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

If you are one of those unlucky individuals who have been accused of irregular behavior by the Educational Commission for Foreign Medical Graduates (ECFMG), then it is extremely important for you to know this information.

ECFMG hearings on irregular behavior are almost always held in Philadelphia, Pennsylvania before a large committee appointed to hear such cases. The committee is composed of doctors, medical school administrators, members of various medical specialty associations, and others. The hearings are usually held in a conference room of a large hotel, in closed session (not open to the public).

Since live witnesses (other than yourself) are not permitted, it is very important that any witness testimony of any kind be reduced to writing, preferably in the form of an affidavit, and submitted prior to the deadline you are provided.

Although it is our best advice that you retain the services of an experienced health lawyer, specifically one experienced in dealing with the ECFMG and in representing applicants in ECFMG hearings on irregular behavior, below we have listed helpful tips we have gathered through our years of experience.

The following are some tips to assist in ensuring your rights are protected.

1. Be sure to request a complete copy of the ECFMG’s file and work case, including any investigation, incident reports, videos, or other materials, before you file a response.

2. Be sure that you file your statement, explanation, or other appropriate documents (depending on the facts and circumstances of your case) prior to the deadline given in the initial letter to you. Document its transition and receipt.

3. If you need an extension of time, request this in writing prior to the expiration of the deadline given to you in the original letter. Do this in writing and keep a copy.

4. Be sure that you request in writing a hearing and to appear in person at the hearing prior to the deadline given in the initial letter to you.

5. If you are unable to appear in person at the hearing in Philadelphia, Pennsylvania, on the date provided in the initial letter, ask that your hearing be postponed until the next available date, and provide good, sufficient reasons why you are unable to attend on the original date given.

6. Be very careful and deliberate about what you state in writing. Any statement you make should be well-organized, professionally prepared, and supported by adequate, relevant, affidavits and documents. This is another reason why you should have an attorney preparing and submitting this for you.

7. In some cases, we recommend hiring an expert to review the case and provide us an expert affidavit to submit. This may be the case when confronted with charges based on statistical analysis, computer systems issue, testing procedures, questionable documents, or other technical matters.

8. Your statement and presentation should directly address the allegations made against you. You are strongly encouraged to review the blog I previously wrote on preparing professional correspondence.

9. Never lie or submit any false information or documents. The ECFMG will thoroughly investigate any suspicious or questionable facts or materials you submit. This can extend to the use of private investigators to locate and interview witnesses, the use of questioned document examiners to analyze documents submitted, and other such methods.

10. Get prepared for your hearing. Think about and rehearse what you will say. You will be under a lot of stress, in front of about 20 people, most of whom will be asking questions to you. If you are not ready for this, it will be to your detriment.

11. Expect the usual questions. But then, also expect the unusual questions that you may be asked. Plan for what questions may be asked by the Committee members. We always prepare our clients to testify and to be prepared to answer various questions that we know are likely to be asked.

12. Remember that you will be in an alien situation, one which you have probably never experienced before. Plan for this. Obtain as much information about the situation as you can. If you are not used to attending contentious hearings and being cross-examined and interrogated (which 99.9% of doctors are not), then you need to have an experienced attorney sitting next to you.

These are important matters that will affect your future career as a physician. Consider how much time you have spent and how much in tuition, fees and student loans you have incurred to get this far. Is it smart to scrimp at this point in time and take the cheap way out by either trying to represent yourself or finding a cheap, inexperienced attorney to represent you?

Contact a Health Care Attorney Experienced in the Representation of Medical Students, Interns, Residents and Applicants, Fellows and Those Involved in Graduate Medical Education, and those being challenged by the National Board of Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG)

The Health Law Firm and its attorneys represent interns, residents, fellows and medical school students in disputes with their medical schools, supervisors, residency programs and in dismissal hearings. We have experience representing such individuals and those in graduate medical education programs in various disputes regarding their academic and clinical performance, allegations of substance abuse, failure to complete integral parts training, alleged false or incomplete statements on applications, allegations of impairment (because of abuse or addiction to drugs or alcohol or because of mental or physical issues), because of discrimination due to race, sex, national origin, sexual orientation and any other matters. We routinely help those who have disputes with the National Board fo Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat , and the Educational Commission for Foreign Medical Graduates (ECFMG), including on hearings and appeals concerning “Irregular Behavior,” “unprofessionalism,” and “Irregular Conduct.”

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

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. The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620

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