A program at Oakland University, Rochester, Michigan, developed and adminstered a preparatory course for the Federal Licensing Examination (FLEX) for non-fully licensed physicians employed in the United States. Statistical data indicated that nearly 75% of the condidates for licensure in states employing FLEX were foreign medical graduates with a pass rate under 50% compared with a pass rate of 85% for U.S. medical graduates. The integrated basic and clinical science curriculum and English/cultural curriculum developed were presented during a three-month program. An elaborate diagnostic appraisal process identified participants' individual strengths and weaknesses prior to program participation. The pass rate of the fifty-nine participants who took the June, 1977, FLEX was 27.1%, approximately 22% below the overall anticipated national norm. Statistical analysis of the scores demonstrated significant improvement in clinical competence and clinical science with less improvement in basic sciences. A detailed comparison of individuals who passed with those who showed the least improvement on the FLEX suggested that certain characteristics such as age, number of years in the U.S., and number of years since graduation from medical school may influence examinees' likelihood of success on the FLEX even following participation in a comprehensive medical review program. (YLB)