Caribbean Medical Student Issues: Student Discipline and USMLE Eligibility

There are a number of advantages to attending medical school in the Caribbean. Obviously, there's nothing wrong with being able to take a break from your studies every once in a while and stroll along a beautiful beach looking out over a crystal clear ocean. The people are friendly, and if you like seafood, there may be no better spot on earth to dine.

Generally speaking, Caribbean schools are also easier to get into than US schools. That can be appealing for some applicants, especially those with weak spots on their resumes looking for a second chance at a medical career.

Of course, if you are an international student, a Caribbean school may be the best stepping to a career in the States.

There are downsides to earning your M.D. in the Caribbean as well, though. For instance, most Caribbean programs don't work with teaching hospitals in the area. Instead, they send their students in years three and four to the US or Canada to perform their clinical rotations or fulfill their clerkship requirements. It's not always easy to pick up and move like that. It can also be difficult to coordinate residency applications, especially getting instructors and administrators in the Caribbean on the same page as supervisors and hospital personnel in the states.

The bigger problem, though, has to do with how Caribbean medical schools tend to be perceived in the US. Many physicians and hospital administrators have an unfair view of these programs as less rigorous and of students as less capable. Consequently, you may have to work harder to get noticed and to get treated fairly by attending physicians you work with, hospital staff, exam administrators, and licensing boards. Some Caribbean students find, for instance, that they are more likely to be accused of disciplinary infractions when taking tests like the USMLE.

If you are facing an allegation of exam misconduct, or you're being treated unfairly in any way by your medical school or the health care facility where you're working, you need to know that you have rights. You're entitled to due process, for example, and to mount a full defense.

You also need to know that you don't have to deal with your situation alone. Professionals at the Lento Law Firm are experienced in fighting for student rights. They know how medical schools operate, they know how the health care system in the US works, and they've helped hundreds of students defend themselves from unfair charges and unfair sanctions.

You've worked long and hard to get to this point. Don't let anyone or anything stand in the way of your medical career. At the first sign of trouble, contact Joseph D. Lento and his Education Law Team to find out what they can do for you.

What Is the USMLE?

Let's start by talking about what the USMLE is and why it is so important to your success as a medical professional. The United States Medical Licensing Exam (USMLE) assesses your ability to apply what you've learned as a medical student in real-world situations. Administered by the National Board of Medical Examiners (NBME) and the Federation of State Medical Boards (FSMB), it is the test that qualifies you to be licensed to practice medicine.

The exam actually consists of three parts.

• Step 1: Assesses what you learned in your first two years of medical school courses
• Step 2: Evaluates your knowledge of clinical medicine
• Step 3: Examines your ability to apply your clinical knowledge to actual patient management; it is among the final hurdles in obtaining your license

In addition, as a student of an international medical school, you will also have to complete Educational Commission for Foreign Medical Graduates (ECFMG) certification requirements before you are allowed to take the final Step 3 portion of the exam.

At any point during this process, you can be accused of misconduct should the NBME, FSMB, ECFMG, or USMLE come to believe you've violated exam protocol.

As you might expect, accusations of this type are extremely serious. It isn't just that your scores could be invalidated or that you might have to retake the test. A finding against you could prevent you from obtaining a medical license. And even if you are eventually licensed, that black mark on your record will follow you for the rest of your career, making it difficult for you to find work, get board postings, and obtain other certifications.

Irregular Behavior and the USMLE

The USMLE refers to exam misconduct as “irregular behavior.” You might also think of it as “cheating.” To give you a more concrete idea of how the organization defines irregular behavior, the USMLE website also lists several concrete examples.

• Unauthorized reproduction of exam materials. Note that this includes reconstructing questions from memory and disseminating them in any way, including through online posting
• Communicating—or attempting to communicate—about any part of the exam, including test items, cases, or answers, with any potential exam taker or with any test prep group before, during, or after the exam
• Registering for, scheduling, or taking an exam when you are ineligible to do so
• Seeking, providing, or obtaining unauthorized exam materials
• Providing false information or giving false statements in connection with any aspect of the exam, including on application forms
• Taking or attempting to take the exam for someone else or attempting to get another person to take the exam for you
• Seeking, providing, or obtaining unauthorized help on any part of the exam
• Making notes anywhere but on the paper provided by the USMLE
• Failing to follow any policy or procedure associated with the exam
• Verbal or physical harassment of examination staff
• Possessing any unauthorized material during the exam, including cell phones, recording devices, cameras, or even electronic fitness trackers
• Making violent, threatening, or unprofessional comments to staff
• Altering or misrepresenting scores
• Failing to cooperate with an investigation

It is worth noting the strict wording of many of these prohibitions. For example, you can be charged for attempting to break a rule, even if you don't actually succeed at breaking it. Likewise, you can be accused of helping others to break the rules. You can be accused of simply writing on the wrong paper, and you can find yourself in trouble for errors on your application forms.

