NBME/USMLE Defense for California Medical Students and Graduates

Medical practice in California can be an extraordinarily rewarding proposition, given the state's economy, sophisticated healthcare system, and other attractions. You've made a huge investment to pursue those rewards under a Medical Board of California license. Yet California requires a medical licensing examination, meaning that NBME / USMLE issues can delay, frustrate, and ultimately prevent your California medical licensure and practice. You could lose your entire investment in your medical education to unresolved NBME / USMLE issues.

The Lento Law Firm's Student Defense Team appreciates the substantial risk that medical examination issues present. Our highly qualified attorneys are available in Los Angeles, San Diego, San Jose, San Francisco, Oakland, Sacramento, Fresno, Long Beach, Bakersfield, Anaheim, Stockton, Irvine, Riverside, Santa Ana, Chula Vista, Fremont, Santa Clarita, San Bernardino, Modesto, Fontana, and across California for your sensitive, strategic, and effective representation addressing NBME / USMLE issues and related Medical Board of California concerns. Trust us to protect your investment and preserve your California medical practice opportunities. Call 888.535.3686 or use our contact form now for our help favorably resolving your NBME / USMLE issues.

Rewards of California Medical Practice

California's outstanding hospitals and other medical care facilities alone prove the enormous opportunities and potential rewards of a California medical practice. Santa Clara Valley Medical Center, Community Regional Medical Center-Fresno, University of San Francisco Medical Center, Cedars-Sinai Medical Center, University of California San Diego Medical Center, Laguna Honda Hospital and Rehabilitation Center, Sharp Memorial Hospital, and LAC+USC Medical Center are leading institutions among those facilities, offering substantial medical employment, practice, and continuing education opportunities. California's gorgeous weather and natural environment, its outstanding residential neighborhoods, and its world-leading arts, music, culture, and entertainment scenes amplify the professional rewards. Retain us to help you favorably resolve your NBME / USMLE issues and preserve those rewards.

California Medical Licensing Authority

California's legislature has adopted a Medical Practice Act, codified at California Business & Occupations Code Sections 2000 et seq., that is similar in form and structure to medical practice acts in other states. The Act's Section 2001 establishes the Medical Board of California to govern and regulate the practice of medicine in the state, including licensed physicians for patient and public protection. The Act's Section 2004 expressly authorizes and obligates the Medical Board of California to license physicians on qualifying grounds. The Act's Section 2052 prohibits practice without a license, defining unlicensed practice as a criminal misdemeanor warranting incarceration for up to one year and a fine of up to $10,000. If you do not resolve your NBME / USMLE issues to obtain a Medical Board of California license, you may lose your ability to practice medicine not only in California but in other states across the country, imposing similar requirements.

California Medical License Application Requirements

Sections 2080 and 2081 of California's Medical Practice Act require that you apply to the Medical Board of California for your medical license on forms that the Board provides and with supporting information and documentation that the Board requires. Don't treat your license application in an offhand, careless, or routine manner, especially given your NBME / USMLE issues. Medical Board officials may construe errors, omissions, inaccuracies, and inconsistencies in your information and documentation as credential fraud and grounds to refuse you a license. Instead, let us help you provide the Medical Board with initial information, updates, and corrections regarding your NBME / USMLE issue that is accurate, complete, and non-misleading while reassuring the Medical Board that we are addressing those issues with a substantial probability of success.

California Medical Licensure General Requirements

Section 2082 of California's Medical Practice Act states the general licensure requirements to obtain a Medical Board of California license to practice medicine in the state. Those requirements include graduation from an approved medical school, passage of an approved medical licensing exam, and completion of the required medical residency, typically one year. Other sections impose good character and background check requirements, while still other sections detail the residency, examination, and related requirements. Medical Board of California administrative rules supply additional details for the general statutory requirements. Let us assist you in addressing and resolving any other Medical Board of California general requirements issues in addition to your specific issues with the exam requirement.

