NBME/USMLE Defense for Hawaii Medical Students and Graduates

A burgeoning Hawaii medical practice could be every newly licensed physician's dream. Hawaii has such spectacular island and ocean scenery, cultural attractions, and temperate weather that it is a prime place to establish a professional career and practice. Reports indicate that Hawaii faces a shortage of many hundreds of physicians, auguring abundant employment and practice opportunities. The Hawaii Medical Board accordingly encourages you to apply for its license.

You won't, though, get your Hawaii Medical Board license without first resolving your USMLE, FLEX, NBME, NBOME, COMLEX-USA, or MCCQE medical licensing exam issues. Don't risk further delays and the denial of your license application. Instead, promptly retain the Lento Law Firm's premier Student Defense Team for the skilled and experienced attorney representation you need. We are available in Urban Honolulu, East Honolulu, Hilo, Pearl City, Kailua CDP, Waipahu, Kaneohe, Mililani Town, Kahului, Ewa Gentry, and across the rest of Hawaii. Call 888.535.3686 or use our contact form now for your best possible medical licensing outcome.

Hawaii Medical Practice Rewards

You know your huge investment in starting a Hawaii medical practice. You should also anticipate your due rewards for your time, effort, skills, and investment. Those rewards, of course, include living in one of the most beautiful, temperate, safe, and friendly places on earth. But the rewards also include the opportunity to build a thriving practice supported by the state's fine healthcare facilities, including the leading Queen's Medical Center, Straub Medical Center, Kaiser Permanente Moanalua Medical Center, Kapiolani Medical Center for Women & Children, Pali Momi Medical Center, Hilo Medical Center, Maui Memorial Medical Center, Wilcox Medical Center f/k/a Wilcox Memorial Hospital, and Adventist Health Castle f/k/a Castle Medical Center. Hawaii's John A. Burns School of Medicine at the University of Hawaii-Manoa further ensures your professional development, offering teaching, research, and continuing education opportunities. Don't risk these rewards. Instead, get our skilled and experienced representation to resolve your licensing exam issues swiftly and surely.

Hawaii Medical Licensing Authority

You indisputably need a license to practice medicine in Hawaii. Section 453-2 of the Hawaii Medical Practice Act states expressly that every physician using the designations Dr., MD, DO, or otherwise representing the capacity and willingness to practice medicine in the state must first obtain a Hawaii Medical Board license. Section 453-13 of the Hawaii Medical Practice Act further makes it unlawful to practice medicine in Hawaii without first obtaining a license from the Hawaii Medical Board. Section 453-13 warns of a $500 fine and up to six months in jail for each day of a violation through unlicensed practice. If you practice without a license, the Hawaii Medical Board may further use that violation to deny your license application, ending your dreams of a Hawaii medical practice. Don't risk these sanctions. Instead, get our skilled help resolving your medical licensing exam issues.

Hawaii Medical License Application Requirements

Section 453-4 of the Hawaii Medical Practice Act requires you to submit proof of your medical competence and knowledge to the Hawaii Medical Board. Hawaii Medical Board Rule 16-85-7 further requires you to complete the Medical Board's application form for its license while attesting to the accuracy of your representations. Rule 16-85-7 also details the extensive and rigorous identification, qualification, and documentation requirements. The attestation requirement alerts you as to the importance of the accuracy of your answers. If you do not complete the Medical Board's application with accurate, complete, comprehensive, and consistent information, you may face credential fraud allegations and denial of your license. Credential fraud issues can easily arise around your medical licensing exam issues, which may come up after you apply and which may change the information you first represented on your license application. Beware the risks of credential fraud charges. Let our attorneys help you review, update, and correct your Hawaii Medical Board license application while we help you address and resolve your licensing exam issues.

