Medical Education Law Blog

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It is Always a Bad Idea For a Doctor to…

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

In my 30 plus years of practice representing physicians, dentists, nurses and psychotherapists, I have defended clients involved in many different situations. Several of these seem to be problem areas which we see repeatedly.

Following is a list of those problems which it would seem to be common sense for a physician or other health care professional to avoid doing. If you do any of these you can rest assured that you will eventually be confronted with charges and an investigation by your state licensing board, the Drug Enforcement Administration (DEA), your national certification board, any facility at which you have privileges and other law enforcement agencies.

I can assure you, it is always a bad idea for a physician or other health care professional to:

1. Write a prescription for any medication for yourself.

2. Start a romantic relationship with a patient.

3. Take someone else’s prescription medication, ever.

4. Write a prescription for or treat a patient, especially a family member, for a condition outside the scope of his or her specialty (e.g., a dentist prescribing antibiotics to her children to treat a cold; a pediatrician prescribing pain medications for an adult; an OB/GYN prescribing antidepressants for a male).

5. Write any prescription for or treat any patient who is in another state when the physician is not licensed in that state.

6. Treat or prescribe for any spouse, other family member, friend or colleague, without opening a medical record and fully documenting the treatment or prescription, as you would for any other patient.

7. Hire a patient to work for you in your office or allow a patient to “volunteer” to work in your office.

8. Pre-sign blank prescriptions for your Physician Assistant, ARNP, Medical Assistant, receptionist, or anyone else, to complete later.

9. Seek psychotherapy or drug/alcohol abuse treatment with a physician or HCP health professional in your own medical group, institution or the staff of your hospital.

10. Add to, alter or change any medical/dental record entry after you know there may be a claim, investigation or litigation involving it.

11. Take and use your own drug samples provided by pharmaceutical companies.

12. Go into a hospital where you do not have clinical privileges and treat or “assist” in treating a patient there, even if it is your own patient.

13. Have a sexual relationship ( including “sexting” or “telephone sex”) with a patient or patient’s immediate family member.

14. For a mental health professional (psychiatrist, psychologist, mental health counselor, social worker, psychiatric nurse practitioner) to have any type of social relationship with a current patient.

If you find yourself doing any of the items listed above, don’t wait until it’s too late. An experienced health care attorney can help guide and defend against licensing issues including investigations from your state licensing board and the DEA.

Contact Health Law Attorneys Experienced with Investigations of Health Professionals and Providers.

The attorneys of The Health Law Firm provide legal representation to physicians, nurses, nurse practitioners, CRNAs, dentists, pharmacists, psychologists and other health providers in Department of Health (DOH) investigations, Drug Enforcement Administration (DEA) investigations, FBI investigations, Medicare investigations, Medicaid investigations and other types of investigations of health professionals and providers.

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: Items health care professionals should avoid doing, investigation by state licensing board, Drug Enforcement Administration (DEA), licensure defense for health care professionals, legal representation for health professionals, DOH investigations, The Health Law Firm reviews, reviews of The Health Law Firm Attorneys, 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 © 2016 The Health Law Firm. All rights reserved.

 

By |2016-10-17T07:16:26+00:00May 15th, 2018|Medical Education Law Blog|0 Comments

Medical Residency and Fellowship Program Problems: Do’s and Don’t’s of Dealing with Graduate Medical Education (GME) Programs

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

Medical residents and fellows, often when experiencing problems with their graduate medical education (GME) programs, wait until it is too late to think of consulting with an experienced healthcare attorney regarding possible solutions. Even when it may appear to be too late, it may not actually be too late to recover.

Try to take appropriate actions and make informed decisions at the earliest possible stages; try not to wait until you have received a notice terminating you to consult with an experienced health lawyer.

Medical Residents and Fellows Play Two Different Roles and Have two Different Sets of Rights.

Always remember that, as a resident or fellow, you actually have two different positions and two different sets of rights apply to you.

First, you are a learner (similar to a student) in an education program. In a teaching hospital or other GME program, you have certain academic rights afforded to you by virtue of this academics arrangement. These may arise from the requirements imposed by certifying bodies such as the Accreditation Council for Graduate Medical Education (ACGME) or the American College of Obstetrics and Gynecology (ACOG). Such standards are usually embodied in both the program’s GME Manual/Handbook and in the separate Residency or Fellowship Program Manual/Hanbook for that medical specialty program. These will include the right to file grievances regarding adverse decisions and the right to hearings and appeals (and other “due process rights”) on adverse actions and decisions.

Whether the adverse action is a failing grade in a rotation, placement on probation, placement on a personal improvement plan (PIP), a requirement to remediate a course, exam or rotation, or a termination from the program, it is important to know what your rights are and to exercise them, at the earliest possible time.