California Medical Licensing Exam Requirements

Section 2184 of California's Medical Practice Act provides that passing scores on each of the three USMLE step exams satisfy the examination requirement for Medical Board of California licensure. Medical Board of California Administrative Rule 1328 also acknowledges the USMLE as a satisfactory exam while adding FLEX and NBME exams as alternatives or in combination. Refer to the complex rule for its considerable details. Together, the statute and rule provide for a ten-year period within which to complete the examination requirements, with an opportunity to extend that period on a showing of good cause. Special exceptions and relief aside, it is likely essential that you resolve your NBME / USMLE issues in order to pass the required exam and obtain a Medical Board of California license for practice within the state. USMLE disqualification may be grounds for disqualification from other exams. Let us help you make that determination of your best exam option while also addressing and resolving your USMLE issues.

Potential USMLE Issues Affecting California Medical Licensure

Your NBME / USMLE issues should concern you. They may prevent your Medical Board of California licensure. Do not minimize or ignore those issues. You would do so at your great peril. But at the same time, USMLE officials anticipate that examinees may face and need to resolve certain issues, either providing adjudication processes and procedures for us to invoke on your behalf or entertaining our informal communications, advocacy, and negotiation. The six major NBME / USMLE issues that you may face, for which we can help you pursue USMLE resolution, include:

1. qualifying for the exam initially or remaining qualified for retakes;
2. passing the exam within the allowable retake attempt limits;
3. defending irregular behavior charges relating to suspected cheating;
4. retaking the exam after anomalous performance in your exam responses;
5. inducing the release of an invalidated score or preserving retake opportunities after that invalidation; and
6. showing extenuating circumstances for an additional retake, when necessary, due to an exam emergency.

California Physician Issues Qualifying for the USMLE

Your first issue may be qualifying for the NBME / USMLE so that you can pass the exam to obtain Medical Board of California licensure. You must satisfy each USMLE exam qualification requirement in its Bulletin of Information. Qualifying initially is only your first challenge. You must also remain qualified as you succeed toward each next step exam or require retakes. USMLE officials may disqualify you at any time for false application information, failure to advance in your medical education program or residency, rules violations arising during exam administration, or on other grounds. Your attempt to qualify or remain qualified may trigger any one or more of the following issues:

• errors, omissions, or false, inaccurate, or inconsistent statements in your USMLE application;
• omissions, contradictions, or inconsistencies in your application documentation;
• problems or questions as to your medical school's accreditation or approval;
• medical school transcripts failing to show required education or showing unresolved disciplinary issues;
• unauthenticated, uncertified, or unattested documentation improperly provided by someone other than the issuer;
• inadequate documentation of claimed citizenship or lawful residency status; and
• disqualifying criminal conviction history, failure to authorize history checks, or agency failure to answer history check requests.

How We Help Address USMLE Qualification Issues

If your qualification issue relates to your medical school, we can communicate, advocate, and negotiate with school officials to resolve pending academic progress or discipline issues and to update and correct your transcript. If your issue relates to your criminal history, we can communicate with criminal court clerks and entertain court proceedings to resolve potentially disqualifying issues and update necessary court records. If your issue relates to your lawful residency status, we can work with government officials to obtain birth certificates, passports, visas, or other necessary documentation. We can also ensure that documentation has the authenticity that USMLE protocols require and arrives by the required transmission route. At the same time, we can keep Medical Board of California officials informed of our diligent and successful efforts at resolution.

California Medical Licensing Exam Attempt Limits

After qualifying for the USMLE, you must next pass each step exam with the necessary score with retake attempt limits. Failing the exam and running out of retake attempts may bar you from obtaining Medical Board of California licensure. To some extent, USMLE and licensing officials anticipate USMLE step exam failures. Exam rigor and exam failures are why the USMLE administers the exam in progressive steps and why the USMLE offers retakes. We can keep the Medical Board of California informed of your retake opportunities and your progress. But beware when your retake attempts approach the USMLE's four-attempts retake limit. You ordinarily get only four tries on each step exam, a limit that California laws and Medical Board of California regulations follow. Run out of retakes, and you could lose out on Medical Board of California licensure.

