International medical graduates (IMGs) trying to practice medicine in the U.S. can face substantial issues gaining a U.S. state medical license. Without that license, an international medical graduate won't be able to put the medical education to work in the U.S. for all the financial, personal, and professional benefits a U.S.-based medical practice can provide. Retain the Lento Law Firm's premier Student Defense Team for your highly skilled and effective representation if you face U.S. state licensing issues after completing your international medical education. Call 888.535.3686 or use our contact form now for the strategic representation you need to favorably resolve your U.S. state licensing issues. Your ambition for U.S.-based medical practice is worth preserving and pursuing.
State Licensing Board IMG Requirements
According to the Federation of State Medical Boards, U.S. state licensing boards maintain special requirements for licensing international medical graduates. If you are an international medical graduate (IMG), you may have different and additional U.S. state licensing requirements than the graduate of a U.S. medical school. Federation of State Medical Boards analysis shows that U.S. state medical boards vary in their special IMG licensing requirements along the following parameters. You can find information about your state here.
State Medical Board Approved-School IMG Requirements
Some state medical boards maintain their own list of approved international medical schools from which they will accept an international medical graduate for licensure. According to the Federation of State Medical Boards above analysis, Kansas, Maryland, Nebraska, and Tennessee are examples of state medical boards having their own approved foreign medical school list. Other state medical boards rely on World Directory of Medical Schools designation that the Educational Commission for Foreign Medical Graduates (ECFMG) has approved the foreign medical school. Florida, Iowa, Idaho, New Jersey, and Nevada are examples of state medical boards relying on ECFMG foreign medical school approval, as the World Directory of Medical Schools reflects. Other states, like California, accept World Directory ECFMG listing or approval by their own board in the absence of World Directory listing. Still, other states, like Georgia, follow the California list. Let us help you with your state medical board licensing issue if it involves whether the state medical board recognizes your foreign medical school.
State Medical Board ECFMG Fifth Pathway Approval
State medical boards also vary in whether they will accept ECFMG Fifth Pathway completion for the international medical graduate to satisfy the state medical board's education requirement. The USMLE's Fifth Pathway program enables an international medical graduate to obtain ECFMG certification based on a medical degree issued jointlybetween a foreign medical school and a U.S. medical school. According to Federation of State Medical Boards analysis, some state medical boards, including California, Illinois, and Minnesota, accept ECFMG Fifth Pathway certification based on the joint medical degree. Other state medical boards, including Ohio, Nebraska, and Iowa, reject ECFMG Fifth Pathway certification based on the joint medical degree. Let us help if you earned a joint medical degree and now face state medical board licensing issues.
State Medical Board GME Requirements
State medical boards also vary in the amount of graduate medical education (residency training) the state board requires for an international medical graduate to qualify for licensure. According to Federation of State Medical Boards analysis, some state medical boards, including Arizona, Colorado, and Idaho, require only one year of graduate medical education. Other state medical boards, including Connecticut, Illinois, and Kentucky, require a minimum of two years of graduate medical education. Still, other state boards, including Delaware, Kansas, and Louisiana, require a minimum of three years of graduate medical education. State medical boards also vary in whether they will accept graduate medical education in a foreign country. Arizona, Minnesota, and Georgia medical boards, among several others, may accept foreign medical residencies. Alabama, Colorado, and New Jersey, among many other state medical boards, will generally not accept foreign medical residency. Let us help you if you have a state licensing board dispute over whether your graduate medical education's location or duration satisfies the medical board's requirement.
State Licensing Board ECFMG Issues
International medical graduates can face other ECFMG issues when seeking U.S. state medical board licensure. Many state medical boards rely heavily on ECFMG certification of international medical graduates, not only for the approval of the foreign medical school for inclusion on the World Directory list but also for collecting, evaluating, and sharing graduation, citizenship or immigration status, and other information critical for licensure. ECFMG requires IMGs to use its Electronic Portfolio of International Credentials (EPIC) service to collect and share information on IMG qualifications with ECFMG officials, USMLE officials, and state medical board officials. For instance, if your ECFMG certification application through EPIC fails to reflect your graduation from an approved international medical school, ECFMG will not certify you to state medical boards for licensure. Yet ECFMG's EPIC service can create its own licensing issues, even if your qualifications comply with state medical board licensure standards. ECFMG may flag, delay, or deny your application for certification, ruining your prospect for state medical board licensure based on any of the following anomalies or issues. Let us help if you face any of the following ECFMG certification issues interfering with your state medical board licensure.