Hawaii Medical Licensure General Requirements

Section 453-4 of the Hawaii Medical Practice Act sets forth general licensing requirements for physicians seeking to practice medicine in the state. You must meet these requirements to get your Hawaii Medical Board license. Section 453-4 requires that you graduate from an approved medical school, generally one recognized by the Liaison Committee on Medical Education or the equivalent body for osteopathic medical programs. You must also complete one year of medical residency and either prove to the Medical Board that you are sufficiently competent and knowledgeable or pass one of the statutorily approved medical licensing exams. Applicants generally must pass an approved exam unless having substantial foreign medical practice experience or other unusual evidence of medical competence. You may also have to provide fingerprints for a criminal history check, demonstrate English language proficiency, prove citizenship or lawful residency, and show proof of your good character and mental and physical fitness. Let us help you with any of these general qualifications requirements, in addition to your medical licensing exam issues.

Hawaii Medical Licensing Exam Requirements

Section 453-4 of the Hawaii Medical Practice Act sets forth the specific medical licensing exam requirements you must ordinarily meet for Hawaii medical licensure. Section 453-4 gives you the widest generally recognized options, including:

• National Board of Medical Examiners examination (NBME);
• Federation Licensing Examination (FLEX);
• United States Medical Licensing Examination (USMLE);
• National Board of Osteopathic Medical Examiners examination (NBOME);
• Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA); or
• Medical Council of Canada Qualifying Examination (MCCQE).

Section 453-4 also gives you the option of combining steps, parts, or components of the NBME, FLEX, and USMLE exams. The Hawaii Medical Practice Act and Hawaii Medical Board do not limit the number of attempts you may make to pass your step exams, although candidates must ordinarily complete all exams within ten years. The exam organizations may impose their own attempt limits. The USMLE, for example, limits attempts to four.

Common Exam Issues Affecting Hawaii Licensure

Medical licensing exam issues tend to fall into one of six broad categories. The category into which your exam issues fall generally determines both the procedures that our attorneys can invoke on your behalf to resolve those issues and the evidence that we would ordinarily expect to present. The following sections address these six categories of medical licensing exam issues and how our attorneys would generally address those issues while keeping the Hawaii Medical Board informed of our efforts so as to keep your license application file open and active:

1. qualifying youto register and sit for the exam;
2. passing each of your step exams within applicable attempt limits;
3. defending cheating charges alleging your suspicious conduct;
4. overcoming anomalous exam performance disqualifying you;
5. overcoming an invalidated exam score; or
6. proving extenuating circumstances for an extra exam attempt.

Hawaii Medical Board Exam Qualification Issues

Your first challenge is to qualify for your USMLE, NBME, FLEX, NBOME, or COMLEX-USA exam. To qualify for the exam, you must meet your exam organization's application requirements, which can be like your Hawaii Medical Board license application requirements. Depending on the step exam for which you are attempting to qualify, you may have to show your medical school standing graduation or medical residency, in addition to your identification, citizenship or lawful residency, and other particulars regarding your character, education, training, and fitness. The Hawaii Medical Board may coordinate with your exam organization or rely in part on your exam organization to ensure that you meet its strict qualification requirements. The USMLE's Bulletin of Information, for instance, lists the organization's detailed exam qualification requirements. Those requirements could cause you any of the following issues:

• issues with inconsistent, inaccurate, or incomplete application statements;
• issues with inconsistent, inaccurate, incomplete, or unauthenticated application documentation;
• contradictions between your application statements and your application documentation;
• issues with your medical school's satisfactory academic progress;
• medical school disciplinary charges alleging your misconduct;
• issues with your medical school's LCME accreditation or other Hawaii Medical Board approval;
• issues with the non-renewal of your medical residency program or your program dismissal for misconduct, unprofessionalism, or incompetence;
• issues with pending criminal charges or past criminal convictions; or
• issues with citizenship, lawful residency status, or documentation of citizenship or residency status.

