ms., Dr., Nurse, Prof., Dean, etc.).  This shows both respect and professionalism.

6.    Always use the complete mailing address, including title, of the person to whom you are sending it.  In the business address of your correspondence include not only the person’s name and honorifics, but title or position and division within the institution or organization to which you are sending it.  In the case of large organizations, you should include the building and suite or room numbers and any internal routing codes, designations, “mail stops” or other organizational routing codes, that the agency or business you are writing requires to route its mail internally.  Large organizations, especially government agencies, all have large mail rooms which sort and route all mail the organization receives from any source.  Correct internal routing codes will help ensure that your correspondence gets to the correct person or official in a timely manner.

7.    Always use a salutation.  This is self-explanatory, but see below.

8.    In your “salutation,” always use the person’s last name with a title or honorific.  It is customary to use the term “Dear” in a salutation in formal writing, so this is permitted.  But you may leave it out.  For example, “Dear Secretary Jones:” or “Secretary Jones:” or “Dear Dr. Johnson:” is correct.  Never refer to the person by that person’s first name in any type of formal correspondence or correspondence that anyone else might read.  Never say:  “Dear Sue:” or “Sharon:”.  Even if you know these people well enough to call them by their first names, don’t do it in this situation;  it’s unprofessional and may be interpreted as “talking down” to the person.

9.    Always end your “salutation” with a colon, not a comma.  A comma is only used in informal communications to those you know well or socially, such as a letter to your mother or a note to your girlfriend.  Unless this is your mother or your girlfriend to whom you are writing, use a colon.  For example, “Dear Secretary Jones,” or “Dear Sue,” is incorrect.  “Dear Secretary Jones:” or “Ms. Smith:” is correct.

10.    Type your correspondence or have it typed for you.  Do not send handwritten letters in formal or professional matters.  Do not write on the other person’s correspondence or documents and send it back.  Prepare and send a professional looking letter or e-mail, even if you must pay someone to type it for you (and if you are sending an e-mail, I know you can type a little bit yourself, anyway).  To do otherwise is to show laziness, disrespect and unprofessionalism.

11.    Always use a type font in your correspondence (inlcuding e-mails) of at least 12 points (10 characters per inch).  Do not use a small, difficult to read type fonts, for example, the size of the type font that most e-mail software defaults to.  Smaller type fonts than 12 points become difficult to read, especially if scanned/rescanned, faxed/refaxed or copied/recopied.  Change the default font in your e-mail software or computer word processing software, if necessary.  You can do this, regardless of how difficult it may seem at first;  I know you can do it, because I can do it.  Make your professional correspondence easier to read, not more difficult to read.

12.    Never use unprofessional looking type fonts for your communications.  Stay away from script type fonts, italics or novelty type fonts.  These are notoriously more difficult to read and look unprofessional.  You are not publishing a flyer for a high school bake sale.  Times New Roman, CG Times and similar type fonts are more professional looking and easier for a person to read.  Use Courier or Letter Gothic type fonts if necessary.

13.    Keep the correspondence to which you are responding unmarked.  One reason to not write on or mark up the other person’s documents or correspondence is that you may need them as evidence in a court of law or a hearing some day.  Nothing looks less professional than a document you are trying to use as evidence when a different person has made handwritten marks all over it.  The impression is similar to one in which a child with a box of crayons has gotten to it.  You don’t want this or need this.  Show respect and self-control.  Keep the other side’s documents pristine.  They will look much better that way as your “Exhibit 1” in the court hearing.

14.    Use a good concise, descriptive reference line or subject line (often called the “re:” line).  Make it a very brief summary.  State what the content of your letter is about.  State if you are responding to a letter or document that you received from the “addressee” (the person to whom you are addressing your correspondence) of your letter.

15.    Include the recipient’s routing information.  If the intended receiver of your letter or correspondence (the “addressee”) included reference numbers, file numbers, account numbers, case name and numbers, a policy number, a routing number, or other similar information on its letter to you, repeat these back in the reference line of your correspondence.  This will help make sure that your correspondence gets routed to the correct file and recipient more timely.  This is especially crucial in large organizations and government agencies.

16.    The contents of the body of your correspondence should be easy to read and easy to understand.  To this end, be sure to use short sentences and short paragraphs.  Each paragraph should convey one idea. Use headers and section titles, if necessary, to organize your correspondence, especially if it is lengthy.  Remember, headings within your letter that help to organize it are like street signs in a busy city.  They will really help any subsequent reader (and this may be a judge or jury) to navigate his or her way through your letter.