How We Help with USMLE Retake Limit Issues

Passing the USMLE exam is largely up to you and your diligent preparation and effective studies. Where we may be able to help is with the USMLE's four-attempts retake limit. If emergencies interfere with any of your step exam attempts, we may be able to gain you additional attempts to address the emergency. USMLE officials implement an extenuating circumstances policy. If you miss a scheduled exam due to your illness or injury, the illness or injury of a close family member dependent on your care, or a similar compelling circumstance, we may be able to invoke the policy to gain an extra attempt. Similarly, if you experience an emergency, attempt the exam anyway, and find during the exam that your attempt was unwise and sure to be unsuccessful, we may be able to invoke the policy for an extra attempt with sound information, argumentation, and documentation. Do not delay in seeking our assistance with this option. Delay could cost you the retake opportunity.

California Physician USMLE Irregular Behavior Issues

You may alternatively face an issue relating to suspected cheating before, during, or after you take and pass the USMLE step exams. You may be perfectly well qualified for the exam and capable of passing it but face allegations that you violated exam rules and gained or attempted to gain an undue advantage. If other examinees, test center staff, or USMLE officials discover evidence of your suspected cheating, USMLE officials may issue you a notice of irregular behavior charges. USMLE policy defines irregular behavior as examinee conduct that may “compromise the validity, integrity, or security” of exam administration. You need not speculate as to the form cheating suspicions may take. The USMLE publishes these examples of irregular behavior:

• misrepresented exam qualifications;
• falsified or altered qualification documents;
• registration when ineligible;
• retake attempts after disqualification;
• taking the exam for another;
• having another to take the exam for you;
• pursuing confidential exam materials;
• disobeying or harassing exam proctors;
• unauthorized materials or devices in the exam room;
• exam materials removed from the exam room;
• exam questions disclosed after the exam;
• misrepresented exam status or scores; and
• refusing cooperation with exam investigation.

How We Address USMLE Irregular Behavior Charges

If USMLE officials suspect cheating, a USMLE investigator may contact you. Retain us immediately on any such contact so that we can help you provide the investigator with timely, accurate, complete, consistent, and well documented responses. We may be able to exonerate you and gain release of your withheld passing score. If instead you receive a formal notice of irregular behavior charges, retain us to respond to those charges in the same timely, truthful, comprehensive, and reliably documented manner. We can invoke the Office of the USMLE Secretariat's adjudication process described in the notice of charges. We can also appear at any necessary hearing and take appropriate appeals. We can also simultaneously inform Medical Board of California officials of our progress in resolving your USMLE irregular behavior charges, especially if USMLE officials have notified Board officials of those charges.

California Physician USMLE Anomalous Performance Issues

You may alternatively complete USMLE step exams without questions over your qualification or alleged misconduct, but nonetheless, have your exam responses triggered USMLE concerns that you were not prepared for the exam or did not give appropriate effort? USMLE officials analyze exam responses. If an examinee's score falls below the normal distribution for prepared examinees giving reasonable effort, those officials may issue a notice of anomalous performance. An anomalous performance notice indicates that your score was so low, or you had so many gaps in your answers that officials did not believe you had the education or gave the effort necessary for a reasonable attempt. They may accordingly bar you from retaking the exam and notify Medical Board of California officials accordingly.