How We Address Exam Qualification Issues:

Our attorneys know how to communicate, advocate, and negotiate with medical school registrars, other medical school officials, medical residency directors, and other officials and recordkeepers to gain swift action on documentation issues. Medical students and graduates can face difficulty getting recordkeepers to respond. We can generally get swifter and surer responses and, if not, invoke formal procedures to do so. Once again, we can also help you resolve underlying disciplinary, academic progress, or other issues that are preventing you from getting the proper documentation to qualify for your medical licensing exam by invoking protective procedures where necessary. Let us also communicate with Hawaii Medical Board officials to ensure they keep your license application open.

Hawaii Medical Board Exam Attempt Limits

You've seen above that the Hawaii Medical Practice Act and Hawaii Medical Board do not impose their own limit on the number of attempts you may make to pass the USMLE, NBME, FLEX, or other licensing exam you are pursuing. Passing your exams is largely up to you, with your exam preparation resources and support. You may still have plenty of attempts available. But you've also seen above that your exam organization may impose its own limit, such as the USMLE's four attempts limit for each step of the exam. So, even though Hawaii does not limit your attempts, you may run out of attempts with your exam organization, which may disqualify you from further attempts and may notify the Hawaii Medical Board of your exam disqualification.

How We Address Exam Attempt Limits:

We can help if you run out of available medical licensing exam attempts. The USMLE offers an extenuating circumstances policy that permits us to advocate for an extra exam attempt if you had a sudden illness or injury interfere with your scheduled exam attempt or if you had another emergency do likewise, such as an illness or injury of a close and dependent family member. We can help you gather the documentation and make a convincing presentation of your special circumstances. But you must act swiftly, either notifying the exam organization before your scheduled exam commences or soon after you withdraw from your unavailing attempt at the exam. Get our help the moment you realize you've exhausted or are about to exhaust your last available exam attempt.

Hawaii Medical Board Irregular Behavior Issues

Perhaps your issue is not with qualifying for your medical licensing exam or with passing each step of the exam. Your issue may instead be with surprising allegations that you may have cheated on the exam. Those allegations can come not only from exam administrators and proctors but also from other examinees who generally have a duty to report suspected exam misconduct. The USMLE's Bulletin of Information, for instance, describes its irregular behavior policy, under which USMLE officials may disqualify you from the exam for appearing to “compromise the validity, integrity, or security” of a step exam. Your exam organization may then notify the Hawaii Medical Board of your suspected cheating and your exam disqualification, causing the Board to reject your license application. Cheating charges can involve any of the following common allegations:

• interfering with an investigation into exam misconduct;
• assisting another examinee in the exam room;
• soliciting assistance from another examinee in the exam room;
• using unauthorized notes, materials, or devices in the exam room;
• efforts to get confidential exam questions to prepare for the exam;
• offers to share confidential exam questions after taking the exam;
• registering for an exam when you are not eligible to register;
• having another take your exam as an impostor;
• ignoring instructions of an exam proctor during the exam;
• trying to remove exam questions or materials from the exam room;
• trying to photograph or record exam questions in the exam room or
• misrepresenting your exam score or qualifications to officials.

How We Address Exam Irregular Behavior Charges:

We can invoke your exam organization's formal or informal procedures for addressing and resolving exam misconduct or other cheating allegations. The USMLE, for instance, follows an adjudication process managed by its Office of the Secretariat. The adjudication process enables us to gather your exonerating evidence to present at a hearing before an impartial decision-maker. We can also help you challenge the complaining witness who may have misidentified you, misunderstood your words or actions, or even blamed you for another's wrong in a cover-up. Our attorneys know how to challenge witness credibility, hearsay, and observations without adequate first-hand knowledge and observation. We will also keep the Hawaii Medical Board informed so that it keeps your license application open.

Hawaii Medical Board Anomalous Performance Issues

Cheating allegations from outside sources are not your only risk surrounding a medical licensing exam. Your exam answers can also lead to allegations that you were either not qualified for the exam or that you entered the exam room without the intent to make an earnest effort on the exam and instead to record exam questions or for similar nefarious purposes. Exam officials analyze examinee scores and answer patterns. A very low score may indicate to those officials that you didn't have the medical education to qualify for the exam. Large unanswered sections of the exam, or all one answer choice for multiple consecutive questions, may indicate to exam officials that you raced through the exam in a false attempt while using your time to assist another examinee or record questions. A USMLE anomalous performance policy authorizes USMLE officials to bar you from future attempts under those circumstances, triggering the Hawaii Medical Board license application denial.