Second, you are an employer of a hospital or institution, as well. You have a written employment contract. You have rights such as to be free from discrimination of various forms. You have the other rights all employees have as set forth in numerous state and federal laws, as well as in the employer’s employee handbooks, manuals and policies and procedures.

If you are being sexually harassed, then you should file a complaint with your employer’s Human Resources Department followed by one with the federal Equal Employment Opportunity Commission (EEOC) or equivalent state agency (such as the Florida Commission on Human Relations Commission or FCHR). If you are being forced to work in a hostile work environment because of discrimination based on your race or nationality, then you should also file a complaint as above. If you have any type of mental or physical handicap or disability or any type of mecial condition which may affect your ability to perform (ADHD being the most common one we have seen) then you should give your employer notice of this and request reasonable accommodations to help you (most employers have online forms or forms available from the Human Resources Office for this. But do this at the earliest possible opportunity, preferably, at the very start of your residency or fellowship.

Be sure you obtain, review and save copies of all of the handbooks, manuals, and policies and procedures discussed above.

Know What the ACGME Says Your Program’s Obligations Are to You as a Resident or Fellow.

Also, review what the ACGME says your program must be doing to properly perform its role as a teaching institution. Go onto the ACGME website and review these requirements. These include, for example, providing regular and meaningful feedback on your performance and being sure you are given the proper opportunities to know what your perceived deficiencies are and to correct them.

If these are not embodied in the institution’s GME Program Manuals/Handbooks, then the program is deficient and may be subject to losing its accreditation.

Advise Your Program Director and the Head of the GME Program If the Program’s Obligations to You Are Not Being Met.

If you are not receiving timely and appropriate feedback on your performance, both formal and informal, give written notice to the Program Director, with a copy to the GME Office requesting that it be placed in your GME file.

If you receive an adverse evaluation because of bias or prejudice, immediately give written notice to the Program Director, with a copy to the GME Office requesting that it be placed in your GME file.

If you are given warnings, counseling, adverse evaluations, remediation or performance plans that are based on incorrect facts, immediately rebut these, in writing, using neutral and objective statements. Provide a copy of this to the Program Director, with a copy to the GME Office requesting that it be placed in your GME file, attached to the document it rebuts.

If you have personal problems, family problems, medical problems or other problems that are affecting your ability to perform, then ask for as much time off as you may conceivably need to take care of these, even if it means taking unpaid time off or an extended leave of absence. It is much better to address this type of issue up front and make up missed rotations and exams than to ignore them and fail. To learn more, click here to read one of my prior blogs on this issue.

You Need to Recognize Problems and Take the Appropriate Actions, Too.

If you have medical problems which affect your performance, seek the correct type of treatment from the appropriate medical specialist, and stay in follow-up treatment. If you have ADHD with which you are coping, you need a good psychiatrist to help you manage it, not a family practice physician. If you are dealing with post-traumatic stress disorder (PTSD), you need a good psychiatrist to help you manage it, not an OB/GYN or mental health counselor. But you also need to apply for reasonable accommodations.

If you are not the brightest person to ever graduate from medical school and you are in the best, hardest, most sought after residency program, maybe you are in over your head. Maybe you should consider changing to a different program before you are terminated form this one.

I represented a resident once who had been diagnosed with cancer twice while in residency. Twice he went through chemotherapy and radiation treatments and defeated the cancer. He also attempted to return to the program, to resume a very demanding schedule and not take time off to properly recuperate. He could have and should have taken a year’s leave of absence for each cancer he had.

He wound up being terminated. He did not recognize his limitations or ask for appropriate accommodations. On the other hand, he was lucky to be alive and to be a doctor, regardless of failure to complete his residency.

Take Action to Protect Your Rights and Request the Appropriate Remedies.

Know your rights under your GME program. Seek the advice of experienced legal counsel at the earliest possible time, even if only to review your options and help decide on a course or action.

Know and exercise your rights as an employee, but remember, you are a special type of employee. Seek the advice of experienced health care legal counsel at the earliest possible time, even if only to review your options and help decide on a course or action.

These problems and issues are ones for a board certified healthcare lawyer, not an employment lawyer, contract lawyer, trial lawyer or criminal defense lawyer. Know the difference. Click here to read about the qualifications of a board certified healthcare lawyer.

You must Exhaust Your Remedies Within Your Program First, If You Decide You must Sue in Court Later.

Don’t believe that you can just go out and sue in court and achieve what you want. First, courts are very reluctant to second guess academic decisions made by teaching institutions. They just don’t like to be in the business of second-guessing clinical professors and academicians. They don’t have the training and knowledge to do so, in many cases. Second, courts expect that you have gone through any internal administrative remedies that you may have within the program (called “exhaustion of administrative remedies”). This includes grievances, appeals, academic hearings and due process provisions. A court will not entertain a case until you have done so, so you may as well go ahead and get this done. To read what our firm does in the area of complex litigation, click here.

