USMLE Takes Action Against Individuals Found To Have Engaged In Irregular Behavior

The USMLE Committee for Individualized Review (CIR) meets periodically throughout the year to review cases involving allegations of irregular behavior by applicants and/or examinees.

At its recent meetings, the CIR considered multiple cases involving the following:

  • falsifying information, including the creation of falsified score reports
  • seeking to obtain unauthorized access to examination materials
  • communicating about specific test items, cases, and/or answers with other examinees
  • providing unauthorized access to examination content on the internet
  • applying for and/or attempting to take an examination when ineligible
  • making notes on test day on something other than materials provided
  • failure to follow test center instructions, including typing past the ‘End Patient Note’ announcement in Step 2 Clinical Skills

Actions taken by the CIR at its recent meetings included:

  • annotating individual USMLE records with a finding of irregular behavior
  • barring access to USMLE for periods up to 3 years
  • reporting the finding of irregular behavior to the disciplinary data bank (Physician Data Center [PDC]) at the Federation of State Medical Boards (FSMB). State medical boards routinely query this data bank as part of their licensing processes
  • canceling the examinee’s score because the validity of a passing level score is in question

As evidenced by the sanctions listed above, a finding of irregular behavior carries significant potential impact. USMLE applicants and examinees are reminded to read the USMLE Bulletin of Information carefully, follow the rules of conduct during testing, and refrain from any pre- or post-examination conduct deemed to be irregular behavior.

Applicants and examinees are also encouraged to watch the USMLE Security Video.

The USMLE is committed to maintaining the integrity of its examination so that state medical boards may continue to rely upon it as an integral part of their decision-making process for licensure. Applicants and examinees are advised to observe all USMLE policies and procedures to avoid the potentially significant implications arising from a finding of irregular behavior.

USMLE encourages you to provide information about cheating and other activity of which you are aware that may compromise the security and integrity of USMLE. Please use the contact form on the USMLE website to report such information.

ECFMG Policies and Procedures Regarding Irregular Behavior

ECFMG also regularly reviews allegations of irregular behavior in conjunction with its programs and services. ECFMG programs and services include but are not limited to, registering international medical students and graduates for USMLE Step 1, Step 2 CK, and Step 2 CS; ECFMG Certification; ERAS Support Services at ECFMG; the Exchange Visitor Sponsorship Program; the ECFMG International Credentials Services; and the Electronic Portfolio of International Credentials.

If the ECFMG Medical Education Credentials Committee determines that an individual engaged in irregular behavior, a permanent annotation to that effect will be included in the individual’s ECFMG record and will be provided to third parties in certain reports.

If it is determined that an individual engaged in irregular behavior, the individual also will be subject to serious sanctions. These sanctions may include, but are not limited to:

  • Barring the individual from future examinations;
  • Barring the individual from ECFMG Certification and/or other ECFMG programs; and
  • Revoking the individual’s Standard ECFMG Certificate.

Individuals who apply to ECFMG programs and services should be familiar with the ECFMG Policies and Procedures Regarding Irregular Behavior, which define irregular behavior and outline possible sanctions. Representative examples of allegations of irregular behavior and actions taken by the ECFMG Medical Education Credentials Committee are also available on the ECFMG website.

USE CAUTION IN SELECTING REVIEW COURSES: Orientation, Practice, and Self-Assessment Materials Available through USMLE, NBME, and Third Parties

The United States Medical Licensing Examination® (USMLE®) program recognizes the importance of providing all examinees the opportunity to learn about the design and content of its examinations and to have some exposure, before examination day, to samples of testing formats and materials. USMLE provides orientation and practice materials for all USMLE Steps and Step Components. These materials, which are available at no cost on the USMLE website, include:

  • Informational materials on the overall USMLE program and content descriptions for each of the USMLE examinations,
  • Tutorials that illustrate the USMLE Step 1, Step 2 Clinical Knowledge (CK), Step 3 multiple-choice question software and the Step 3 computer-based case simulation (CCS) Primum® software,
  • Sample multiple-choice test questions with answer keys for each Step,
  • Sample Step 3 CCS cases with feedback, and
  • Orientation materials for Step 2 Clinical Skills (CS).

In addition, the National Board of Medical Examiners® (NBME®) provides, for a fee, self-assessment services to help the examinee evaluate his or her readiness to take USMLE. These services help individuals become familiar with questions like those that have appeared on USMLE and provide performance feedback on the individual’s areas of relative strength and weakness. See www.nbme.org to obtain additional information and to purchase self-assessment services.

