The Consequences of a Finding of Irregular Behavior

Posted September 1st, 2020 by .

Categories: ECFMG, Healthcare Litigation, NBME, USMLE, xHospital Credentialing.

Per our website at this link, we write What is at stake when a medical student, medical school graduate or medical professional receives a letter informing them that they are alleged to have engaged in irregular behavior? Put simply, everything.”

Unfortunately, this statement is not an exaggeration.

On the consequences of a finding of irregular behavior, ECFMG states:

“Engaging in irregular behavior can end your medical career before it starts.” visit this link:

Per the Federation of State Medical Boards (FSMB), which, along with the National Board of Medical Examiners (NBME) administers the USMLE Program:

“Remember, the stakes on a medical licensing exam are high! Don’t do something that might jeopardize your future as a licensed physician.” visit this link

More than a decade ago, FSMB released a study titled “An Assessment of USMLE Examinees Found to Have Engaged in Irregular Behavior, 1992-2006”.  The study notes that a mere 37.2% of individuals found to have engaged in irregular behavior were later able to obtain a full license to practice medicine.  The study concludes:

“A finding of irregular behavior by the USMLE program carries significant consequences for the prospective career of an individual.  State medical boards have denied licenses to individuals with irregular behavior and been unwilling to support the prospective licensure of individuals with indefinite bars. The irregular behavior annotation to the transcript appears to divert the license application from its routine administrative handling to a more individualized review of the candidate’s qualifications, including his/her character and fitness to practice medicine.”

The study

What to take from the foregoing:

  1. Read and know all the rules and policies of ECFMG and the USMLE Program in order to understand what actions – or inactions – might be considered irregular behavior.
  2. If alleged to have engaged in irregular behavior, understand all the policies and procedures and know your rights. Hire experienced counsel to represent you in connection with your response to the allegations.  Make a personal appearance, with experienced legal counsel, before the committee that will determine the fate of your career.
  3. If you have been subjected to a finding of irregular behavior, all is not lost. Our firm has represented many clients who have gone on to obtain residency training positions, medical licensure, and employment even in the face of a prior finding of irregular behavior.  Hiring experienced counsel to assist in navigating ERAS and NRMP applications, as well as applications for state medical licensure, can have a significant impact on your ability to move forward with your career despite an irregular behavior finding.

Our firm is one of a select few in the country with more than 10 years of experience in representing clients in the defense of irregular behavior allegations.  Should you find yourself in need of legal support along your career path (medical school, residency training, medical licensure, etc.), please contact our firm for assistance.

For more than 10 years, Dennis L. Abramson has dedicated a significant portion of his practice to counseling and representing medical students, IMGs, residents, fellows, and practicing physicians in compliance and disciplinary matters related to ECFMG, USMLE, NBME, and NRMP, including responding to and defending allegations of irregular behavior and violations of the Match® agreement. Should you need advice or counsel with a related issue, please contact Mr. Abramson at 610-664-5700 or

Mr. Abramson regularly updates this page with the latest developments related to ECFMG, USMLE, NRMP, ABIM, irregular behavior, and physician licensing and credentialing issues, so check back soon.

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