Intealth ECFMG

Educational Commission for Foreign Medical Graduates

ECFMG 2024 Information Booklet

The United States Medical Licensing Examination (USMLE)


USMLE Program and Irregular Behavior

The USMLE program defines irregular behavior as including, "any action by applicants, examinees, potential applicants, or others that could compromise the validity, integrity, or security of the USMLE process." Test center staff monitor, in person and via video/audio recording, administration of the USMLE Steps and are required to report any violations of the USMLE or test center rules. You must follow instructions from test center staff throughout the examinations; failure to do so may result in a finding that you have engaged in irregular behavior and permanent annotation of your USMLE transcript. See Testing Regulations and Rules of Conduct and Irregular Behavior in the USMLE Bulletin of Information. See ECFMG’s Policies and Procedures Regarding Irregular Behavior, which also may apply.

Important Notes: Seeking, providing, and/or obtaining information relating to examination content that may give or attempt to give unfair advantage to anyone who may be taking the examination, which includes postings regarding examination content and/or answers on the Internet, is a violation of the USMLE Rules of Conduct.
Evidence of violation of any test administration rule, including the USMLE Rules of Conduct, will result in actions being taken under USMLE Policies and Procedures Regarding Irregular Behavior. If you are found to have engaged in irregular behavior, your score report and transcripts will include this finding, you may be barred from taking the USMLE in the future, and your score may be canceled.
Anomalous performance and/or unusual testing history may impact your access to the USMLE. If your performance raises concerns about your readiness to test or your motivation to pass, the USMLE program reserves the right to restrict your future access to its examinations and/or to impose conditions upon future access. Do not test if you are not able or not ready on your scheduled test date. Taking a Step examination to familiarize yourself with the examination format, or for any reason other than to pass, is prohibited and may result in restrictions on your future access to the USMLE.

The above-described conduct may also be considered irregular behavior under ECFMG’s Policies and Procedures Regarding Irregular Behavior.

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[Last update: August 21, 2023]

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