An Assessment of USMLE Examinees Found to Have Engaged in Irregular Behavior, 1992–2006

Abstract

ABSTRACT Purpose: The United States Medical Licensing Examination® (USMLE®) program takes active measures to ensure the integrity of the licensing examination process. This study looks at the examinees found by the USMLE program to have engaged in irregular behavior and their subsequent success in completing the examination sequence and obtaining a full, unrestricted medical license. Methods: Working with the Office of the USMLE Secretariat, all individuals determined by the program to have engaged in irregular behavior related to the examination were identified for the period 1992–2006. These individuals were then searched against databases at the Federation of State Medical Boards for board action history and licensure status. Results: A total of 433 individuals were deemed to have engaged in irregular behavior by the USMLE Committee on Irregular Behavior. Subgroups disproportionately represented included males (66.7%) and international medical graduates (78.8%). Document falsification was the most common infraction under computer-based test administration. Less than half of the irregular behavior cohort (45.7%) successfully completed the USMLE sequence. Only 37.2% completed the USMLE sequence and obtained a full, unrestricted medical license in a U.S. jurisdiction. Graduates of U.S. and Canadian medical schools were the subgroup most likely to complete the USMLE sequence and obtain their medical license. Conclusions: A finding of irregular behavior by the USMLE carries significant potential consequences. State medical boards have denied licenses to individuals with irregular behavior and been unwilling to support the prospective licensure of individuals barred from the program indefinitely.