ECFMG Application Issues Interfering with Medical Licensure
International medical graduates may face issues completing their ECFMG application for certification with consistent and comprehensive information that ECFMG accepts as accurate and complete. Your EPIC application may, for instance, reflect different (maiden, married, middle, etc.) names, legal residence, school attendance dates, or other information from your supporting records. Inconsistencies in information and incomplete information are two common red flags that can stall your ECFMG certification, causing state medical boards to follow suit in delaying or denying your licensing process. Let us advocate with ECFMG and state medical board officials and invoke their respective dispute resolution processes if you have ECFMG application issues interfering with your state medical board licensure.
ECFMG Documentation Issues Interfering with Medical Licensure
International medical graduates may also face ECFMG documentation issues that delay or prevent state medical board licensure. Once again, you may meet all ECFMG certification requirements to present your EPIC file to your state medical board for licensure. However, your documentation of your EPIC file may lack one or more documents that ECFMG certification standards require. You may, for instance, have graduated from an ECFMG approved foreign medical school. However, your medical school may not have prepared and presented a transcript and degree in the name and form that ECFMG standards accept. You may have notified your foreign medical school's registrar or other administrators of the need for a modified, replaced, updated, or corrected transcript or other degree document but have not received a timely and helpful response. Or your school may have submitted an acceptable transcript that ECFMG officials nonetheless anomalously reject. Let us help you resolve ECFMG documentation issues interfering with your state medical licensure.
ECFMG Authentication Issues Interfering with Medical Licensure
International medical graduates may also face ECFMG certification delays and denials based on the inadequate authentication or improper transmission of otherwise acceptable documents. For instance, your foreign medical school may have submitted to ECFMG your accurate transcript reflecting your graduation but not on the requisite school letterhead or form or without the registrar's required attestation or certification. Or you may have supplied a duplicate transcript in lieu of the registrar's doing so, which ECFMG protocols will not accept, requiring instead that the registrar supply an original transcript. Authentication issues of school and other documents can arise around notarization, seals, letterheads or other official forms, originals versus copies, who transmits the document, and other details. Let us help you address and resolve ECFMG authentication issues interfering with your state medical licensure.
State Licensing Board Irregular Behavior Issues
International medical graduates can also face state medical licensing board issues based on ECFMG irregular behavior charges. ECFMG publishes a policy and procedure on irregular behavior to address complaints that an international medical graduate candidate for ECFMG certification may have subverted ECFMG examination, certification, and services. You may have done nothing at all wrong in compiling and submitting your ECFMG materials, completing your application for certification, and qualifying for, taking, and passing USMLE and other medical exams. Yet ECFMG may misconstrue your anomalous submissions or actions as if you were attempting to cheat, deceive, or otherwise subvert their processes. ECFMG officials take complaints from USMLE proctors, medical school administrators, and fellow IMGs who suspect your misbehavior or the misbehavior of others acting on your behalf. An ECFMG irregular behavior charge is a huge red flag to state medical board licensing officials. You likely won't get a state medical license without resolving your ECFMG irregular behavior charges.
Addressing ECFMG Irregular Behavior Charges
Consistent with its constitutional due process obligations, ECFMG offers protective procedures to international medical graduates facing ECFMG irregular behavior charges. Our attorneys can invoke those protective procedures from the early investigation stage to the referral stage, written submission stage, hearing stage, and appeal stage for your earliest and most effective resolution of ECFMG irregular behavior charges. We know how to document, advocate, communicate, and negotiate for swift and efficient administrative resolution of anomalous issues. If you have already lost your ECFMG hearing, let us appeal your adverse result. If you have already lost your appeal, let us explore alternative oversight relief within ECFMG and, alternatively, direct action before your state medical board. We may be able to get your ECFMG certification and state licensure back on track.
