If you are an international medical graduate facing state medical board licensing issues, then you know that your U.S. medical practice and career are at risk of delay and destruction. You know that your every ambition in the medical field may be on the line. Fortunately, you have swift and sure steps you can and should take to address and favorably resolve those state medical board licensing issues. Retain the Lento Law Firm's premier Professional License Defense Team to help you take those steps to preserve and protect your huge investment in your medical education and the substantial return you expect from a U.S. medical career for your investment. Call 888.535.3686 or complete this contact formnow for our highly skilled and effective representation. Take the right steps now.
Step 1: Know What's on the Line
Truly, your first step as an international medical graduate facing a state medical licensing board issue is to know what that issue could affect. If you don't know what's on the line, you may not give your licensing matter the attention it deserves. And make no mistake: any obstacle, no matter how small or large, that stalls, delays, and threatens your medical licensure places you at risk of losing everything you invested and everything for which you've worked in earning your international medical degree. You could lose the value of all your time, effort, tuition, and foregone earnings in other fields incurred in earning your medical degree. You could likewise lose all the medical practice income, benefits, professional reputation, and personal rewards you expected to enjoy after gaining your state medical licensure. You cannot generally practice medicine in the U.S. without a state medical license. You may be able to turn your international medical degree into a health administration job or other health field job not requiring professional licensure, although the educational programs for those jobs differ. But you won't practice medicine. Know what's on the line.
Step 2: Retain Us as Your Highly Qualified Counsel
Now that you know what's on the line, let us help you preserve and protect it. Your next step after recognizing what you have on the line in your state medical licensing board issue is to retain our highly skilled, strategic, and effective attorneys as your Professional License Defense Team. Don't go it alone. You very likely lack the law and administrative knowledge, skills, and experience to navigate and advocate effectively. Even if you do have adequate law and administrative experience, representing yourself is generally unwise because you will lack independent judgment. You need someone more skilled and experienced than yourself to tell you what you need to know to make your best decisions for your best outcome.
Step 3: Do Not Retain Unqualified Counsel
Beware, unqualified counsel. Too many international medical graduates and other professionals facing licensing issues retain a local criminal defense lawyer they know or recommend to them by family or friends. Local criminal defense lawyers are generally very good at criminal court procedures but generally lack the administrative knowledge, skill, and experience for effective representation in ECFMG, USMLE, and state medical licensing board proceedings. The same is true of local civil litigators, real estate attorneys, family lawyers, and general practitioners. Administrative licensing practice, especially before the ECFMG, USMLE, and state medical boards, is a boutique or niche practice in which very few lawyers engage substantially. Professional license defense is our niche. We have the knowledge, skills, and experience you need for your best outcome. An unqualified lawyer can be worse than no lawyer at all.
Step 4: Know with Whom You Must Deal
Knowing the officials with whom you must deal to resolve your state medical licensing issue and their relative roles and responsibilities is a good next step for ensuring that you obtain your best possible licensing outcome. The following three bodies carry the brunt of medical licensing administrative procedures. Understand and appreciate that the roles, responsibilities, and requirements of each body differ. Your actions, and our actions on your behalf, will depend on recognizing those different roles and responsibilities and meeting those different requirements.
The Educational Commission for Foreign Medical Graduates
You may be generally aware that the Educational Commission for Foreign Medical Graduates (ECFMG) is the body that certifies international medical graduates for U.S. medical residency and the USMLE Step 3 exam. Certification for residency and exams may not sound like a big step in your medical licensure. It is a big step, and you need to respect it. Without ECFMG certification, you will generally get nowhere. You won't get your residency, sit for and pass your last USMLE step exam, or gain state medical board licensure. With ECFMG certification, you may be most of the way home toward licensure. The ECFMG does two primary things for you relative to your U.S. state medical licensure. First, the ECFMG recognizes your medical school as one that meets its standards and is accepted in many U.S. states as qualifying to issue you a medical degree that will meet that state's medical board standards. Second, the ECFMG certifies, through your EPIC system submissions, whether you have, in fact, earned a medical degree from one of its qualified medical schools at a time when that school held ECFMG certification.
The U.S. Medical Licensing Exam
The U.S. Medical Licensing Exam (USMLE) is, of course, the professional examination you must pass to qualify for a U.S. state medical license. You surely know the USMLE Step 1, Step 2, and Step 3 exam requirements because you very likely already passed the Step 1 and Step 2 exams during your international medical education and have studied diligently for the Step 3 exam if not already attempted or passed it. When applying for and taking the USMLE step exams, you certified that you read and understood the USMLE requirements for exam preparation and conduct. However, you may not yet fully appreciate that USMLE officials have relatively elaborate procedures and dedicated staff to enforce those exam requirements. The USMLE maintains and enforces an anomalous performanceprocedure, extenuating circumstances procedure, and invalidated exam score procedure. Beware USMLE officials. Treat their communications and requests with all due respect and urgency. And let us help you do so.