Beyond these USMLE and NBME services, there are a variety of commercial test preparation materials and courses that claim to prepare examinees for USMLE examinations. Examinees who are considering using such services should fully understand the nature of these services, the sources of any content being used, and the basis for any claims being made. None of these third-party materials or courses are affiliated with or sanctioned by the USMLE program and information on such materials and courses is not available from the Educational Commission for Foreign Medical Graduates (ECFMG), the Federation of State Medical Boards (FSMB), NBME, USMLE Secretariat, or medical licensing authorities.

Please note that it is unlawful for any test preparation program or any individual to use, disclose, distribute, or provide access to questions or answers from actual USMLE exams. An examinee who is involved with any enterprise that disseminates USMLE content should be aware of the consequences, which include the possible cancellation of USMLE registration and/or testing, the withholding or cancellation of scores, and the imposition of additional sanctions.

USMLE Takes Action Against Individuals Found To Have Engaged in Irregular Behavior

The USMLE Committee for Individualized Review (CIR) meets periodically throughout each year to review cases involving allegations of irregular behavior by applicants and/or examinees.

At its recent meetings, the CIR heard multiple cases involving the following:

  • falsified information, including the creation of falsified score reports
  • soliciting and/or seeking to obtain unauthorized access to examination materials
  • communicating about specific test items, cases, and/or answers with another examinee
  • applying and/or attempting to take an examination when ineligible
  • making notes of any kind on anything other than materials provided
  • failure to follow test center instructions, including writing past the ‘end patient note’ announcement

Actions taken by the CIR at its recent meetings included annotating the individual’s USMLE record with a finding of irregular behavior, barring access to USMLE for periods ranging from 0-3 years, and reporting the finding of irregular behavior to the disciplinary data bank of the Federation of State Medical Boards. State medical boards routinely query this data bank as part of their licensing processes.

As evidenced by the sanctions listed above, a finding of irregular behavior carries significant potential impact. USMLE applicants and examinees are reminded to read the USMLE Bulletin of Information carefully, follow the rules of conduct during testing, and refrain from any pre- or post-examination conduct that might constitute irregular behavior. Specific examples of conduct deemed to be irregular behavior can be found in the Bulletin of Information.

The USMLE is committed to maintaining the integrity of its examination so that state medical boards may continue to rely upon it as an integral part of their decision-making process for licensure.  Applicants and examinees are advised to observe all USMLE policies and procedures to avoid the potentially significant implications arising from a finding of irregular behavior.

USMLE encourages you to provide information about cheating and other activity of which you are aware that may compromise the security and integrity of USMLE. Please use the contact form on the USMLE website to report such information.

ECFMG Policies and Procedures Regarding Irregular Behavior

ECFMG also regularly reviews allegations of irregular behavior in conjunction with its programs and services. ECFMG programs and services include but are not limited to, registering international medical students and graduates for USMLE Step 1, Step 2 CK, and Step 2 CS; ECFMG Certification; ERAS Support Services at ECFMG; the Exchange Visitor Sponsorship Program; the ECFMG International Credentials Services; and the Electronic Portfolio of International Credentials.

If the ECFMG Medical Education Credentials Committee determines that an individual engaged in irregular behavior, a permanent annotation to that effect will be included in the individual’s ECFMG record and will be provided to third parties in certain reports.

If it is determined that an individual engaged in irregular behavior, the individual also will be subject to serious sanctions. These sanctions may include, but are not limited to:

  • Barring the individual from future examinations;
  • Barring the individual from ECFMG Certification and/or other ECFMG programs; and
  • Revoking the individual’s Standard ECFMG Certificate.

Individuals who apply to ECFMG programs and services should be familiar with the ECFMG Policies and Procedures Regarding Irregular Behavior, which define irregular behavior and outline possible sanctions. Representative examples of allegations of irregular behavior and actions taken by the ECFMG Medical Education Credentials Committee are also available on the ECFMG website.