State Licensing Board USMLE Issues
International medical graduates can also face USMLE issues interfering with their state medical board licensure. USMLE officials generally rely on ECFMG certification of international medical graduates to qualify those IMGs for the USMLE's Step 3 exam. But USMLE officials and Prometric testing center officials, or other proctors and testing centers the USMLE employs, may raise their own issues with an international medical graduate's application, submissions, exam preparation, exam performance, and behavior before, during, and after the exam. The USMLE maintains policies and procedures that permit its officials to invalidate passing test scores based on these and other anomalies, complaints, and suspicions. USMLE issues can lead to the withholding or invalidation of your passing USMLE score. Invalidation of your USMLE exam score will surely prevent your state medical board licensure unless and until addressed. Consider the following common USMLE issues and how we may be able to help you address them.
USMLE Application Issues Affecting State Licensure
International medical graduates can face USMLE issues over their USMLE application information, whether for the Step 1 and Step 2 exams during your international medical education or through ECFMG for your post-graduate Step 3 exam. Under USMLE exam procedures, your submissions and representations relating to your qualification to take the USMLE exams must be accurate and non-misleading. USMLE officials may withhold and invalidate your passing USMLE score if, for instance, USMLE officials believe you have misrepresented the number of your exam attempts, the period over which you have taken and retaken USMLE step exams, the fact, and timing of your medical school graduation, or any other information or documentation material to your USMLE qualifications. Let us help you invoke the USMLE's procedures for resolving charges of false or deceptive representations and behaviors.
USMLE Preparation Issues Affecting State Licensure
International medical graduates can also face USMLE issues around their preparation for the exams, resulting in the withholding and invalidation of their subsequent passing scores. USMLE publications warn that soliciting or accepting test preparation materials or information that discloses actual USMLE exam questions or answers violates USMLE test preparation policies. Another examinee or other person may report that you solicited or accepted such materials based on their observation, your admission, or other evidence. Let us help you challenge the allegations if the USMLE withholds and invalidates your passing score based on reports of prohibited test preparation.
USMLE Test Center Issues Affecting State Licensure
International medical graduates can also face USMLE issues affecting state licensure around their USMLE test center conduct. If test center proctors, fellow examinees, or others report your misbehavior during a USMLE exam, USMLE officials may withhold and invalidate your passing score, causing you to lose your ability to qualify for state medical board licensure. USMLE exam policies prohibit a range of common test misbehaviors, including:
- bringing prohibited materials into the exam room;
- bringing prohibited devices into the exam room;
- disobeying or threatening an exam proctor or other test center staff;
- soliciting another to impersonate you to take the exam;
- impersonating another to take the exam for them;
- soliciting answers from another examinee during the exam or
- sharing answers with another examinee during the exam.
Let us help you if you face any of these allegations, resulting in the withholding or invalidating of your USMLE exam score. We can invoke USMLE procedures to present your exonerating and mitigating evidence.
USMLE Post-Exam Issues Affecting State Licensure
International medical graduates can also face USMLE issues affecting their state licensure for post-exam misconduct. USMLE policies prohibit you from photographing or otherwise reproducing from memory, or even communicating with others about, USMLE exam questions after the exam, with the intent of distributing those materials or that information to others for use on future exam preparation. If anyone reports your having done so, USMLE officials may withhold or invalidate your passing exam score. Let us help you resolve those allegations in your favor by invoking the USMLE's dispute resolution procedures.
State Licensing Board Medical School Issues
International medical graduates can also face state medical board licensing issues based on their international medical school issues. Medical schools, both inside and outside the U.S., face peculiar academic challenges. Medical school is the hardest of all academic programs, according to many. International medical graduates may have faced more than the usual medical school challenges because of travel, culture, language, educational support, instructional quality, program quality, and other issues. Your international medical school graduation reflects that you overcame your academic issues. However, ECFMG and state medical board officials may not accept your graduation as satisfactory evidence that your academic issues are behind you. Let us help if any of the following common IMG academic issues are interfering with your state medical licensure.