How We Address USMLE Anomalous Performance

A USMLE anomalous performance notice will not offer you any adjudication procedure. Adjudication might require USMLE officials to disclose their analysis and methods of analysis, compromising exam security and confidentiality. Instead, you must generally live with the determination that your score did not pass and your performance so deficient as to trigger serious concerns over your education or effort. On the other hand, you may have a good idea of what happened, such as that you missed sections of the exam, recorded your answers in an unintended pattern of errors, or made other unintentional errors in your exam approach. We may be able to present that sort of information and any supporting documentation we can discover and acquire to successfully advocate for your opportunity to retake the exam, which may be all you need to pass. We would simultaneously communicate our diligent efforts and your good case for a retake to the Medical Board of California to keep your licensing application open.

California Physician USMLE Invalidated Score Issues

On the other hand, USMLE analysis of your exam responses may show that you scored so high on the exam that your success fell outside the normal distribution for highly prepared and capable examinees, suggesting that you may have had access to confidential exam questions. If you answered previously used questions correctly but missed new test questions, that pattern may confirm a substantial probability of cheating, enough that USMLE officials will notify you of your invalidated score. If you receive such a notice, it will indicate that USMLE officials are refusing to release your (presumably passing) score. The notice may also indicate that USMLE officials are barring you from retaking the exam and disqualifying you from further registration. USMLE officials may also notify Medical Board of California officials of their invalidated score decision, subjecting your license application to immediate denial.

How We Address a USMLE Invalidated Score

The USMLE notice of invalidated score should indicate that USMLE officials offer an adjudication process, like the process available after an irregular behavior charge. Retain us immediately upon your receipt of any such notice. We can help you investigate and evaluate the circumstances of your exam administration to discover any potential explanation for USMLE suspicions and to gather evidence to respond to those suspicions. We can timely invoke the adjudication process to present your exonerating evidence and explanation, with reliable supporting documentation. We may be able to obtain the release of your invalidated score, showing your approved passage. If not, we may be able to negotiate your continued qualification for the exam so that you can retake it. We would simultaneously communicate the fact and strength of your answer to the USMLE invalidated score notice, to the Medical Board of California so that it keeps your file open until favorable resolution of the issue.

California Medical Board Response to USMLE Issues

Do not be surprised if Medical Board of California officials seem eager to reject your application and close your file based on your NBME / USMLE issues. California's Medical Practice Act and the Medical Board's own rules and protocols require some level of diligence in acting on physician license applications. Board officials cannot just leave files open indefinitely. They generally need applicants to provide timely updates and especially to respond affirmatively to disqualifying information that other sources like the USMLE provide. You applied for a Medical Board license and paid the fee. Your application, to some degree, places the onus on Board officials to decide on your application. You should thus expect Medical Board responses and action on your application, even if you would prefer that the Board await final resolution of your USMLE issues after you exhaust all avenues for relief with our skilled and experienced representation. The Board's sure response will be application denial if you have not resolved those issues to show your exam passage.

Our Role Addressing California Medical Board Response

If Medical Board of California officials deny your license application before we have exhausted your avenues for relief of your USMLE issues, we can help you invoke the state's administrative review procedures described immediately below to reverse that final decision, reopen your application, and move forward toward the final favorable resolution of your USMLE issues.

California Administrative Review Procedures

The Medical Board of California has adopted its Administrative Rule 1308 providing for a hearing under California's Administrative Procedures Act in the event that an applicant wishes to challenge the Board's denial of a license application or other final agency action. You must affirmatively request the hearing, which the Board must approve. We can help you make that request. An Administrative Procedures Act hearing generally occurs before an administrative law judge under circumstances where we would be able to present evidence of our diligent efforts to resolve your USMLE issues. We might even have successfully resolved those issues by the time of your administrative hearing, giving the ALJ convincing grounds to reverse the Medical Board's license denial and reopen your application for approval.

Premier USMLE Defense in California

The Lento Law Firm's Student Defense Team is available across California to help you favorably resolve your medical licensing matter involving NBME / USMLE issues. We have helped hundreds of students, graduates, and other professionals in California and nationwide with their licensing issues. Call 888.535.3686 or use our contact form now to retain our premier attorneys.