Your State Medical Board
The last and ultimately most significant body with which you must deal to obtain your medical board is the state medical board itself. You chose the state of your U.S. medical licensure or your U.S. medical residency, and other contacts and employment opportunities helped you do so. Your choice of state matters because medical licensure is state-by-state. If you intend to practice in Texas, then you will need a license from the Texas Medical Board. If you intend to practice in California, then you will need a Medical Board of California license. And so on for each state in which you may pursue clinical practice. You surely know so, given the point you have reached in your medical licensure journey. However, you may not know the lengths to which your state medical board will go to ensure your character and fitness for medical practice. Yes, you need ECFMG certification for the USMLE Step 3 exam. And yes, you need to pass the Step 3 exam for a state medical license. But you must also meet the state board's criminal history, mental and physical health, and other character and fitness requirements. Let us help you with any issue you face before your state medical board.
Step 5: Preserve Relevant Records
So, you've recognized what you have at stake. You've decided to retain us rather than represent yourself or retain unqualified counsel. And you know the organizations with which you must deal and why they have different roles, responsibilities, and requirements. You've made a good start. Another early step, though, one that can soon prove critical to your successful licensing outcome, is to preserve all records, items, and information related in any way to your medical licensing matter. Medical licensing issues often depend on their prompt, fair, and favorable resolution on documentation. Paper or electronic evidence of who communicated what information to you, when, and how you responded can make or break your case. If you have purposely or carelessly deleted emails, texts, or electronic files, including drafts or revisions of electronic files, thrown away paper notes and records, and emptied electronic or paper trash, making those records unavailable to you and others, then ECFMG, USMLE, and state medical board officials may construe your actions as a cover-up, or you may simply fail to have available to you the records you need to prove your diligence, innocence, and fitness. Here are a few examples where your record retention could prove critical:
- you make multiple drafts of electronic submissions to ECFMG, USMLE, or your state medical board, the final one of which is incomplete or innocently inaccurate, following which officials claim that your submission was purposefully inaccurate, incomplete, and fraudulent;
- you obtain multiple versions or make multiple copies of your transcript, degree, passport, birth certificate, visa, other citizenship or immigration papers, criminal history, civil court filings, medical or mental health records, or other required documentation, and ECFMG, USMLE, or state medical board officials allege that your final documentation was altered and fraudulent;
- your medical school officials or ECFMG, USMLE, or state medical board officials instruct you in electronic, recorded audio, or other preserved communications to follow certain procedures, submit certain information in certain forms, or otherwise instruct, advise, and direct you as to proper application processes but later deny having done so and allege your misconduct for following their instructions;
- you fail to retain explanatory cover letters, cover emails, postmarked envelopes, or other indicia of the reliability and authenticity of materials you submit with ECFMG, USMLE, or state medical board applications, and officials later claim the unreliability and inauthenticity of your submissions; or
- you suffer illness, injury, or other extenuating circumstances relieving you from attending your scheduled USMLE Step 3 exam and warranting rescheduling, but you fail to obtain and preserve contemporaneous records proving your extenuating circumstances, leading officials to deny your relief and count your absence against you for purposes of the USMLE's retake limit.
Step 6: Set Aside the Time
Another early step that you should take is to set aside the time to address your international medical graduate licensing issue. International medical graduates often have highly complex demands on their time, not only the medical residency requirements and USMLE Step 3 exam studies U.S. medical graduates face, but also extra ECFMG, citizenship or immigration, and other medical licensure administrative requirements that U.S. medical graduates may not face. You are doubtless busy for good reasons. You may also have international travel requirements and many personal obligations beyond your professional obligations. Somehow, though, within all your other responsibilities, you need to prioritize the time to address your medical licensing issues. Do not procrastinate. Instead, get our help. We may be able to relieve you of the things you lack the skill, time, and energy to accomplish. Even as little as five or ten minutes, or half an hour or an hour, of your time, may move your medical licensing matter forward so that you can attend with good concentration and confidence to your other matters. Set aside the time to address licensing, and use that time promptly and wisely.
Step 7: Keep Up with Your Medical Studies
Another thing to keep in mind early in addressing your medical licensing issues is that you should keep up with your medical residency requirements, USMLE Step 3 exam studies, or other medical practice and study requirements. Do not take a medical licensing issue as an excuse to ignore your medical professional obligations. If your issue is qualifying for the USMLE Step 3 exam, then keep studying for the exam as if you will soon qualify. You don't want to learn that you have, with our help, overcome your ECFMG certification issue so that you can sit for the USMLE Step 3 exam but then fail the exam because you relaxed or abandoned your studies. As best you can, keep things usual, customary, and ordinary. Follow your reliable, professional routines, even while carrying the burden of your medical licensing issue. But let us carry that burden for you so that you have the mental health and energy to continue on toward your medical licensure and career. Don't succumb to your issues, and don't use them as an excuse for a hiatus that later damages your relationships or reputation or diminishes your chances of exam passage and licensure.