Academic Progress Issues Interfering with State Licensure
International medical graduates can face academic progress issues around failing grades in required courses, course withdrawals, incomplete courses, course retakes, cumulative grade-point averages below school minimums for good standing, too many terms off, too few credits attempted per term, and too long of a program duration, among other academic issues. Your international medical school may have placed you on academic probation, suspended you, reprimanded you, or required you to take remedial courses. Your efforts may have enabled you to graduate but may have left you with significant questions about the sufficiency of licensing purposes of your academic record. We may be able to help you appeal grades, remove resolved academic probation, remove remediated reprimands, or otherwise improve the appearance of your academic record sufficiently to meet state medical board licensing standards. We may also be able to intercede and advocate with state medical licensing board officials for your academic approval.
Professionalism Issues Interfering with State Licensure
International medical graduates can also face professionalism issues arising out of their international medical school studies and, in particular, their clinical studies. Professionalism issues can show up in clinical course evaluations, clinical course grades, and academic discipline proceedings, leaving records that alert state medical licensing board officials to your issues. Professionalism issues may entail insubordination toward clinical supervisors, disrespect toward clinical colleagues, harassment of subordinates, chronic tardiness or absenteeism for clinical rounds, patient neglect or abuse, poor dress, demeanor, or hygiene, intoxication or impairment while on duty, and similar misbehaviors that disrupt the clinic or endanger patients. We may be able to invoke your medical school's procedures or advocate and negotiate with medical school oversight personnel to remove inaccurate, exaggerated, or remediated indications of professionalism issues. We may alternatively be able to invoke state medical board procedures to advocate and negotiate for your licensing on conditions or with assurances.
State Licensing Board IMG Misconduct Issues
International medical graduates can also face state medical board licensing issues due to misconduct charges and allegations while in medical school. Medical students inside and outside the U.S. can face academic misconduct charges, behavioral misconduct charges, and sexual misconduct charges. Academic misconduct may involve exam cheating, falsifying clinical hours, plagiarism, or research fraud. Behavioral misconduct may involve violence or threats of violence, property theft or damage, trespass, vandalism, computer misuse, and similar wrongs. Sexual misconduct may involve sexual assault, sexual harassment, stalking, dating violence, or sexual exploitation. Any of these charges, especially if resulting in any form of discipline, may affect state medical licensure, even if your international medical school permitted you to resume or persist in your studies and awarded you a medical degree.
Addressing State Licensing Board IMG Misconduct Issues
We may be able to help you address and resolve your medical school misconduct issues, interfering with your state medical board licensure, by invoking your international medical school procedures or advocating and negotiating with your school's oversight officials for correction of or relief from the recorded discipline. We may, in other words, be able to help you clean up your medical school misconduct record based on remedial actions you took or a better understanding school officials finally reached. Alternatively, we may be able to invoke state medical board procedures to advocate and negotiate with board licensing officials for a medical license with conditions or assurances. Let us help you address your misconduct issues interfering with your state medical licensure.
State Licensing Board IMG Character Issues
International medical graduates can also face state medical board licensing issues arising out of character and fitness issues that came to light during the international medical education. Medical students inside and outside the U.S. can reveal character and fitness issues, especially under the challenges and stresses of a medical program. However, international medical students may face greater character and fitness issues, given the additional challenges and stresses of international travel, cultural barriers, language barriers, and differences in the quality, resources, and support of international medical schools. Character issues can involve a propensity for violence demonstrated outside of school, pornography, prostitution, or solicitation of prostitution, and dishonest acts such as intentionally writing bad checks, credit card fraud, or theft. Fitness issues can involve drug, alcohol, gambling, or sex addictions, physical injury, illness, or disability, or mental illness or disability. State medical licensing boards may take special note of your character and fitness issues, even if your international medical school allowed you to persist and graduate after disclosure of those issues. State medical boards are the last line of defense against unqualified medical practice.
