Nepali Doctors Confront 3 Tough Choices as US Court Upholds USMLE Score Invalidation

A federal court in Washington D.C. has rejected a legal challenge to the invalidation of USMLE scores for a group of Nepali doctors, including the named plaintiff in the case. The court’s decision, released Friday by Judge Christopher Cooper, details the reasons behind the dismissal and outlines three options available to the affected individuals.

Court’s Reasoning

The court found that the plaintiff, referred to anonymously throughout the ruling, failed to demonstrate a strong likelihood of success on the merits of their claim. The judge cited “credible reports of cheating” as the primary justification for the USMLE’s decision to invalidate the scores, rejecting allegations of discriminatory animus against Nepali test-takers. Additionally, the court emphasized the importance of protecting public safety by ensuring the competence of medical professionals, outweighing the potential harm to individual doctors.

The court decision states, “Weighing the four relevant factors, the Court concludes that such extraordinary relief is not warranted. Dr. *** has not shown that she is likely to succeed on the merits of her claims because the current record demonstrates that NBME took action against the putative class because of credible reports of cheating, not discriminatory animus against Nepalis. The balance of equities and public interest also weigh against permitting potentially unqualified doctors from matriculating to residency programs and administering care to patients. The Court will, accordingly, deny Dr. ***’s motion for a preliminary injunction and deny the corresponding motion for class certification without prejudice to renewal at an appropriate time should the case proceed in this Court.”

The court decision continues, “In sum, Dr. *** has not shown that she is likely to succeed on the merits of her claims, and the balance of equities and public interest both weigh against granting this extraordinary relief. The Court will accordingly deny Dr. ***’s request for a preliminary injunction. Because the motion for provisional class certification was trained at the request for emergency relief, which the Court has denied, the Court will also deny that motion, without prejudice to renewal at an appropriate time should the case proceed in this Court.”

The court decision further addresses additional matters, stating, “Before wrapping up, there are two additional items that the Court must address. At the close of the motion hearing on this matter, Dr. *** requested the Court grant an injunction pending appeal pursuant to Federal Rule of Appellate Procedure 8(a). In determining whether to grant such an injunction, courts consider four factors: (1) likelihood of success on the merits of the appeal; (2) irreparable injury; (3) substantial harm to other parties; and (4) the public interest. See Hilton v. Braunskill, 481 U.S. 770, 776 (1987). If those four factors ring a bell, that’s because the “standards for evaluating a motion for injunction pending appeal are substantially the same as those for issuing a preliminary injunction.” Republican Nat’l Comm. v. Pelosi, No. 22-cv-659 (TJK), 2022 WL 1604670, at *2 (D.D.C. May 20, 2022) (quotation marks omitted). Unsurprisingly, then, the Court will deny the motion for an injunction pending appeal for the reasons above.”

The court decision concludes with the mention of Dr. ***’s request to extend the deadline for putative class members, stating, “Dr. *** also asked the Court to extend the deadline for putative class members to respond to the Board’s email by selecting one of the three available options: request reconsideration, retake the exams free-of-charge, or stand pat. At a minimum, Dr. *** requests that the Court enter an order waiving the requirement that applicants forfeit their right to sue if they select the first or second options. Yet she cites no authority empowering the Court to enter such relief, and the Court is aware of no such authorization. The parties previously stipulated that the Board would push the deadlines for responding until after the Court’s decision on the preliminary-injunction motion. See Joint Stipulation at 1. The Board, of course, did not have to agree to that deal. And now that the Court has entered its decision and the stipulation has terminated, the Court lacks power to extend its terms.”

Moving Forward

Following the court’s decision, the affected individuals, including the named plaintiff, face three choices:

• Appeal the decision: This option involves seeking a reversal of the lower court’s ruling by a higher court. However, the court’s reasoning suggests a potentially uphill battle.
• Refile the case: The plaintiff could choose to refile the lawsuit, potentially with new evidence or arguments, in an attempt to achieve a different outcome. This path would require significant legal resources and involve further delays.
• Accept USMLE options: The USMLE has offered three options to the affected individuals: requesting reconsideration of their score invalidation, retaking the exams free of charge without further action, or choosing to stand pat.

The court order emphasizes that the decision only applies to the request for a preliminary injunction and does not preclude future legal action. The option for individuals to request reconsideration of their score invalidation raises questions about the process and potential for success. The long-term impact of this case on the USMLE and its procedures for addressing allegations of cheating remains to be seen.