17.    Be sure to skip a line between each paragraph and, preferably, indent the first line of each paragraph.  [Note:  Some writers will tell you not to indent the first line of each paragraph in professional correspondence.  However, I feel that this makes the correspondence more difficult to read, so I encourage indenting or tabbing in on the first line of each paragraph.]  This makes it easier on the reader and more likely that your ideas will not get lost in a crowd of words.

18.    Keep your paragraphs short and to the point.  Nothing turns readers off as much as a single lengthy paragraph written from margin to margin taking up the whole page.  I suppose some people may have never been taught what paragraphs are.  However, I am willing to bet that most were.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at 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 the Orlando, Florida, area. www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: The Health Law Firm, legal representation for health care physicians, reviews of The Health Law Firm, tips for professional correspondence, The Health Law Firm attorney reviews, legal representation for nurses, professional correspondence for a legal dispute, owners of health care businesses defense attorney, physicians defense lawyer, 30 tips for professional correspondence, The Health Law Firm reviews

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.
By |2018-05-18T12:57:32+00:00May 15th, 2018|Medical Education Law Blog|0 Comments

UCF Medical Student and Her Furry Friend Bring Smiles to the Faces of Ill Children During the Holidays

i4Perfection150429-1A6A0291-Edit-EditBy Ritisha K. Chhaganlal, J.D.

University of Central Florida (UCF) second-year medical student, Christa Zino, and her 2-year-old adopted canine friend, Ion (a boxer), know that smiles can go a long way in healing the spirits of hospital-bound children during the holidays.  And they don’t stop there.  Zino and Ion visit Nemours Children’s Hospital (Nemours) in Orlando most Friday evenings to bring some joy to children who often have to endure extended hospital stays, arduous medical tests and procedures, and separation from family, home and school.  Most of these young children lack a normal childhood experience due to their illnesses, but Zino knows that Ion has what it takes to keep these tenacious little ones going strong regardless of their current circumstance.

That’s why even a busy schedule and final exams cannot keep Zino and Ion away from Nemours this month.  UCF Today quoted Zino as stating, “When I think it is too much and that I can’t handle everything, this reminds me…why I want to be a pediatric surgeon.  I want to help children like the ones I see every week.”

For more information on the benefits of animal-assisted activities, visit the Nemours website here.

Getting to Know Ion: 65 Pounds of Friendly Canine.

Ion is one of Zino’s three canine companions chosen by Zino to become officially certified for pet therapy.  Ion was adopted by Zino from Florida Boxer Rescue.  Zino says Ion is reserved around children and “gentle in a way he never is when he’s just with me [Zino].”  The fact that Ion is all-around a big fur ball of friendly should not be surprising considering his beginning (prior to rescue).  Apparently Ion has always lacked aggression, which most dog owners would appreciate, but ironically landed Ion on Craigslist by a disgruntled former owner who was disappointed that Ion was not a “fighting champion.”

Good riddance, however, because it seems Ion has found his perfect fit with Zino as a “health care professional,” providing therapy to others in the form of palm kisses and snuggles.  And he’s quite the hit within the UCF campus community of medical students as well, providing Zino’s fellow stressed-out and sleep-deprived classmates with a welcomed “pick-me-up” three times a week.

Zino’s Inspiration to Assist Children: Drawing From Her Own Experience.

Zino knows firsthand how dismal hospital life can be for a child because she was an extended-stay patient as a child herself.  Zino was diagnosed with a bile-duct blockage as a toddler.  With her condition being so rare in someone so young, Zino spent 18 months in and out of hospitals and away from her home and Chihuahua in Apopka, Florida.

While Zino recalls very little from her experience, the one thing she vividly remembers is her visit from a furry friend.  As reported by the Orlando Sentinel, Zino says she simply remembers “being happy” as a therapy dog sat on her bed keeping her company during a difficult time.

It was this very experience and positive memory that has led Zino to pursue a career as a pediatric surgeon as well as to carry on the grand tradition of meet-and-greets between sick children and a furry friend who shows up just in time to make them smile.

To read the full story as reported by UCF Today, click here.

Comments?

Are you currently a medical student, or are you considering a career in medicine?

Contact a Health Care Attorney that is Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education.

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.

To contact The Health Law Firm please call (407) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Kotala, Zenaida.  “Therapy Dog Brings Smiles Back to Sick Children, Medical Students.”  UCF Today: 21 Dec. 2015.  Web.  21 Dec. 2015.