However, if you are in a program in a state or federal hospital or university program, you will have greater due process of law rights available to you to enforce in court under the U.S. Constitution and state laws than what you would have in a private institution.

Also remember that in court litigation, your GME handbook or manual, your Program handbook or manual and your program’s or hospitals policies and procedures will be your “GME contract” which you can enforce, in addition to your written employment contract.

Remember That External Complaint Mechanisms Are Also Available That May Help Remedy Your Situation.

We discussed filing discrimination and harassment complaints with ouside agencies such as the EEOC and the state human relations commission (such as teh Florida Commission on Human Relations). However, you can also file a complaint with the ACGME or other accrediting body, if the program is not meeting its standards. For information on how to do this, click here.

The U.S. Department of Health and Human Services (HHS), Office of Civil Rights (OCR), may also be an appropriate place to file a complaint, under many circumstances. For examples, click here.

For more information on what we, as healthcare lawyers, can do to help you, please visit this article on our website.

Contact Experienced Health Law Attorneys Representing Medical Students, Residents and Fellows.

The Health Law Firm routinely represents medical students, residents and fellows who run into difficulties and have disputes with their medical schools or programs. We also represent 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. Our attorneys can represent you anywhere in the U.S. and anywhere in Florida.

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.

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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 © 2018 The Health Law Firm. All rights reserved.

By |2018-04-05T19:17:57+00:00May 15th, 2018|Medical Education Law Blog|0 Comments

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.

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“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

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

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

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

What Medical Students Need to Know About a Finding of “Irregular Behavior” on a USMLE Step Transcript – Part One

i4Perfection150429-1A6A0291-Edit-EditBy Ritisha K. Chhaganlal, J.D. and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health

The United States Medical Licensee Examination (USMLE) Step exams are a major component of students’ journey through medical school.  Most students focus on preparing a study plan and earning the ideal score to get into a residency program of their choice.  However, many medical students are not aware of the potentially career-damaging finding of “Irregular Behavior” on their USMLE Step transcript.

In this two-part series blog, we will discuss what constitutes irregular behavior and what the next course of action should be if there is a finding of irregular behavior.

What is Irregular Behavior?

In short, irregular behavior is typically regarded as cheating by medical school officials and residency program directors, even though it is not exactly the same thing.  Any such finding will be stamped on a USMLE transcript with a detailed letter of explanation attached to it.  This letter may come from the National Board of Medical Examiners (NBME), the USMLE, or the Educational Commission for Foreign Medical Graduates (ECFMG).  Regardless of the organization it came from, the letter alleging irregular behavior typically states the following:

-A bulletin or policy related to the exam stating that irregular behavior is not permitted.

-The facts alleging irregular behavior in this case.

-The opportunity to respond to the allegations, in person, with counsel.

What a Finding of Irregular Behavior Can Mean for Medical Students.

A finding of irregular behavior can be a career ending event.  At the very least, it may delay graduation from medical school.  It may also disqualify medical graduates from many jobs or residency positions.  Additionally, USMLE Step scores are withheld from the test-taker while the USMLE Committee reviews the matter, or until a hearing has been held.

If a finding of irregular behavior is made, then usually the test-taker’s best score is voided and he or she must retake the exam.  The USMLE committee may also require the test-taker to wait a year or more to retake the exam.  Further, the finding of irregular behavior will be stamped on the test-taker’s USMLE transcript and visible to anyone that views it.

Conduct Defined as “Irregular Behavior.”

The USMLE defines “irregular behavior” as conduct that includes (but is not limited to) the following:

(1)    Seeking, providing, or obtaining unauthorized access to examination materials;

(2)    Providing false information, making false statements, or similar conduct in relation to application forms, scheduling permits, or related documents;

(3)    Taking an examination when the examinee is not really eligible for it (or attempting to do so);

(4)    Impersonating another test-taker or engaging a different person to take the examination for the actual applicant;

(5)    Obtaining, giving, or receiving assistance during the examination or attempting to do so (except for certain authorized acts);

(6)    Making notes in the secure areas of the test center, except for notes on the writing materials provided at the test center for this purpose;

(7)    Failing to comply with or follow any USMLE policy, procedure, or rule;

(8)    Failing to follow instructions of the test center staff;

(9)    Abuse or harassment (verbal or physical) of test center staff or any other disruptive or unprofessional behavior at the test center;

(10)    Being in possession of any unauthorized materials, including photographic equipment, or communication or recording devices, including electronic paging devices and cellular telephones, in the secure testing areas;

(11)    Changing or misrepresenting your examination scores to others;

(12)    The unauthorized reproduction of any examination materials or dissemination of them by any means, including via the Internet (this includes, for example memorizing them and repeating them, restructuring them, discussing the actual questions and answers, etc.). Note: all test questions and testing materials are copyrighted. You could be prosecuted or sued for violation of the NBME’s copyrights, and this has actually happened; and

(13)    Communicating or attempting to communicate about specific test questions, answers, items, or cases with any other examinee, potential examinee, or preparation group at any time.

