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

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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