George Indest HeadshotBy 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 United States Medical Licensing Examination (USMLE) Secretariat or the Educational Commission for Foreign Medical Graduates (ECFMG) accusing you of irregular behavior? We have recently been made aware of letters being sent out in January to a number of those who took the Step 2 CS Exam in Houston.

Allegations are being made that some of the test takers (and we understand that there were hundreds taking Step 2 CS prep courses and studying before the examination) may have had actual information from the exam that they were sharing.

The USMLE has often made allegations of this nature regarding notes, outlines, and other materials that individual students and study groups have assembled on their own, using their deductive reasoning and experience. They often accuse the students of having obtained the information directly from the tests, which is, of course, a violation of USMLE and ECFMG policies.

You must challenge such allegations of irregular behavior, explain and refute them and request a hearing on them. Otherwise, you are likely to be found guilty of having committed “irregular behavior” which most medical and residency program administrators and directors consider the same as cheating. Furthermore, if that happens, then all of your future transcripts of your USMLE test scores are then stamped with “IRREGULAR BEHAVIOR” and a letter with the charges against you is attached to it. It then goes with the transcripts whenever they are sent out in the future. This could ruin your chances of getting a license, chances of getting a good residency program and could ruin your whole career as a physician.

Other Types of “Irregular Behavior.”

Examples of the types of conduct which we have seen before include:

– Attending a commercial USMLE preparation course that provides some of the actual examination questions.

– Soliciting information on the contents or questions on the examination.

– Using a cell phone during the examination.

– Talking with another person during the examination.

– Sharing information on the types of questions or cases that were on your examination with another person or a blog over the internet.

These are just a few. For more examples, please see another blog I wrote on this by clicking here.

What Should You Do?

What should you do if you find yourself in this situation?

1. First of all, don’t panic. Read the letter carefully and figure out exactly what is being charged against you.

2. Do not delete or destroy any e-mails, test prep materials or study materials you have on your computer. Your attorney may be able to use these to help defend you.

3. Retain the services of a good, experienced health law attorney who is familiar with the USMLE, ECFMG, and the hearings and proceedings these organizations have. By experience, I mean someone who has represented individuals accused of irregular behavior at the hearings held in Philadelphia on this. Retain one right away.

4. Check the background of whatever attorney you consider hiring to make sure he has the experience and has no unfavorable actions against him in his background.

5. Obtain copies of any receipts you may have had for prep courses and prep materials you ordered or took.

6. Your attorney will request a copy of any files or investigation the USMLE or ECFMG has on you so that you can see what you may need to refute.

7. Do not let the time period go by for requesting a hearing and submitting information and documents.

8. Start obtaining character reference letters and copies of any awards, achievements or accomplishments you have.

9. Submit a good, well-organized package of documents to the organization for the hearing.

10. Request an in-person hearing and be prepared to get to Philadelphia a day ahead of time to work with your attorney to prepare for the hearing.

The foregoing are just a few of the many steps that I try to follow in every case.

Our attorneys have represented many individuals in many different hearings, appeals and test challenges over the years. We can help you.

Again, it is crucial to act decisively and act promptly to prove your innocence and preserve your valuable career in medicine. Click here to learn more about how the firm can help you with USMLE and irregular behavior matters.

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

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

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