Full opinion text
ORDER ARCARA District Judge. This antitrust case was referred to Magistrate Judge Leslie G. Foschio, pursuant to 28 U.S.C. § 636(b)(1), on April 24,1991. On February 24, 1994, plaintiffs filed a motion for class certification. On May 4, 2000, defendants filed a cross-motion to dismiss the Second Amended Complaint. On January 3, 2003, Magistrate Judge Foschio filed an Amended Report and Recommendation, recommending, inter alia, that defendants’ cross-motion to dismiss the Second Amended Complaint be granted because plaintiffs lack antitrust standing. ’ Magistrate Judge Foschio found that plaintiffs lack antitrust standing because: (1) they have failed to allege a cognizable antitrust injury; and (2) they are not “efficient enforcers” of the antitrust laws. In the event that this Court were to reject his recommendation that the case be dismissed, Magistrate Judge Foschio also recommended, in the alternative, that plaintiffs’ motion for class certification be granted under Federal Rule of Civil Procedure 23(b)(3) and denied under Federal Rule of Civil Procedure 23(b)(2). Plaintiffs and defendants both filed objections to the Report and Recommendation on February 14, 2003. They both filed responses to the objections on March 14, 2003, and replies thereto on March 28, 2003. Oral argument on the objections was held on May 23, 2003. Pursuant to 28 U.S.C. § 636(b)(1), this Court must make a de novo determination of those portions of the Report and Recommendation to which objections have been made. Upon a de novo review of the Report and Recommendation, and after reviewing the submissions and hearing argument from the parties, the Court adopts Magistrate Judge Foschio’s recommendation that the Court grant defendants’ motion to dismiss the Second Amended Complaint. As Magistrate Judge Foschio found in his thorough and well-reasoned Report and Recommendation, the plaintiffs, in their Second Amended Complaint, have faded to allege antitrust standing. Antitrust plaintiffs “must plead and prove that the injury they have suffered derives from some anticompetitive conduct and is the type the antitrust laws were intended to prevent.” Todorov v. DCH Healthcare Auth., 921 F.2d 1438, 1450 (11th Cir.1991). Here, plaintiffs seek as damages the loss of the higher income they allegedly would have received had they been able to become board certified through the practice track. However, as the Seventh Circuit held in the analogous case of Sanjuan v. American Bd. of Psychiatry & Neurology, Inc., 40 F.3d 247, 251 (7th Cir.1994), cert. denied, 516 U.S. 1159, 116 S.Ct. 1044, 134 L.Ed.2d 191 (1996), a plaintiff-doctor’s inability to charge higher fees because he or she has been denied board certification does not constitute a cognizable form of injury under the antitrust laws. “[T]he claim that a practice reduces (particular) producers’ incomes has nothing to do with the antitrust laws, which are designed to drive producers’ prices down rather than up.” Id. (citations omitted). “Plaintiffs, who want to obtain a credential that will help them charge higher prices, have pleaded themselves out of court on the[ir] antitrust claim.” Id. at 252. Moreover, as Magistrate Judge Foschio found, in addition to failing to allege an antitrust injury, this action must be dismissed because, under the facts and circumstances present here, plaintiffs are not “efficient enforcers” of the antitrust laws and therefore lack standing for that reason as well. The Supreme Court has held that for standing to sue under Section 4 or Section 16 of the Clayton Act, in addition to meeting the threshold requirement of having alleged an antitrust injury, a party seeking redress must also be a “proper plaintiff’ under the antitrust laws. Cargill, Inc. v. Monfort of Colorado, 479 U.S. 104, 110 n. 5, 107 S.Ct. 484, 93 L.Ed.2d 427 (1986); see also Todorov, 921 F.2d at 1450 (to have antitrust standing, a plaintiff must be “an efficient enforcer of the antitrust laws”). Here, plaintiffs’ objective is to advance