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Issue 132 - September 30, 2008

An Announcement Regarding Fraudulent Letters of Recommendation

The submission of fraudulent letters of recommendation by applicants to ECFMG continues to be of great concern.

In July 2007, The ECFMG Reporter (Issue 116) contained important information on the issue of fraudulent letters of recommendation. However, since that time, additional instances of fraudulent letters of recommendation have come to ECFMG’s attention.

The submission to ECFMG of fraudulent letters of recommendation constitutes irregular behavior as defined by ECFMG.

Examples of fraudulent letters of recommendation include, but are not limited to:

The submission of fraudulent letters of recommendation is a very serious matter. Allegations of submission of fraudulent letters of recommendation, along with all other allegations of irregular behavior, are reviewed by the ECFMG Medical Education Credentials Committee, a standing committee of the ECFMG Board of Trustees. If the Committee determines an individual has engaged in irregular behavior:

Furthermore, ECFMG may:

In recent years, the ECFMG Medical Education Credentials Committee has made a determination of irregular behavior in 14 cases based upon the submission of fraudulent letters of recommendation. In all but one of these cases, the physician’s Standard ECFMG Certificate was revoked. Since these individuals are no longer certified by ECFMG, they are not eligible to enter an accredited residency program in the United States and are not eligible to take USMLE Step 3, both of which require ECFMG Certification.

In June 2006, ECFMG instituted the “original document” policy requiring all international medical students and graduates participating in the Electronic Residency Application Service (ERAS®) to submit original letters of recommendation. This policy is consistent with U.S. medical school practices. These letters must be written on official letterhead and signed by the letter writer in an ink color other than black. For enhanced authentication, applicants are advised to request the letter writer to affix an institutional seal to the letter of recommendation.

ECFMG makes a visual inspection of the letters when they are received to determine if they are originals or copies. If ECFMG determines that a letter of recommendation is a copy, the document will be stamped to indicate that it is a copy before it is made available to program directors. Refer to the letter of recommendation requirements on the ERAS Support Services at ECFMG website for more information on this policy.

Directors of residency and fellowship programs are responsible for verifying the authenticity of letters of recommendation. In most of the recent cases reviewed by the ECFMG Medical Education Credentials Committee, the fraudulent letters of recommendation were detected by program directors attempting to verify a letter’s authenticity.

For detailed information on ERAS policies, visit the website of the Association of American Medical Colleges (AAMC) at www.aamc.org.

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[last update: September 30, 2008]