Addressing State Licensing Board IMG Character Issues
We may be able to help you address and resolve your state licensing board character and fitness issues in one of two main ways. We may be able to help you go back and correct or update underlying records reflecting your character or fitness issue in ways that give state medical licensing board officials a more accurate picture of your good qualifications for medical licensure and practice. We may, for instance, be able to help you gain mental or physical examination, re-examination, or updated or corrected reports regarding your recovery from your prior disability or impairment. Alternatively, we may be able to invoke state medical board procedures to enable us to present the evidence of your recovery and good character and fitness while giving appropriate context to your past issues. We may also be able to advocate and negotiate for a medical license with conditions or assurances.
State Licensing Board IMG Immigration Issues
International medical graduates can also face citizenship or immigration issues interfering with their state medical board licensure. Your ECFMG certification should have addressed your citizenship or immigration issues. If you are not a U.S. citizen and instead require a visa to attend a U.S. medical residency and seek state medical board licensure, you may have availed yourself of the ECFMG's Visitor Sponsorship Program assisting IMGs with qualifying for a U.S. J-1 visa. Your ECFMG file may not have adequately resolved your immigration issue to state medical board satisfaction. If your immigration status is interfering with your state medical board licensure, we may be able to work with immigration officials, ECFMG officials, or state medical board officials to satisfy all concerns. Our attorneys know the documentation requirements necessary for appropriate qualification.
Your Risk with State Medical Board Licensing Issues
State medical board licensing issues can present you with special risks. You may think that a state medical board licensing red flag will only delay your licensure without affecting your other interests. Indeed, a medical board issue may prolong and substantially delay your medical licensing. It may eventually lead to the denial of a license. But even if your medical licensing board issue simply remains pending, that delay in your prompt and confident licensure may affect your other professional and personal interests. Foremost, your U.S. medical residency program may decide that your medical licensing issues disqualify you from program admission, participation, or continuation. Even if you have begun your U.S. medical residency and completed a first year, your residency advisor or medical director may use your medical licensing issue as an excuse to non-renew your residency program. Your medical licensing board issue could even adversely affect your ECFMG certification and your qualification for USMLE Step 3 exam. Credentialing can be like a house of cards. Knock out one card, and the whole house falls. Beware the risks of state medical licensing board issues. Let us help you promptly address and resolve them in your favor so that they do not adversely affect your other interests.
Your Stakes in State Medical Licensure
You may already find it obvious how significantly a delay in or denial of your U.S. state medical board licensure may affect your professional and personal interests. But take stock again. Denial of a U.S. state medical board license may mean that you have no prospect whatsoever for the practice of medicine in the U.S. You may try applying to another state medical board, but your application will likely have to disclose your prior denial, of which licensing officials in your second application state will in any case very likely discover. Your international medical degree from St. George's University Medical School, Saba University School of Medicine, Ross University School of Medicine, American University of the Caribbean School of Medicine, American University of Antigua School of Medicine, Medical University of the Americas, or another international medical program has great value. Once you are licensed, your education's value can be just as great as the value of a U.S. medical education. Don't lose all that investment to state medical board licensing issues. Preserve and protect your investment with our attorneys' highly skilled services.
Qualified Defense Attorney Representation
Don't retain unqualified attorney representation. It could do you more harm than good. Professional licensing matters are administrative in forums, rules, customs, conventions, and nature. Professional licensing matters are not adversarial court proceedings. Your local criminal defense attorney won't generally have the administrative knowledge, skills, and experience for your effective representation, especially in such a complex administrative matter as an international medical graduate's state medical licensing qualifications. Our attorneys have helped hundreds of medical students and graduates, as well as graduates of other professional programs, with school misconduct, certification, and licensing issues. We have the skills and experience you need for your best medical licensing outcome.
Premier Attorneys for IMG State Medical Licensure
If you are an international medical graduate facing state medical board licensing issues, retain the Lento Law Firm's premier Student Defense Team for the highly effective attorney services you need. Call 888.535.3686 or use our contact form now to tell us about your case.
