Home Medizin Der Richter wird ungültige USMLE-Ergebnisse nicht aufheben

Der Richter wird ungültige USMLE-Ergebnisse nicht aufheben

von NFI Redaktion

A federal judge described the matter as a „danger that the public should not tolerate“ and rejected a request for temporary reinstatement of the results of 832 medical graduates from Nepal suspected of cheating on the United States Medical Licensing Exam (USMLE). In a ruling on February 23, Judge Christopher R. Cooper of the US District Court for the District of Columbia denied Latika Giri’s emergency motion to prevent the National Board of Medical Examiners (NBME) from declaring the results invalid, stating that the public interest clearly outweighed granting the motion.

„At the forefront is the paramount interest in public safety,“ Cooper wrote in his 32-page order. „This concerns the qualifications of physicians applying for medical residency programs… Granting the injunction would create an unacceptable risk of individuals who lack the necessary knowledge and skills, which they allegedly obtained fraudulently through their exam results, providing medical care to unsuspecting patients nationwide.“

Giri’s lawyers did not respond to requests for comment on the order. NBME also did not respond to requests for comment. The Board had previously stated that it would not comment on pending litigation. The decision is the latest development in a widespread cheating scandal reported by Medscape Medical News. Giri, an International Medical Graduate (IMG) from Kathmandu, sued NBME earlier this month, alleging that the Board discriminated against Nepalese medical graduates when it invalidated hundreds of exam results associated with the country. Giri also accused NBME of violating its own procedures by annulling the results before giving examinees the opportunity to argue and appeal. She requested the District Court to prevent NBME from declaring her exam results invalid while the proceedings continue, and to restore her original results.

In court documents, NBME argued that it did not invalidate the results because the examinees were Nepalese, but because the staff concluded that there was „good reason to question the validity of the results.“ The annulments were based on concerns that the results reflected prior access to secure exam content and not the knowledge and understanding of medical principles and skills that the exams are intended to evaluate, according to NBME’s legal response.

„The USMLE program has taken appropriate and necessary measures to prevent the significant harm and disruption that would result from potentially unqualified individuals being allowed to participate in the Residency Match 2024,“ NBME stated in court documents. „Granting the requested injunction would not only cause great harm to NBME… but also to the state licensing authorities that rely on USMLE results to ensure that physicians have the minimum competencies required for safe and effective healthcare.“

In his ruling, Cooper wrote that Giri had not demonstrated that the Board’s actions discriminated against Nepalese physicians. „Nothing in the record suggests that NBME was looking for a problem in Nepal based on ethnicity or national origin,“ Cooper wrote. „It followed the trail of evidence, including tips about organized fraud at medical schools and a testing center in Nepal, as well as on an online forum where a ‚connection to Nepal‘ was a ticket.“

NBME: Nepal Outpaced All Other Countries in USMLE

Court documents shed more light on NBME’s investigation into alleged fraud and the anomalous patterns the Board reportedly identified among Nepalese medical graduates. Responding to anonymous tips, the USMLE program commissioned NBME’s Psychometrics and Data Analysis Department (PADA) in early 2023 to analyze the performance data of examinees at test centers in Jordan, Nepal, and Pakistan, according to court records. The initial data analysis found the data specific to the individual test center in Nepal to be „most extreme,“ the unit found. Among over 400 test centers worldwide, including in the United States, the test center in Nepal achieved the highest scores for Step 1 in 2021 and the highest scores for Step 2 CK in 2022, according to court documents. For the 2022 Step 1 exam, for example, the average score of examinees at the Nepalese test center was 240. No other test center in the world had an average examinee score above 227, NBME’s legal response stated. The average item response time for examinees tested at the Nepal center in 2022 was also among the fastest of all international centers for Step 1 and Step 2 CK. Additionally, the number of examinees taking the USMLE Step 1 and Step 2 CK at the Nepal test center had significantly increased, according to court documents. The volume of Step 1 exams at the Nepalese test center more than doubled from 281 examinees in 2019 to 662 examinees in 2022. The rapid increase continued in 2023, when the examinee volume was nearly three and a half times higher than in 2019. The data corroborated with anonymous tips received by the USMLE program office, suggesting there may be a widespread collection and dissemination of live USMLE exam content in Nepal.

Investigation Finds Similar Correct and Incorrect Answer Matches

The similarity of matches between the analyzed exams raised red flags as well. According to court documents, investigators conducted a „matching analysis“ for all examinees tested at centers in Jordan, Nepal, Pakistan, and two centers in India. For the 2022 Step 1 exam and the 2021 and 2022 CK Step 2 exam, the analysis revealed a significantly higher percentage of examinees with a statistically significant level of match agreement in the examinee group tested at centers in Jordan, Nepal, Pakistan, and India compared to the baseline group, according to legal records. Data showed that the vast majority of examinees with a statistically significant number of matching incorrect answers were tested at the Nepalese test center.

Another analysis found that the number of examinees at the Nepalese test center increased significantly in the months leading up to the release of new test items by the USMLE program, „suggesting that candidates who had prior access to disclosed exam questions wanted to test before new questions were added to the item pool.“ „Investigators also identified posts on social media and in online chatrooms indicating that groups in private chatrooms were collecting and sharing large amounts of secure exam materials. Some posts advised examinees to use the full exam time during the USMLE to avoid suspicion of having had prior access to secure exam materials,“ court documents stated.

During the investigation and analysis, the USMLE program identified 832 examinees with passing exam results, for which the program had a significant and good-faith basis for questioning the validity, according to court records. Of the total, 618 examinees had one Step test result marked as doubtful, 202 had two Step test results marked, and 12 had results marked in all three Step tests.

NBME Defends Departure from Traditional Procedures

In court documents, NBME denied allegations that it violated its own procedures by invalidating the exam results of suspected cheaters. Giri’s report claimed that examinees suspected of fraud are usually first informed about the matter, given the opportunity to provide relevant information, and granted the right to appeal—during which time their results are treated as valid. However, NBME stated that the USMLE program is authorized to take any actions it deems appropriate in response to concerns about the validity of results, when the USMLE Committee for Individual Review or the USMLE Composite Committee concludes that alternative or supplementary procedures are warranted in response to a specific set of facts or circumstances.

„After the one-month investigation and analysis… the USMLE program concluded that alternative measures were warranted to allay concerns regarding the invalidity of the scores, in the interest of providing a process that is timely, efficient, effective, and fair, given the large number of examinees involved in the investigation,“ the Board stated in its legal response.

In his ruling, Cooper wrote that the current scenario involving more than 800 test takers is „clearly a situation that requires a procedure focused on efficiency.“ There is no evidence that the Board would not have taken swift action if there had been evidence of fraud on a comparable scale elsewhere, he wrote. The judge also rejected Giri’s request to…

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