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

Have you received a letter or e-mail from the United States Medical Licensing Examination (USMLE) organization accusing you of “Irregular Behavior” on a Step Exam?

The USMLE Secretariat, the National Board of Medical Examiners (NBME) and the Educational Commission for Foreign Medical Graduates (ECFMG), have recently been contacting many different applicants who have taken a Step examination and, without good cause (in our opinion) accused them of participating in “Irregular Behavior” in taking the examinations required to become licensed in the United States.  Accusations have involved the Step 1, Step 2 and Step 3 examinations and invalidation of test scores.

What are some of the accusations?

The actions we have recently seen that the USMLE states is “Irregular Behavior” in its notices include the following:

–Offering to provide actual test questions and answers on a listserv, Face Book group, group chat app, or other social media on the Internet.

–Asking for a copy of or purchasing information or test materials, including actual test questions and answers on a listserv, Face Book group, group chat app, or other social media on the Internet.

–Having answers on a Step exam that was taken that are identical to the answers given by others taking the examination.

–Taking too little time to answer test questions (indicating that the test taker has seen the question previously and was already familiar with it).

–Writing down or typing up actual test questions and answers from memory after having taken a Step exam and then giving that to someone else.

There are many other examples we will write about in later blogs.

Are applicants from one country being targeted?

Most recently, it has appeared from the number of calls our firm has received, that the latest round of e-mails and letters are targeting all test takers and applicants form one country, even those that may have completed their Step exams long ago.

It appears that the latest round of e-mails and letters notifying of “Irregular Behavior” are calculated to weed out those who may have actually “cheated’ or been involved in what the USMLE calls “Irregular Behavior.”  These letters and e-mails give the test taker three (3) different “options” for responding to the USMLE and electing how they desire to defend themselves from such allegations.

It is very important that you select the correct options and respond in the correct manner in order to protect yourself and defend against a finding of “Irregular Behavior” that could end your medical career and haunt you for life!

Contact an Experienced Healthcare Attorney with USMLE Irregular Behavior Defense Experience Immediately.

It is critical for you to contact an experienced health care attorney who has knowledge and experience with the medical system in the U.S. and has actual experience in defending applicants accused of “Irregular Behavior” by the USMLE.  Our firm and its attorneys do!  And we have attorneys who are Board Certified by the Florida Bar in the Legal Specialty of Health Law.

Yes, we can represent you in this matter even though the USMLEECFMG and NBME headquarter offices are all in Philadelphia, Pennsylvania.  You do not need a Pennsylvania attorney for this.

Additional Adverse Consequences to “Irregular Behavior” Findings:

If you do not defend your self correctly and respond in a timely manner, or if the USMLE decides you have committed “Irregular Behavior,” there are many additional adverse possible results that flow from this.  These include:

–Step exam test scores may be invalidated and you may have to take them all over again.

–A stamp of “Irregular Behavior” will be placed on your USMLE Test Score Transcript and every organization and institution that has received it or will receive it in the future will get a copy showing this along with a letter explaining what you did.

–The fact that you were found to have committed “Irregular Behavior” will be placed on your physician profile with the Federation of State Medical Boards of the United States (AFSMB) and all future employers and hospitals will be able to see it.

–Future medical boards you apply to for a medical license will receive this.

–You could lose your ability to participate in the Match for residency programs in the U.S. for years or for life.

–You could lose an existing residency that you are in.

–You can be suspended from or barred from using the services of the USMLE for any purpose (including obtaining future test scores, input to ERAS for matching), for one year, three years or life.

–ECFMG will be notified and you will be similarly barred from using its services, as well.

–You could lose your sponsorship for a visa and face deportation form the U.S.

This is just a sample of the possible adverse consequences.

Don’t Wait!  Contact the Health Law Firm for a Consultation, Today!

You should not put this off.  Time is of the essence in most cases.  Contact attorneys who have experience in USMLE and ECFMG “Irregular Behavior” hearings and appeals and in responding to such accusations.

You may have valid defenses to the accusations of Irregular Behavior, but only an experienced health lawyer is going to be able to assist you in finding these and effectively raising these in your defense.  Don’t wait until it is too late!

Call The Health Law Firm! We are available to help you on these issues anywhere in the U.S.

Contact health law attorneys experienced in defending against USMLEECFMG and NBME allegations of Irregular Behavior, in preparing and filing a response to these, in preparing and filing a Personal Statement for these, in attending a hearing on these or in appealing these.

To contact The Health Law Firm, please call (407) 331-6620 or toll-free at (888) 331-6620 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 a member of the bar in Florida, Louisiana and the District of Columbia (D.C.).  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 Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.


“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 © 2024, George F. Indest III, The Health Law Firm. All rights reserved.  No part of this work may be reproduced in any form in any medium without the express written permission of the copyright holder.  The copyright holder reserves the exclusive right to have his name associated with this work.