USMLE Investigations and Consequences

USMLE prohibitions are serious. So too, are the procedures when an official believes a student has committed misconduct.

In allegations of irregular behavior, the USMLE conducts a full investigation. You should know that the organization must let you know that you are the subject of such an investigation. In addition, you are expected to cooperate fully with the investigation. Failure to do so is considered its own form of rule violation and can result in additional charges. Likewise, you can be charged for providing any false or misleading information to investigators.

You'll have to deal with an interruption in your studies, even if you're eventually found innocent. While you are under investigation, you are barred from registering for an exam. Any registration you may already have is canceled. USMLE also has the authority to withhold any previously unreleased scores.

If you are facing a sanction as a result of the investigation, you are entitled to defend yourself at a hearing (see below).

However, should you be found responsible for a violation, you face serious consequences. Among the potential sanctions, you can be barred from taking any future exams. Obviously, this would put an immediate end to your medical career. In addition, the USMLE includes a notation about your irregular behavior with any copy of your test scores, past or present. It also reserves the right to report this behavior to any third party it feels has a legitimate interest, whether or not that party has specifically requested the information.

Suffice it to say that any time you are made aware of any misconduct involving the USMLE, you should act immediately to confront the allegation, and you should seek representation from Joseph D. Lento and his Education Law Team in doing so.

Less Obvious Offenses

When you are dealing with bureaucracy as complex as that of the USMLE, you can't take anything for granted. While the organization outlines several specific types of infractions, it's important to recognize that many offenses aren't as obvious as you might expect.

Why is this important? Obviously, you want to avoid making inadvertent errors, especially if they could potentially get you into trouble. As a Caribbean medical student, though, you must recognize that—through no fault of your own—your behavior can be subject to added suspicion. US physicians and medical organizations can sometimes be prejudiced against Caribbean medical schools and hold this against students who have attended those schools. In such instances, these less obvious offenses offer a useful excuse to penalize you simply for your background.

• Attending a USMLE prep course offered by a third party where actual test questions are used. Of course, you may not be aware that this test prep involves real questions, but you can still be held accountable for “seeking copies of actual test materials.”
• Talking with another person during the exam. Any communication while the test is taking place may be regarded as an attempt to solicit or provide answers.
• Using your phone during a break. Using a cell phone while you are on an exam break—even an officially sanctioned break—might be taken as an attempt to either get answers or reveal test materials to third parties.
• Applying for the exam after you have withdrawn from medical school. It is important you recognize that if you are no longer a medical student, you are ineligible to take the exam. You should cancel any scheduled exams if you are no longer enrolled.
• Completing your USMLE application incorrectly. As the rules state, you can be investigated for providing false or misleading information. In the strictest sense, that could be construed to cover honest mistakes you might make in filling out the paperwork.
• Talking with anyone about the exam after the fact. Most people would assume that it's reasonable to tell your wife or a friend what the USMLE was like. You might even think it's fair to post online about just how the test was. Anything you reveal to another person, though, could potentially be taken as an attempt by you to disseminate materials. And copying test materials is expressly forbidden, even if you're simply copying from your own memory.

Of course, just because the USMLE has accused you of violating some obscure aspect of a rule does not mean it is right for the organization to do so. If you're being held accountable for some honest mistake, you have the right to challenge the organization's decisions. Joseph D. Lento and his Education Law Team are prepared to stand beside you and do everything they can to defend your reputation and preserve your future.

Defending Yourself From Charges

All of this information begs the question: what do you do if you should find yourself accused of irregular behavior in connection with the USMLE?

• First, make sure you preserve any and all materials related to the accusation, including test prep materials, texts, and emails. You can't know what a defense attorney may be able to use to exonerate you. As a result, it's better to keep all of it and let them evaluate its usefulness.
• Track down all materials related to any test prep you may have done. Again, you cannot know what might be relevant to your case. Turn everything you can find over to your attorney.
• Gather evidence of your character. You want to be able to show what kind of person you are. This can help to convince decision-makers that you are innocent of the charges against you. Hang on to awards, honors, achievements, certifications, and any letters of recommendation that others have written on your behalf.
• Request an in-person hearing. The USMLE may suggest that the investigator can decide your case or that an administrator can determine your guilt or innocence in a closed-door session. An in-person hearing gives you the opportunity to present your case yourself and to bring an attorney with you to the proceedings.
• Finally, and most importantly, it goes without saying that you need to contact the experienced professionals at the Lento Law Firm. They can help you come up with a defense strategy, work with you to gather evidence, and make sure the USMLE treats you fairly.