their own economic interests by obtaining access to the same higher levels of compensation created by the charged conspiracy. In other words, plaintiffs’ economic incentive is to keep prices higher and to share in those higher prices with the members of the alleged conspiracy. Such a motivation is inimical to being an “efficient enforcer” of the antitrust laws. In their objections, plaintiffs ask that the Court grant them a further opportunity to amend their complaint to state that they seek only to recover the difference between their actual earnings and the amount they would have earned in a competitive market absent the conspiracy. However, such an amendment would be futile because it would still not sufficiently plead an antitrust injury. The bottom line is that, even with the amendment, plaintiffs seek to increase the price they charge to consumers as compared to the price charged by other non-board certified emergency medicine physicians. As such, the amendment does not allege a cognizable antitrust injury. Sanjuan, 40 F.3d at 251-52. Furthermore, this case is already 13 years old. The amendment proposed by the plaintiffs would be inconsistent with the now-developed record. Throughout the case, plaintiffs have claimed that they are entitled to the same supercompetitive prices earned by board-certified physicians. They now want to change their entire theory of the case in order to avoid dismissal. Even now, however, they are unable to offer an expert report that would support their theory, despite having had years to secure such a report. For all these reasons, the Court denies plaintiffs’ request to file another amended complaint. In sum, for the reasons set forth both in Magistrate Judge Foschio’s Report and Recommendation and herein, the Court grants defendants’ motion to dismiss the Second Amended Complaint. The Clerk of Court is hereby ordered to take all steps necessary to close the case. IT IS SO ORDERED. AMENDED REPORT AND RECOMMENDATION FOSCHIO, United States Magistrate Judge. JURISDICTION This matter was referred, pursuant to 28 U.S.C. § 636(b)(1)(A) & (B), to the undersigned on April 24, 1991 by Hon. Richard J. Arcara for all pretrial matters. The matter is presently before the court on Plaintiffs’ motion for class certification, filed February 24, 1994 (Doc. No. 69) (“Plaintiffs’ Motion”), and Defendants’ cross motion to dismiss the Second Amended Complaint, pursuant to Fed. R.Civ.P. 16(b)(1) filed May 4, 2000 (Doc. No. 773) (“Defendants’ Cross Motion”). BACKGROUND In their Second Amended Complaint, brought pursuant to Sections 4 and 16 of the Clayton Act, 15 U.S.C. § 15 (“Section 4”), 15 U.S.C. § 26 (“Section 16”), Plaintiffs alleged violations of Sections 1 and 2 of the Sherman Act, 15 U.S.C. § § 1, 2, and sought monetary damages and injunc-tive relief. Prior proceedings in this action include Daniel v. American Board of Emergency Medicine, et al, 802 F.Supp. 912 (W.D.N.Y.1992) (¿‘Daniel I ”) (sustaining Amended Complaint against motion to dismiss); Daniel v. American Board of Emergency Medicine, et al., 988 F.Supp. 112 (W.D.N.Y.1997) (“Daniel //”); and, Daniel v. American Board of Emergency Medicine, et al., 988 F.Supp. 127 (W.D.N.Y.1997) (“Daniel III ”). Discovery on the merits of Plaintiffs’ claims has been stayed pending resolution of the numerous motions filed by Defendants attacking the Second Amended Complaint and Defendants’ opposition to Plaintiffs’ instant motion for class certification. In a Report and Recommendation filed on January 16, 1996 (Doc. No. 435), the undersigned recommended dismissal of ten Defendants, including Tri-City Medical Center, University of California Medical Centers at Los Angeles, Irvine and San Diego, University of Massachusetts Medical Center, University Hospital of University of New Mexico School of Medicine, Oregon Health Services University Hospital, Ohio State University Hospital, University Hospital at State University of New York at Stony Brook, and Lincoln Medical and Mental Health Center, on grounds of 