Step 8: Keep Up with Your Health
Another early step to take, one closely associated with the two prior steps, is to continue to maintain your good physical and mental health practices. If you exercise regularly, as you should for your general health, then continue to do so. Don't use medical licensing issues as an excuse to stop running, walking, lifting, swimming, or doing other things you usually do to keep yourself strong and healthy. The same applies to your mental health. While your physical exercise contributes to your mental health, you may have other laudable mental health practices involving sleep or rest time, social time, arts and recreation time, religious observances, prayer and meditation, and other balancing and relaxation practices. Keep those up as far as you are able while we help you address and resolve your medical licensing issues. How you hold up under stress is a measure of your professional character and fitness. As a physician, you know the importance of mental and physical health to persevering. We can help you maintain that balance by managing your licensing issue.
Step 9: Maintain Your Professional Demeanor
Another early step to take has to do with your professional hygiene, dress, and demeanor. Some individuals allow the extra stress and demands of important and uncertain things like an international medical graduate's medical licensing issue to cause them to forgo bathing, shaving, haircuts, or dry cleaning or laundering of professional clothing. International medical graduates facing licensing issues may start to dress differently, ignoring appropriate professional dress, and may treat colleagues, patients, and supervisors differently, dropping greetings and exhibiting a glum demeanor. Changes in your professional demeanor can complicate your medical licensing proceeding. You may need to rely on your professional colleagues, supervisors, and employer representatives for the records, statements, secure employment, and testimony you need to resolve your medical licensing issue favorably. Don't sacrifice the trust and confidence of your colleagues, employer representatives, and supervisors. Keep up appearances. Let us help relieve you of the burden of your medical licensing proceeding so that you can do so.
Step 10: Avoid Substance Abuse
Another step that is always wise, but especially so early in an international medical graduate's medical licensing proceeding, is to avoid substance abuse and similar issues that may complicate the licensing issue and even change its outcome from favorable to unfavorable. We get it. One way that international medical graduates and their U.S. medical graduate counterparts may relax or attempt to deal with the stress of medical licensing issues is to drink alcohol or use drugs. But appearing for your residency under the influence of intoxicants, suffering a driving under the influence charge, or facing a restraining order or other civil proceeding arising out of intoxicant-fueled misbehavior could be your undoing when it comes to maintaining a reliable, professional record. Avoid substance abuse at all costs during this important time when we are helping you resolve your medical licensing issue. As a corollary, if you have a substance abuse, addiction, or dependency issue, then now is certainly a good time to address it before it reaches the attention of colleagues, supervisors, or licensing officials.
Step 11: Beware Lax Communication
Another early step in properly managing your medical licensing issue as an international medical graduate is to beware of lax communications with anyone related to that issue, particularly with ECFMG, USMLE, or state medical board officials. By lax communications, we mean speaking inadvisedly, offhandedly, carelessly, or when unprepared with anyone related to your medical licensing matter. You've certainly heard of the general advice for criminal suspects, captured in the Miranda warnings, that anything you say can and will be used against you. Your medical licensing matter is not a criminal proceeding. You do not have Miranda rights. Nor do you have other protections afforded criminal defendants. But the caution can still be a good one. Whenever a medical licensing official contacts you, you should have our help in responding fully, timely, and accurately. If, instead, you give offhand, inaccurate, and incomplete responses, the licensing officials may hold those responses against you on separate charges of misconduct while also using them to undermine the reliability of your later accurate and complete representations. Talk to us first, if you possibly can, especially when providing factual details. We'll help you be sure that your details are accurate and consistent with your own records and memory. That way, you won't be creating problems for yourself.
Step 12: Cooperate with Us
And one last early step. Once you retain our attorneys, cooperate with us. If we ask for your information, get it to us promptly. If we suggest that you do something or avoid doing something, then try your best to follow our advice. Let us know where and how we can help you. Otherwise, though, we know how to manage your international medical graduate licensing issue best. Trust us, and cooperate with us.
Premier License Defense for IMG Licensing Issues
If you are an international medical graduate facing ECFMG, USMLE, or state medical board licensing issues, your best first step is to promptly retain the Lento Law Firm's premier Professional License Defense Team. Our attorneys have provided hundreds of medical and other professionals nationwide with the strategic, skilled, sensitive, and effective advocacy they need for successful professional licensing outcomes. Let us help you preserve and protect your huge investment in your international medical degree and U.S. medical practice. Call 888.535.3686 or use our contact formnow for our premier representation.
