We express a grave concern about the statement released by USMLE on January 31, 2024 in regards to USMLE examinees from Nepal.  We wholeheartedly support your investigation and agree that appropriate steps must be taken to uphold the integrity of the exam, however, we are concerned that mentioning the country’s name on the statement as a whole in your statement undermines the hundreds and thousands of international medical graduates from Nepal who are currently already practicing in the United States. The statement also collectively punishes and humiliates any Nepali applicant. While irregularities should be investigated by the USMLE, and individual applicants should be reached out to, we are petitioning the USMLE to immediately change and clarify that it does not mean to malign physicians from the entire country of Nepal. Specifically, the following sentence, “As part of an ongoing investigation, the USMLE program has identified a pattern of anomalous exam performance associated with Nepal, which challenges the validity of test results for a group of examinees.” The above is a biased and unfair blanket statement on the country of Nepal. 

Leaving the USMLE statement as is pushes a narrative that individuals from certain countries are more likely to engage in academic dishonesty, and this is harmful and likely deeply rooted in stereotypes. This kind of country-shaming is a form of discrimination that casts a shadow over the achievement of a supermajority of physicians from Nepal who have succeeded through their perseverance, honesty, and intelligence. It is essential to recognize that the actions of a few should not dictate the perception of the many. Tying the allegations of few applicants with the nationality of the individuals involved has a larger negative impact that goes beyond the current applicant pool but affects the entire Nepali community in the United States. Singling out one country has the potential to stigmatize physicians and other healthcare professionals who have received training in that country, possibly giving rise to biases against individuals from that region.

Currently in the United States, there are over 2,000 physicians who graduated from Nepali medical schools. Many of them served the country in the frontlines of the COVID-19 pandemic response, and many work in rural areas in the United States where there is shortage of doctors and other doctors are unwilling to go. In many ways, fulfilling our country’s healthcare gap depends on IMGs as well, of which Nepal trained physicians are a vibrant group. Generally, most IMGs serve the US healthcare system with quality and integrity.  

While we are confident that the USMLE investigation will uncover and address any wrongdoing, our concern lies in the lasting impact of singling out a country on the credibility of physicians who have diligently followed the rules of the USMLE exams and are now practicing here. We urge USMLE to urgently remedy the problems in the USMLE statement as have been outlined above.