Santich, Kate.  “Canine Spreads Cheer to Ill Children.”  Orlando Sentinel: 18 Dec. 2015: Final Ed.: A1 &A6.  Print.

About the Author: Ritisha K. Chhaganlal, J.D., is an attorney with 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.

KeyWords: Graduate medical education (GME), medical graduate attorney, Association of American Medical Colleges (AAMC), Accreditation Council for Graduate Medical Education (ACGME), graduate medical education attorney, lawyer for medical students, medical resident attorney, residency program legal dispute, residency program litigation, medical school litigation, legal representation for medical residents, medical students legal counsel, United States Medical Examiners (NBME) lawyer, health law attorney, The Health Law Firm, UCF medical student, University of Central Florida College of Medicine, canine therapy

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.

Copyright © 1996-2015 The Health Law Firm. All rights reserved.

 

 

By |2015-12-21T18:58:31+00:00May 15th, 2018|Medical Education Law Blog|0 Comments

Cuban Lung Cancer Vaccine Followed Up With Clinical Trials In The United States

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A lung cancer vaccine that was developed in Havana, Cuba, will be the first such clinical trial to be approved by The Food and Drug Administration (FDA) for testing to take place in the U.S.  The approval was announced on October 26, 2016, by New York Governor Andrew Cuomo with officials from the Roswell Park Cancer Institute in Buffalo, NY.  The trial could start as soon as November 2016 and will enroll around 60 to 90 patients. They are estimating that it will take about three years to complete.

This lung cancer trial will test the CIMAvax-EGF vaccine, combined with an immunotherpay drug called Opdivo. Opdivo has already been approved in the U.S. To learn more about the CIMAvax-EGF vaccine visit the Roswell Park Cancer Institute website by clicking here.

A Research Partnership.

Governor Cuomo praised the fact that the FDA’s action followed the promotion of a research partnership between Roswell and Cuba’s Center of Molecular Immunology (CIM) that occurred during a New York state trade mission in 2015.

Leading Cause of Cancer Deaths.

Lung cancer is the leading cause of cancer deaths in the U.S. There is a five year survival rate of only 17 percent of those who fall ill with lung cancer.  According to Grace Dy, the principal investigator in the Roswell Park trail, “We’re at an early stage in the development of this vaccine, which has never before been given to U.S. patients, so we have a lot to learn through this study, But the evidence so far is encouraging.”

The vaccine developed by CIM has been approved by a number of countries such as Paraguay and Peru.  Even though the vaccine has been approved by several countries already, Len Lichtenfeld, deputy chief medical officer as the American Cancer Society, has taken a cautious stance on the matter.

Litchenfeld stated, “currently we do not have the information we need to have to know whether or not this vaccine could be useful in treating lung cancer or possibly be used to prevent cancer in patients at high risks of developing lung cancer. The studies that have been reported from Cuba are small and have limitations that prevent us from knowing how the treatment could be applied to the typical patient with lung cancer.”

Currently, the United States and Cuba are working collaboratively to make certain that this vaccine will be as effectively as possible and help those suffering from lung cancer.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:
“CHIPSA Looks Into Cuban Lung Cancer Vaccine United States Is Studying.” CHIPSA Hospital. (2016). Web.

Lee, Kelvin. “Where Does CIMAvax Currently Stand?” Roswell Park Cancer Institute. (March 28, 2016). Web.

McGinely, Laurie. “In A First, U.S. Trial To Test Cuban Lung Cancer Vaccine.” The Washington Post. (October 27, 2016). Web.

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 the Orlando, Florida, area. www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for Food and Drug Administration (FDA) investigations, FDA investigation fraud defense attorney, legal counsel for clinical research, clinical research defense attorney, reviews of The Health Law Firm, The Health Law Firm reviews, misconduct in science legal defense, clinical investigator defense attorney, institutional review board (IRB) investigation defense, legal representation for health care professionals, Department of Health (DOH) investigation defense attorney, scientific investigation attorney, legal counsel for Food and Drug Administration (FDA) investigations, Food and Drug Administration (FDA) investigations defense attorney, The Health Law Firm, clinical investigation misconduct defense counsel, National Institutes of Health (NIH) grant fraud defense attorney, Office of Research Integrity (ORI) defense attorney

“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 © 2016 The Health Law Firm. All rights reserved.