USMLE Takes Action Against Individuals Found To Have Engaged in Irregular Behavior

USMLE Takes Action Against Individuals Found To Have Engaged in Irregular Behavior

The USMLE Committee for Individualized Review (CIR) meets periodically to review cases involving allegations of irregular behavior by applicants and/or examinees. At its recent meetings, the CIR heard multiple cases involving a range of alleged irregular behavior, including the following:

  • Supplying inaccurate information in connection with the application process
  • Altering or misrepresenting examination scores, including providing counterfeit score reports, to third parties
  • Impersonating an examinee
  • Engaging someone to take the exam in one’s place
  • Possessing unauthorized materials in the secure testing area
  • Making notes on something other than the erasable boards provided for that purpose
  • Failing to follow test center instructions, including writing past the ‘end patient note’ announcement during Step 2 CS

When the CIR found conduct was irregular behavior, it imposed sanctions that in some cases included annotating the individual’s USMLE record with the finding, barring the individuals from access to USMLE for periods up to five years and reporting the finding of irregular behavior to the disciplinary data bank of the Federation of State Medical Boards. (State medical boards routinely query this data bank as part of their licensing processes.)

As evidenced by the sanctions listed above, a finding of irregular behavior carries significant potential impact. USMLE applicants and examinees are reminded to read the USMLE Bulletin of Information carefully, follow the rules of conduct during testing and refrain from any pre- or post-examination conduct that might constitute irregular behavior. In particular, examinees should scrupulously avoid reproducing and/or communicating about examination content. Additional specific examples of conduct deemed to be irregular behavior are listed in the Bulletin of Information.

The USMLE is committed to maintaining the integrity of its examination so that state medical boards may continue to rely upon it as an integral part of their decision-making process for licensure.

USMLE encourages you to provide information about cheating and other activity of which you are aware that may compromise the security and integrity of USMLE. Please use the contact form on the USMLE website to report such information.

 

ECFMG Policies and Procedures Regarding Irregular Behavior

ECFMG also regularly reviews allegations of irregular behavior in conjunction with its programs and services. ECFMG programs and services include but are not limited to, registering international medical students and graduates for USMLE Step 1, Step 2 CK, and Step 2 CS; ECFMG Certification; ERAS Support Services at ECFMG; the Exchange Visitor Sponsorship Program; the ECFMG International Credentials Services; and the Electronic Portfolio of International Credentials.

If the ECFMG Medical Education Credentials Committee determines that an individual engaged in irregular behavior, a permanent annotation to that effect will be included in the individual’s ECFMG record and will be provided to third parties in certain reports.

If it is determined that an individual engaged in irregular behavior, the individual also will be subject to serious sanctions. These sanctions may include, but are not limited to:

  • Barring the individual from future examinations;
  • Barring the individual from ECFMG Certification and/or other ECFMG programs; and
  • Revoking the individual’s Standard ECFMG Certificate.

Individuals who apply to ECFMG programs and services should be familiar with the ECFMG Policies and Procedures on Irregular Behavior, which define irregular behavior and outline possible sanctions. Representative examples of allegations of irregular behavior and actions taken by the ECFMG Medical Education Credentials Committee are also available on the ECFMG website.

USE CAUTION IN SELECTING REVIEW COURSES: Orientation, Practice, and Self-Assessment Materials Available through USMLE, NBME, and Third Parties

The United States Medical Licensing Examination® (USMLE®) program recognizes the importance of providing all examinees the opportunity to learn about the design and content of its examinations and to have some exposure, before examination day, to samples of testing formats and materials. USMLE provides orientation and practice materials for all USMLE Steps and Step Components. These materials, which are available at no cost on the USMLE website, include:

  • Informational materials on the overall USMLE program and content descriptions for each of the USMLE examinations,
  • Tutorials that illustrate the USMLE Step 1, Step 2 Clinical Knowledge (CK), Step 3 multiple-choice question software and the Step 3 computer-based case simulation (Primum® CCS) software,
  • Sample multiple-choice test questions with answer keys for each Step,
  • Sample Step 3 Primum cases with feedback, and
  • Orientation materials for Step 2 Clinical Skills (CS).

In addition, the National Board of Medical Examiners® (NBME®) provides, for a fee, self-assessment services to help the examinee evaluate his or her readiness to take USMLE. These services help individuals become familiar with questions like those that have appeared on USMLE and provide performance feedback on the individual’s areas of relative strength and weakness. See www.nbme.org to obtain additional information and to purchase self-assessment services.

Beyond these USMLE and NBME services, there are a variety of commercial test preparation materials and courses that claim to prepare examinees for USMLE examinations. Examinees who are considering using such services should fully understand the nature of these services, the sources of any content being used, and the basis for any claims being made. None of these third-party materials or courses are affiliated with or sanctioned by the USMLE program and information on such materials and courses is not available from the Educational Commission for Foreign Medical Graduates (ECFMG), the Federation of State Medical Boards (FSMB), NBME, USMLE Secretariat, or medical licensing authorities.

