The United States Medical Licensing Examination invalidated the examination scores of several test takers from Nepal for anomalous exam performance.

Issuing a statement, USMLE, the individual medical licensing authority that authorises medical practice in the USA, said the decision was taken based on a pattern of anomalous exam performances.

The number of Nepali students whose scores were invalidated by the agency is unknown.

“Examinees with results in question are being notified by the USMLE Secretariat’s office that their previous Step scores have been invalidated and that they will be required to take a validation exam,” reads the statement.

Medical students, especially those with MBBS and post-graduate degrees and seeking higher degrees from universities in the United States, need to pass validation exams of the USMLE to fulfil the medical science requirement for the Educational Commission for Foreign Medical Graduates. Applicants must pass Step 1 and Step 2 clinical knowledge of USMLE. This requirement is necessary and a core component of the Educational Commission for Foreign Medical Graduates (ECFMG) Certification.

“Highly irregular patterns can be indicative of prior unauthorised access to secure exam content,” reads the statement. “Invalidated test scores no longer meet the requirements for ECFMG Certification.”

Nepal Medical Council, the national regulatory body of medical doctors, said that in 2023, over 2,400 doctors had taken a Letter of Good Standing (LoGS), which is required to pursue a higher degree in a foreign university and practise abroad.

“Most of the Letters of Good Standing were taken for the United States of America, followed by Maldives and the United Kingdom,” said Dr Bishwa Raj Dawadi, registrar at the council. “Those who took Letters of Good Standing for Maldives were taken for job purposes.”

Most Nepali doctors who seek higher degrees in the United States and the United Kingdom do not return even after the completion of their studies.

It is said that over 500 Nepali doctors had taken USMLE’s examination and passed the step 1 and step 2 tests.

According to Dawadi, invalidating the examination scores is the USMLE’s decision, and the council cannot do anything about it.

“We [the Council] also cross-check low scores and high scores of the medical students,” said Dawadi.

The USMLE raised questions on the high scores of medical doctors. “Some have already reached the United States and some are preparing to go there for further studies,” a former official at the Council said on condition of anonymity. “In a recent case, high scores of doctors have become an issue, which is unfortunate.”

The USMLE had invalidated the scores of students in the past too. “It had invalidated not only the student and the exam centre but also the country,” said Dr Janak Koirala, an infectious disease expert, who returned to Nepal from the USA a few years ago.