Avoiding Common Mistakes

Just as there are things you need to do when you've been charged with irregular behavior, there are things you definitely shouldn't do. Among these:

• Don't fail to act. A charge from the USMLE is serious, and it can be scary. You're future as a doctor is on the line. As a result, you may find yourself paralyzed, afraid to act in case you do something wrong. Some students even convince themselves that the charge will just go away if they ignore it. You must act, and you must do so swiftly. If you make contacting an attorney from the Lento Law Firm your first priority, they can help you get over many of your fears and move forward.
• Don't try to defend yourself. The situation is too serious to handle yourself. You may believe that if you talk with officials yourself, you'll be able to work out the problem. The officials who want to talk to you are not on your side, though. They believe you are guilty, and they will use even innocent things you might say to try and prove your guilt. Joseph D. Lento and his Education Law Team know how to talk to officials. They know how to protect your interests. Make sure you have someone from this team on your side the moment you are accused.

Too often, students don't take irregular behavior charges seriously. After all, “irregular behavior” doesn't sound particularly serious. It is. Your licensing exam is, in many ways, the most important part of your education. An accusation of irregular behavior now, just as you are nearing the finish line, can be devastating. Don't wait until after the damage is done to respond, and don't try to handle it all on your own.

Preparing for Hearings

You are entitled to a hearing before a committee, and you should take advantage of this right. A hearing gives you an opportunity to make your case in your own voice, and it ensures your fate isn't decided by a single individual. The committee will be made up of a variety of medical professionals—doctors, professors, and other members of the healthcare community.

As your hearing approaches, there are some important steps to take to prepare yourself.

• Request a complete copy of your USMLE file. You have the right to see all the evidence the organization has gathered against you. Don't respond to this information directly. Instead, turn it over to your attorney. They'll help you make sense of it and decide what might be useful in proving your innocence.
• Document everything that happens in writing. Keep a record of every communication you have with USMLE. Take notes on any investigative interviews. Hold on to any documents you're issued. Request signatures on everything.
• Be absolutely truthful. As mentioned above, providing false or misleading information can result in an additional charge. Your every statement will be scrutinized by investigators, and they will find out if you're lying.
• Be thoughtful in your responses. Take your time to answer any questions, and be careful what you write. Many of the documents you submit will be investigators' and decision makers' first chance to gauge who you are as a person. Make sure you are organized, succinct, and to the point.
• Prepare a statement. Finally, before the hearing begins, take the time to prepare a statement summarizing your response to the allegations.

As with all other aspects of your case, an experienced attorney from the Lento Law Firm can be vital in helping you to prepare for your hearing.

Finding the Right Representation

We'll say it again: you absolutely need an attorney at your side if you are facing an accusation of irregular behavior in connection to the USMLE. The situation is serious. It's also incredibly complex. In fact, not just any attorney will do.

Students are sometimes tempted to hire a family attorney or someone who is local. In fact, some local attorneys may actually believe that a USMLE case is a minor matter and easy to resolve. In fact, the opposite is true. A USMLE investigation and hearing can often be more involved than a criminal or civil court proceeding. In addition, the rules are very different, and you don't have the same due process protections you would have in an actual court case.

You need an attorney who understands education law, who is familiar with judicial procedures in education cases, who has experience working with students, and who knows exactly what is at stake. To put it simply, you need someone from the Lento Law Firm.

Joseph D. Lento built his firm on representing students. No one knows more about what you're up against, no one knows the system better, and no one will fight harder to protect your future than Joseph D. Lento and his Team.

Fighting for Your Future

Getting through medical school and obtaining your license is no easy path. If it was, everyone would do it. You have to expect you'll be tested every step of the way, that your every action will be scrutinized and your every decision questioned.

As a Caribbean med student, you face special challenges other students don't. You may have to deal with bias against you based purely on where you earned your degree. You may sometimes have to fight against unfair treatment. You may occasionally have to demand your rights.

The USMLE, though, is one of the very last steps on your journey. Fail here, and you haven't just undone all the good work you've put in up to this point. You'll have undone it all just as you're reaching the finish line. Don't let that happen.

If you're facing an unfair allegation, contact Joseph D. Lento and his Education Law Team and let them help. Let them offer advice; give them a chance to put together a defense strategy; ask them to accompany you to meetings and proceedings. The Lento Law Firm was built to help students succeed. They believe in you and your dreams, and they're prepared to do whatever they can to help make those a reality.

To find out more about exactly what Joseph D. Lento and his Team can do for you, contact the Lento Law Firm today at 888-555-3686, or use our automated online form.