 

By |2016-12-19T07:00:46+00:00May 15th, 2018|Medical Education Law Blog|0 Comments

Medical School Applications Reach an All-Time High in 2015: Good News in the Face of Physician Shortage

i4Perfection150429-1A6A0291-Edit-EditBy Ritisha K. Chhaganlal, J.D.

The Association of American Medical Colleges (AAMC) reported in March of 2015, that by the year 2025, demand for physicians will exceed the supply by a projected shortfall of 46,100 to 90,400.  Although significant, these numbers are much smaller than numbers previously projected in a 2010 study.  That study reported demand to exceed supply by 130,600.  One of the factors supporting the difference between the 2015 and 2010 projections is the rise in the number of physicians completing their graduate medical education from 27,000 to approximately 29,000 annually.

To read the full Final Report addressing The Complexities of Physician Supply and Demand: Projections from 2013 to 2025 submitted by IHS Inc. for AAMC, click here.

With this being the case, the new number of medical school enrollees for 2015, should shed some hope over these dismal projections.  According to data released by AAMC in October 2015, the number of students enrolling in medical schools across the nation has increased by a whopping 25 percent since 2002, reaching an all-time high of 20,630 this year.  Locally, the University of Central Florida (UCF) College of Medicine received 4,875 applicants this year.  That is an increase from last year by about 700 applicants.  Overall, the number of medical school applicants rose by more than 6 percent in 2015, which doubles the percentage of 2014.

https://www.aamc.org/download/446454/data/applicants2015large.png

Increased Efforts to Diversify.

President and CEO of the AAMC, Darrell G. Kirch MD, stated, “The nation’s medical schools are creating innovative education and training programs to prepare tomorrow’s doctors to meet the challenges of the changing health care environment.  This dynamic landscape is leading to a record number of students applying to and enrolling in medical school.”

Dr. Kirch is hopeful that the consistent increases in the number of applicants and the broadened diversity of students enrolling in medical school will continue.  Dr. Kirch encourages medical schools to sustain efforts in their communities to diversify the applicant pool through pipeline programs, outreach efforts and holistic review initiatives.

The year 2015 brought increases in nearly every racial and ethnic category as medical school classes continued to diversify.  Most significantly, African American enrollees rose by 11.6 percent from last year, with the number of applicants increasing by an impressive 16.8 percent.  The number of Hispanic or Latino applicants was not far behind with a marked 10.3 percent increase from last year.  This category saw an increase in enrollees as well.  And while the percentage of male enrollees versus female enrollees remained consistent with last year’s numbers, first-time applicants saw a 6.2 percent increase among women.

To read more about the overall increases in applicants and enrollees, click here.

Physician Shortage May Still Persist.

In a statement released in March 2015, Dr. Kirch said, “The doctor shortage is real–it’s significant–and it’s particularly serious for the kind of medical care that our aging population is going to need.”  Dr. Kirch relied upon the study conducted by the Life Science division of IHS Inc. for AAMC in support of his statement.  The study shows that physician demand over the next decade is projected to grow faster than supply by up to 17 percent.  Furthermore, the forecast is believed to persist under every likely scenario including:

(a)    increased use of advanced practice nurses (APRNs);

(b)    greater use of alternative settings such as retail clinics;

(c)    delayed physician retirement;

(d)    rapid changes in payment and delivery; and

(e)    other modeled scenarios.

Dr. Kirch contends, “Because training a doctor takes between five and [ten] years, we must act now, in 2015, if we are going to avoid serious physician shortages in 2025.”  Dr. Kirch believes that the solution for the higher-end physician shortage projections will require a multi-pronged approach.  This approach includes:

(a)    innovation in delivery;

(b)    greater use of technology;

(c)    improved, efficient use of all health professionals on the care team; and

(d)    an increase in federal support for residency training with the goal being to train at least 3,000 more doctors each year.

The study confirmed that no single solution is sufficient on its own in providing a resolution to the physician shortages.  It must be a collaboration of efforts.  And according to Dr. Kirch and judging by this year’s numbers, it would seem medical schools are most certainly doing their part to prepare the next generation of health care professionals able to take on the growing health care needs of our aging population.

To read more about the key findings on the physician supply and demand through 2025, click here.

Contact a Health Care Attorney that is Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education.

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.

To contact The Health Law Firm please call (407) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

“Medical School Applicants, Enrollees Reach New Highs.”  Association of American Medical Colleges: 22 Oct. 2015.  Web.  29 Dec. 2015.

Miller, Naseem S.  “Medical School Applications Increased in 2015.”  Orlando Sentinel: 26 Oct. 2015.  Web.  28 Dec. 2015.