Other Negative Findings by USMLE That May Be Detrimental.

In addition to irregular behavior, USMLE has also accused a test-taker of “Anomalous Results.”  This means that a test-taker made answer selections that look suspect (i.e., putting down answer choice “C” for every question).  For more information about other negative findings by USMLE, contact our office.

Stay tuned for the second part of this two-part blog series on irregular behavior where we will discuss the steps that are recommended to combat a finding of irregular behavior.

Comments?

Have you been accused of irregular behavior? How did you handle this allegation? Do you think a report of irregular behavior would hurt your professional career in any way?

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 state 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 covenants (covenants not to compete).

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

4 Indest-2009-3About the Authors: Ritisha K. Chhaganlal, J.D., is an attorney with The Health Law Firm.  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: United States Medical Licensee Examination (USMLE) Step exams, irregular behavior, 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, National Board of Medical Examiners (NBME) lawyer, health law attorney, The Health Law Firm, Educational Commission for Foreign Medical Graduates (ECFMG), anomalous results, USMLE Step transcript

“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 © 1996-2016 The Health Law Firm. All rights reserved.

 

By |2016-01-28T16:13:13+00:00May 15th, 2018|Medical Education Law Blog|0 Comments

Investigating Caribbean Medical Schools for USMLE Irregularities

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

We are asking whether the National Board of Medical Examiners (NBME), perhaps acting through the Educational Commission for Foreign Medical Graduates (ECFMG), is investigating Caribbean medical schools such as Ross University School of Medicine, Dominica, West Indies (RUSM); Aureus University School of Medicine, Aruba (AUSM); American University of the Caribbean School of Medicine, St. Maarten (AUCSM); Atlantic University School of Medicine, St. Lucia (AUSOM); or others, based on recent potential client consultations. We have had recent reports that seem to indicate at least one such investigation might be ongoing and relate to allegations that students may have been advised to falsify information provided on applications to take the United States Medical Licensing Examination (USMLE), Step 1, Step 2CK and Step 2CS.

Providing incorrect. incomplete or false information on an application to take one of the Step examinations is, of course, defined as “irregular behavior.”  This is a term used by the USMLE to refer to a number of different types of situations.  Please see a previous blog I wrote on this subject by clicking here.

Unfortunately, if you are accused of irregular behavior and you are not successful at disproving this charge, your transcript of USMLE step examination test scores will be marked with an entry of “Irregular Behavior.”  It is on there for life.  To someone reading this transcript, this often is interpreted the same as “Cheater.”  We have heard from those who have suffered this outcome that it has prevented them from matching for residencies and obtaining jobs.  To see another blog I wrote about this, click here.

From what we have been able to piece together, there are allegations that one or more staff members at one or more Caribbean medical schools advised to delete any reference to a prior medical school attended on that person’s application to take a Step examination.  Why this could have been done, we can only speculate.

Regardless, we have been informed that officials from one or more of the organizations involved in approving those who sit for the Step exams have been requesting affidavits from students relating to all of the facts and circumstances surrounding such advice from a medical school employee.  In another case, we have seen a written request from one of the organizations for any information regarding any conversations that student had with officials at two different Caribbean Universities, including complete details.

The last such big scale investigation of which we were aware centered around the now defunct Optima University prep course cheating scandal involving hundreds of foreign medical graduates.  To read an article I wrote on this, click here:

To see a blog I wrote on this, click here:

Hopefully, this matter will not turn out to be as serious as the Optima University matter was.

For some tips on preparing for a hearing to defend against allegations of irregular behavior, see this prior blog I wrote by clicking here.

Regardless, if you are approached by an investigator, receive a letter asking for an affidavit or statement from you or if you are accused of irregular behavior, please at least consult with a good, experienced attorney who knows about such matters before you do anything else.

What characteristics should you be looking for in an attorney to represent you in such cases?  Here are some questions I suggest you ask or research to obtain answers to before hiring an attorney.

1.
  What is your legal specialty?  Do you have one?  Is it recognized as a legal specialty by your state Bar association and supreme court?

2. 
Are you familiar with the NBME, USMLE and ECFMG, and hearings on irregular behavior?  Explain.

3.  How many hearings have you done where you appeared before a committee on irregular behavior of the ECFMG or NBME?

4.  How many physicians have you represented and in what types of cases?

5.  How long have you been practicing law?

 6.  Have you ever been disciplined by your state bar or any court or organization before which you practiced? (Research this one for yourself.)

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.

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By |2016-12-23T06:00:22+00:00May 15th, 2018|Medical Education Law Blog|0 Comments
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