How We Address Exam Anomalous Performance:

Our attorneys can work with you to gather evidence of your strong medical school academic performance, showing that you had the capability to pass the step exam on which you scored very poorly or failed to make an effective attempt. We can also help you prove the circumstances that interfere with your earnest attempts, such as a mental lapse, misunderstanding as to the exam format or instructions, a technology issue, or misrecorded exam answers. We can also communicate with Hawaii Medical Board officials to satisfy their own concerns once they receive notice of your disqualification.

Hawaii Medical Board Invalidated Score Issues

A very low score is one problem, while a very high score presents another problem. If, instead of a very low score, you score well above the normal distribution of high scores, exam officials may presume that you had an undue advantage of some kind, even if they have no other evidence of misconduct. In that case, they may withhold your passing score under an invalidated score policy. Likewise, a batch of identical answers and passing scores among examinees at a single test center or with a similar connection could result in your passing score's invalidation. Suspect score invalidation if your fellow examinees all receive their exam results but you do not. You may soon receive notice of your invalidated score. Retain us to confirm the cause of your score delay.

How We Address Invalidated Exam Scores:

Much as with anomalous exam performance, our attorneys can invoke your exam organization's formal procedures or follow informal channels to present your exonerating explanation and evidence. Your exam organization won't necessarily reveal the details of its answer analysis. Doing so could compromise its exam security measures. But we may nonetheless be able to use circumstantial evidence to prove your innocence of any wrongdoing in obtaining an unusually high score. You may, for instance, have a very high MCAT score and other standardized test scores, proving your peculiar capacity for test-taking. You may also have a very strong medical school academic record, which we can document, including potential affidavits from your medical professors as to your keen aptitude and good character for honesty. Even if we cannot obtain the release of your passing score, we may be able to gain you another attempt, which you should be able to ace again, proving you had no unfair advantage.

Hawaii Medical Board Response to Exam Issues

Ultimately, your goal is to satisfy the Hawaii Medical Board and ensure that you meet the statutory requirements for licensure. The Hawaii Medical Board has its own obligation to act diligently on your application, no matter what your exam organization is or isn't doing to resolve your exam issues. You may find that the Hawaii Medical Board closes your file and rejects your application before you have exhausted your procedural avenues and available remedies with your exam organization. In that instance, we can communicate, negotiate, and advocate with the Medical Board to keep your file open or to reopen it while we show the Medical Board the diligence and likely success of our efforts on your behalf to resolve your exam issues. Let us help you keep your license application open rather than have to reapply and suffer the attendant delay and risk of presumptive denial.

Hawaii Administrative Review Procedures

You generally hold a constitutional right to due process against state board action affecting your property and liberty interest in your Hawaii medical practice. To recognize and respect that constitutional right, various sections of the Hawaii Medical Practice Act, including Section 453-8.2 on license discipline, refer to Hawaii Revised Statutes Chapter 91, which is the state's Administrative Procedure Act providing abundant procedural protections. We can invoke your procedural safeguards to arrange, attend, and advocate at a formal hearing of the Hawaii Medical Board's adverse decision. If you have already lost your hearing, the procedural safeguards include appeal and even judicial review in appropriate cases. Let us pursue all your procedural rights until we obtain the best possible licensing outcome.

Premier Hawaii Medical Licensing Exam Defense

The Lento Law Firm's premier Student Defense Team is available across Hawaii to help you promptly address and favorably resolve your medical licensing exam issues. Our attorneys represent hundreds of medical students and graduates, as well as students and graduates in other professional programs across Hawaii and nationwide. Call 888.535.3686 or use our contact form now to retain our skilled and experienced attorneys.