“New Physician Workforce Projections Show the Doctor Shortage Remains Significant.”  Association of American Medical Colleges: 3 Mar. 2015.  Web.  29 Dec. 2015.

About the Author: Ritisha K. Chhaganlal, J.D., is an attorney with 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.

KeyWords: Graduate medical education (GME), medical graduate attorney, Association of American Medical Colleges (AAMC), Accreditation Council for Graduate Medical Education (ACGME), graduate medical education attorney, lawyer for medical students, medical resident attorney, residency program legal dispute, residency program litigation, medical school litigation, legal representation for medical residents, medical students legal counsel, United States Medical Examiners (NBME) lawyer, health law attorney, The Health Law Firm, UCF College of Medicine applicants, UCF College of Medicine enrollees

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.

Copyright © 1996-2015 The Health Law Firm. All rights reserved.

By |2015-12-30T15:05:17+00:00May 15th, 2018|Medical Education Law Blog|0 Comments

New Analysis Shows Number of Residency Positions Keeping Up With Increase in Medical Graduates

i4Perfection150429-1A6A0291-Edit-EditBy Ritisha K. Chhaganlal, J.D.
According to a study done by the Association of American Medical Colleges (AAMC), the number of students enrolling in medical schools has reached an all-time high.

In 2014, the total number of applicants rose by 3.1 percent. AAMC President, Darrel G. Kirch M.D., expressed concerns regarding the availability of residency training positions for aspiring doctors. Dr. Kirch stated: “As we face a worsening shortage of both primary and speciality physicians over the next two decades, Congress must increase federal support for residency training by lifting the 17-year-old cap on residency training positions imposed under the Balanced Budget Act.” To read the AAMC’s press release in its entirety, click here.

It is unsurprising that medical students across the nation are concerned about securing a residency position after graduation. However, an analysis conducted by The New England Journal of Medicine (NEJM) suggests that this General Medical Education (GME) “squeeze” is actually not as severe as many believe.

History Behind Medicare Resident Limit Caps.

The Balanced Budget Act of 1997 (BBA) was established to cap the number of residents and fellows for the purposes of calculating Medicare reimbursements against each hospital’s most recent cost report. There are a few exceptions; the BBA cap on the number of residents does not apply to new programs in underserved rural areas for three years. After three years, these programs are considered to have enough time to fill their residency cohorts.

The Medicare program is the largest source of funding for GME. Given this limit of funding, many believe that it will also limit the number of residents and fellows.

Analysis Indicates Growth in Entry-Level GME Positions.

The NEJM studied data from the Accreditation Council for Graduate Medical Education (ACGME), AAMC, and the American Association of Colleges of Osteopathic Medicine (AACOM), for the time periods of 2004-2005 and 2013-2014. The NEJM found that entry-level GME positions increased from roughly 25,000 in 2004-2005, to about 29,000 in 2013-2014. This is a total increase of approximately 4,000 positions. Additionally, the number of U.S. graduates with M.D. and D.O. degrees grew from about 19,000 in 2004-2005, to roughly 23,000 in 2013-2014. This is an increase of approximately 4,000 graduates.

If the number of GME positions increases as it has been over the past decade, it is projected that there will be approximately 34,000 positions for medical graduates entering their first year of residency in 2023-2024. The number of medical students is expected to increase due to newly opened M.D. and D.O. schools. As a result, it is assumed by AAMC that a 2.4% annual growth of medical graduates will continue onto 2023-2024.

In 2023-2024, the number of graduates projected will be marginally more than 29,500. With these numbers, there will be approximately 4,500 more open positions for residency than U.S. medical graduates in 2023-2024. While the number of positions available to graduates compared to 2013-2014 is less, the amount of GME positions will still significantly exceed the amount of U.S. medical graduates.

What Does this Mean for Medical Graduates?

Although the amount of GME positions will exceed the amount of medical graduates, the gap is still narrowing over the years. Over the past 50 years, medical graduates benefitted from “selection subsidy,” which allowed them to start residency at the location and in the speciality of their own choosing. However, the likelihood of a medical graduate finding the exact location and speciality he or she desires may not be an option anymore. Despite this, the most intense competition for these residency positions lies amongst the International Medical Graduates (IMGs). Although U.S. graduates will be affected by this slight “squeeze,” IMGs face an overall tougher road. To read one of our previous blogs focusing on future physicians, click here.

Comments?

Do you think there is not enough residency positions to meet the influx of medical graduates? Do you think Congress should fund more GME positions in order to create a larger margin for U.S. graduates?

