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

In Part 2 of this blog, I will continue to discuss the types of actions the USMLE considers to be “irregular behavior.”  To read Part 1 of this blog, click here.

Specific examples of conduct that may be deemed to be irregular behavior include, but are not limited to the following (continued):

5. Seeking, providing, or obtaining unauthorized assistance during the examination or attempting to do so.  This would include using radio devices to obtain information, using phones or watches to obtain information, bringing pieces of paper with you into the exam that have information written on them, or speaking with other test-takers in a bathroom or hallway about the contents of the exam.  This also includes writing down information from a test to remove from the test location.

6. Making notes of any kind while in the secure areas of the test center, except on the writing materials provided at the test center for this purpose.  This is self-explanatory.

7. Failing to adhere to any USMLE policy, procedure, or rule including instructions of the test center staff.  This might include, for example, to stop when the time is up or to follow any other announced instructions of a test proctor.

8. Verbal or physical harassment of test center staff or other examination staff, or other disruptive or unprofessional behavior during the registration, scheduling, or examination process.  Cursing or other disruptive behavior during the exam might be included in this.  Setting the test center on fire is definitely included in this.

9. Possessing any unauthorized materials, including, but not limited to, photographic equipment, communication or recording devices, fitness and tracking monitors, and cell phones, in the secure testing areas.  The security is just about as good as in a Las Vegas casino.  So don’t try to sneak any hidden communications equipment or spy equipment into the test site.  Also, don’t try to sneak in or use any “cheat sheets,” “crib notes,” notes written on your skin, notes written on the bottom of your shoes;  these have all been tried and failed.

10. Altering or misrepresenting examination scores.  Believe it or not, you always get caught when you do this.  The school or residency program always confirms the test scores with USMLE and reports any discrepancies.

11. Unauthorized reproduction by any means, including, but not limited to, reconstruction through memorization or dissemination of copyrighted examination materials by any means, including the Internet.  The USMLE copyrights each of its tests.  It is very aggressive in enforcing its copyrights through civil and criminal prosecutions, as well as charges of “irregular behavior.”

12. Communicating or attempting to communicate about specific test items, cases, and/or answers with another examinee, potential examinee, or formal or informal test preparation group at any time before, during, or after an examination.  We have seen this happen mostly through Listservs and specifically, the USMLE Forum.  However, there are also other websites of which we have been made aware where summaries of test questions or exams (some rather dated) have been posted.  Stay away from these and do not post anything on them or request any possibly infringing information from them.

13. Failure to cooperate fully in any investigation of a violation of the USMLE rules.  The USMLE states that this is “irregular behavior.”  But we are not sure that we agree with this one, especially if such “cooperation” might lead to incriminating oneself.
The USMLE warns that, although there are a number of reputable test preparation courses out there, it is illegal for a company or individual use, disclose, distribute, or solicit content from recent test takers, or to the otherwise provide access to questions or answers from actual USMLE examinations.  And if the USMLE determines that a test prep course has obtained its actual test questions or materials, watch out.  Not only will the prep course company or owner be in serious trouble, those that enrolled in and took any courses with them will be in trouble.

When in doubt, don’t do it.

What to Do If You Get a Letter from the USMLE Accusing You of “Irregular Behavior.”

If you get a letter from the USMLE (or the Education Commission for Foreign Medical Graduates (ECFMG)) advising you that you are suspected of “irregular behavior,” this is the time to consult with an attorney experienced in dealing with such matters, immediately, before responding.  If you are contacted by an investigator for the USMLE or ECFMG investigating someone else suspected of “irregular behavior,” this is also the time to consult with an attorney experienced in dealing with such matters, immediately, before responding;  you may wind up being charged also.

There are only a very few law firms or attorneys in the whole U.S. who have experience in dealing with the USMLE, ECFMG and the National Board of Medical Examiners (NBME);  we are one of them.  The consequences to your career could be catastrophic unless you seek and obtain good legal advice on what to do.  Don’t wait.

This is Part 1 of a two part blog.  To read Part 1 of this blog, click here.

To learn more, click here to read a prior blog I wrote on the USMLE exam.

Contact Experienced Health Law Attorneys Today.

The attorneys of The Health Law Firm provide legal representation to medical students, residents, interns and fellows in academic disputes, graduate medical education (GME) hearings, contract negotiations, license applications, board certification applications and hearings, credential hearings, and civil and administrative litigations. 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.

Warning: “Much of the material above is provided by the USMLE.  No copyright or other rights are claimed for any material belonging to the USMLE, the NBME or others.”

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