Please note that it is unlawful for any test preparation program or any individual to use, disclose, distribute, or provide access to questions or answers from actual USMLE exams. An examinee who is involved with any enterprise that disseminates USMLE content should be aware of the consequences, which include the possible cancellation of USMLE registration and/or testing, the withholding or cancellation of scores, and the imposition of additional sanctions.

Sharing or Discussion of USMLE Content Constitutes Irregular Behavior

Examinees are advised in the USMLE Bulletin of Information that USMLE policies and procedures governing examinations have been established to ensure that no examinee or group of examinees receives unfair advantage on the examination, inadvertently or otherwise, thus jeopardizing the standard conditions and the principles on which the examinations are developed and scored. Provision of information relating to examination content by examinees may provide such advantage to individuals who have yet to take the examination. Examinees are directed to maintain the confidentiality of the Step examinations and are directed not to provide information relating to examination content that may give or attempt to give unfair advantage to individuals who may be taking the examination.

The following is a statement from an examinee who disseminated content from a Step 1 examination and, as a result, was determined to have engaged in irregular behavior.

To Whom It May Concern:

As a student at American University of the Caribbean School of Medicine, I received excellent training and direction as a future physician. I was taught the importance of medicine academically, but failed to realize its importance professionally.

After having taken my USMLE Step 1, I made a nearly career-ending mistake. I returned home, went through my study aid book, and noted from memory any question topics and specific test questions I could remember to help my friends prepare for their upcoming exams. Earlier that morning, I had signed a document stating I will not reproduce, by any means, secure USMLE content. Through my actions, I failed to uphold the integrity of our profession, not appreciating the importance of my signature to the USMLE pre-exam agreement.

After having done so, I was called before the USMLE Committee on Irregular Behavior for a review of my case. I faced a lifetime ban from ever taking a USMLE exam again. I was fortunate enough to be banned for two years, however with permanent annotation of my USMLE transcript of Irregular Behavior, as well as notification to ECFMG and FSMB. I am genuinely grateful for the lesson I have learned. However, I wish I did not have to learn my lesson in this way. My transgression had the potential of undermining the validity of other examinees’ Step 1 scores and, on a broader scale, licensing and other decisions made based on those scores. While I thought I was simply helping my friends, I was actually doing them and our profession a disservice.

I want to bring this to your attention, so as to emphasize adherence to the rules, with preservation of integrity and professionalism. I want to remind all AUC students to take USMLE’s rules regarding the integrity of its testing process seriously for failure to do so, as in my case, could have dire consequences on your future as a physician.

 
Sincerely,
Recent AUC Graduate

On-line Posting or Discussion of USMLE Content Constitutes Irregular Behavior

If you post or discuss United States Medical Licensing Examination (USMLE) examination content via the Internet, you will be in violation of the USMLE Rules of Conduct, as outlined in the USMLE Bulletin of Information. Examination content includes, but may not be limited to, questions, case content, and answers.

The Bulletin specifically advises that, “you will maintain the confidentiality of the materials, including the multiple-choice items, and the case content for Step 2 CS and Primum CCS. You will not reproduce or attempt to reproduce examination materials through memorization or any other means. Also, you will not provide information relating to examination content that may give or attempt to give unfair advantage to individuals who may be taking the examination. This includes postings regarding examination content and/or answers on the Internet.”

The USMLE program continuously monitors Internet forums and chat rooms. Examinees who post information about examination content are identified and referred to the USMLE Committee on Irregular Behavior. If the Committee finds that you posted examination content, your scores may be delayed and you may be subject to the following sanctions:

  • Permanent annotation of your USMLE transcript (such annotations will read “Irregular Behavior/Security Violation” and will be seen by any entity that receives your transcript, i.e., residency training programs, state licensing authorities, etc.);
  • A report to the Federation of State Medical Boards Board Action Databank (a central repository for formal actions taken against physicians and available to licensing and disciplinary boards, the military, governmental and private agencies, and organizations involved in the employment and/or credentialing of physicians);
  • A bar from taking future administrations of USMLE.

A determination of irregular behavior can put your medical career in jeopardy. Do not endanger your career: Do not post information from exams you have taken and do not solicit others to provide such information.

For more information, refer to Testing Regulations and Rules of Conduct and Irregular Behavior in the USMLE Bulletin of Information, available on the USMLE website.