Contact a Health Care Attorney that is Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education.

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 indiviuals 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.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

Sources:

Vernon, Jamila. “More Students Going to Medical School Than Ever Before.” AAMC. October 29, 2015. Web.

“Why a GME Squeeze in UNlikely.” NEJM. November 4, 2015. Web.

“Medicare Resident Limits.” AAMC. Web.

“US Residency Training Before and After the 1997 Balanced Budget Act.” JAMA. September 10, 2008. Web.

About the Author: Ritisha K. Chhaganlal, J.D., is an attorney with 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.

KeyWords: Graduate medical education (GME) positions, international medical graduate attorney, Association of American Medical Colleges (AAMC), Medicare resident limit caps, Accreditation Council for Graduate Medical Education (ACGME), American Association of Colleges of Osteopathic Medicine (AACOM), graduate medical education attorney, lawyer for medical students, medical resident 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 Examiners (NBME) lawyer, teaching hospital plaintiff attorney, health law attorney, The Health Law Firm

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2015 The Health Law Firm. All rights reserved.

By |2015-12-10T19:18:12+00:00May 15th, 2018|Medical Education Law|0 Comments

Universities Turning to New Unconventional Strategies to Prevent Medical Errors

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A study by patient safety researchers published in the British Medical Journal (BMJ) in 2016 revealed that common medical errors are now the third leading cause of death in the United States. Now, universities are looking to address this problem by focusing on ways of teaching students, clinicians and administrators to look at these problems in a new light.

Click here to read the study published in the BMJ.

Teaching a Martian to make a PB & J Sandwich.

These new programs focus on the importance of communicating medical directions. So, what does making a peanut butter and jelly sandwich have to do with preventing medical errors? Well, the program sheds new light on just how carefully worded medical directions need to be. For example, students in these new programs are directed to explain how to make the sandwich to someone who is completely unfamiliar with the English language, such as a Martian.

Simple directions become much more confusing to those who are not familiar with our ways of speaking. Donna Woods, an associate professor who directs this new course work, further elaborated on this concept by saying, “Invariably the student will write, ‘open the bag of bread’ and so the acting patient (the Martian) rips the bottom of the bag of bread instead of opening the twisty tie at the top of the bag.”

The new method is meant to teach the students that their directions can often be misunderstood and not carried out as intended. Therefore, medical professionals need to be aware of this and be very precise in their delivery of medical directions.

The Importance of Doctor-patient Communications.

The new course also focuses on doctor-patient communications and has implemented an unconventional method of teaching it. The class splits into two teams and are directed to build the tallest building possible. They are to build according to how the customer or in their case, the patient desires it. In this study, the patients were instructed to only reveal how they wanted their building to look if asked. This method highlights how in the hustle and bustle of the medical world, the act of asking patients what they need and want is often overlooked.

This type of course, paired with new methods, are designed to show students why the medical field can be so complicated and the ways in which they can improve it to avoid common medical errors.

To learn more on the dilemma of medical errors in the U.S., click here to read one of my prior blogs.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm we provide legal services for all health care providers and professionals. We represent physicians accused of wrongdoing, in patient complaints and in Department of Health investigations. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, Durable Medical Equipment suppliers, medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. We represent facilities, individuals, groups and institutions in contracts, sales, mergers and acquisitions.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing physicians in investigations and at Board of Medicine and Board of Osteopathic Medicine hearings.

To contact The Health Law Firm, please call (407) 331-6620 and visit our website at www.ThehealthLawFirm.com.

Sources:

Sweltlitz, Ike. “Teaching a Martian to make a sandwich helps clinicians catch medical errors.” The Boston Globe. (November 7, 2016). Web.

White, Jesse. “5 strategies for hospitals to prevent medical errors.” Healthcare Business Technology. (May 19, 2016). 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 the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

Key Words: New course work to prevent medical errors, medical errors in the health care field, legal representation for medical errors, importance of communicating medical directions, importance of doctor-patient communications, medical errors defense attorney, medical negligence defense attorney, legal representation for health care professionals, legal representation for medical students, legal representation for medical fellows, legal representation for medical residents, medical student defense attorney, defense attorney for medical fellows and residents, reviews of The Health Law Firm, The Health Law Firm attorney reviews

“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 © 2016 The Health Law Firm. All rights reserved.

By |2016-11-23T16:09:00+00:00May 15th, 2018|Medical Education Law Blog|0 Comments
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