Are You Taking the USMLE Step Exams? Follow Our Tips If You Want to Score Higher

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

Here are some common-sense tips you should be sure you follow that may help you to reduce stress and score higher when you take your United States Medical Licensing Examination (USMLE) Step examinations. You should be doing everything within your control to minimize your stress and the risk of being late for the examination. Again, these are common sense; if you have taken a lot of standardized examinations, you may already be aware of these.

1. Do not plan on driving to the test site from your home the morning of the examination, even if you leave in the same city as the testing center.
a. Unexpected car problems could occur.
b. Traffic backups and delays always occur.
c. Accidents always happen.
d. Road problems, construction delays, and detours are common.
Eliminate these unnecessary risks.

2. Find the hotel closest to the testing center and stay there the night before the test. Hopefully, this will be within walking distance of the test site if it is necessary to walk there.

3. Read all of the applicable testing procedures, the applicable USMLE and/or Educational Commission for Foreign Medical Graduates ( ECFMG) Handbook, Guidelines and Procedures again the day before the examination you are taking. You signed an agreement to be bound by these and you are expected to know these for the examination. Be sure you understand how scheduled and unscheduled breaks work, how the time is accounted and what you are allowed to do and prohibited from doing on breaks.

4. Make sure you know ahead of time exactly how much time you will be given for each part of the examination and for breaks, Be sure you have calculated how much time you have for each question on each section of the examination, answer within the times you have calculated and move on through the examination in a timely manner.

5. Do not let other occurrences and disturbances in the testing center upset you or distract you.

6. If some extremely disruptive event occurs, for example, fire alarms and evacuations taking place, other examination takers having seizures and being removed by paramedics, etc., consider leaving and taking an incomplete on this examination. Be sure to ask the test center monitors/proctors to file an incident report on what occurred at the test center, Then, within 24 hours, write to the USMLE and ECFMG and advise the organization of exactly what happened and why you had to leave.

7. Bring your own lunch, snacks, and beverages, including something like energy bars or chocolate bars, to provide needed sustenance. Do not leave the testing center for lunch unless you absolutely have to, and then, stay local and on foot. Do not take the risk of driving someplace and back.

8. If a certain testing center has a bad reputation for being a poor testing site or having frequent computer failures, schedule to take the test at a site in another city or state. Travel there and stay at a hotel within walking distance of the test site, perhaps a few days before the examination date. You can then use the additional time and isolation for additional studying and test preparation.

9. Do not refer to or use any cell phone, tablet or personal device while the test is still underway. Be sure you are familiar with all test-taking procedures.

10. To avoid any risks of misunderstandings, do not write down anything during the examination or about the examination at the testing center. Outside during lunch may be okay; otherwise, wait until you return home.

Although common sense, you would be surprised how many test-takers violate these common-sense tips and then suffer the consequences.

Plan for and have as stress-free of an examination as you can. Control the controllable.

For more helpful tips and to learn more about examples of “Irregular Behavior,” click here to read my prior blog.

Additionally, click here to view one of our blogs on our experience with the USMLE, ECFMG, and NBME, and Hearings on “Irregular Behavior.”

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 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 www.TheHealthLawFirm.com.

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. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 Toll-Free: (888) 331-6620.

Current Open Positions with The Health Law Firm. The Health Law Firm always seeks qualified individuals interested in health law. Its main office is in the Orlando, Florida, area. If you are a current member of The Florida Bar or a qualified professional who is interested, please forward a cover letter and resume to: [email protected] or fax them to (407) 331-3030.

“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 way in any medium without the written permission of the copyright owner. The author of this work reserves the right to have his name associated with any use or publication of this work or any part of it.

Have You Received a Notice of “Irregular Behavior” from the USMLE? Important Information for You!

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 www.TheHealthLawFirm.com.

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. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.


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“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.

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