11th Amendment immunity, state action immunity, Local Government Antitrust Act immunity, and personal jurisdiction. District Judge Richard J. Ar-cara adopted the Report and Recommendation in an Order filed on November 19, 1997 (Doc. No. 580). Daniel III. Based on later filed motions seeking dismissal upon 11th Amendment and state action immunity grounds, the undersigned recommended dismissing four additional Defendants. Report and Recommendation filed January 20, 2000 (Doc. No. 751) (recommending dismissal of Defendants Kettering Medical Center, Children’s Hospital — San Diego, and University Medical Center Corporation (Tucson, Arizona)) and Report and Recommendation filed September 27, 2001 (Doc. No. 830) (recommending dismissal of Defendant Riverside Medical Center, but recommending against dismissal of Defendant Our Lady of Mercy Medical Center). In a Report and Recommendation filed on February 12, 1999 (Doc. No. 642), the undersigned recommended that final judgment, pursuant to Fed.R.Civ.P. 54(b), be entered as to Defendants Tri-City Medical Center, University of California Medical Centers at Los Angeles, Irvine and San Diego, University of Massachusetts Medical Center, University Hospital of University of New Mexico School of Medicine, Oregon Health Services University Hospital, Ohio State University Hospital, University Hospital at State University of New York at Stony Brook, and Lincoln Medical and Mental Health Center. Judge Arcara adopted the Reports and Recommendations by Orders filed August 21, 2002. Doc. No. 846 (adopting Report and Recommendation filed February 12, 1999 (as amended by Order filed October 9, 2002 (Doc. No. 862))), Doc. No. 847 (adopting Report and Recommendation filed September 27, 2001), and Doc. No. 848 (adopting Report and Recommendation filed January 20, 2000). Final judgments dismissing all the above Defendants were filed on August 23, 2002 and on October 10, 2002. Doc. Nos. 849, 850, 851 and 863. Plaintiffs have appealed such dismissals on September 19 and November 5, 2002; Tri-City Medical Center cross appealed on October 2, 2002. (Doc. Nos. 868 and 857, respectively). Two of the original Defendants have settled the claims against them including Porter Memorial Hospital (Stipulation and Order filed September 21, 1994 (Doc. No. 313)), and Medical College of Pennsylvania and Hospital (Order filed May 29, 2001 (Doc. No. 822)). The court is also informed that three previously dismissed Defendants, Oregon Health Sciences University, Children’s Hospital-— San Diego, and University Medical Center — Tucson, settled in principle with Plaintiffs. Doc. No. 870. Plaintiffs’ Memorandum of Law in Support of the motion for class certification was filed on February 24, 1994 (Doc. No. 70). At Defendants’ request, limited discovery was permitted, by order dated October 28, 1998, directed to Plaintiffs’ Motion (Doc. No. 630). Plaintiffs’ Revised Memorandum of Law in Support of Class Certification was filed on March 6, 2000 (“Plaintiffs’ Revised Memorandum”) (Doc. No. 761) together with a Declaration of Jeremy R. Kasha, Esq. in Support of Plaintiffs’ Motion for Class Certification dated March 4, 2000 (Doc. No. 762) with attached exhibits. Defendants’ Memorandum of Law in Opposition to Plaintiffs’ Motion for Class Certification and in Support of Defendants’ Cross Motion to Dismiss for Lack of Standing along with Declaration of Jeffrey D. Ubersax, Esq. (“Ubersax Declaration”) (Doc. No. 775) with attached exhibits was filed May 4, 2000 (“Defendants’ Memorandum”) (Doc. No. 774). Plaintiffs’ Reply Memorandum of Law in Support of Plaintiffs’ Motion for Class Certification and in Opposition to Defendants’ Cross Motion to Dismiss was filed July 17, 2000(“Plaintiffs’ Reply Memorandum”) (Doc. No. 797). Defendants’ Surreply Memorandum in Support of Defendants’ Cross Motion to Dismiss (Doc. No. 811) and Defendants’ Surreply Memorandum in Opposition to Plaintiffs’ Motion for Class Certification (Doc. No. 812) were filed on July 31, 2000 (“Defendants’ Surre-ply Re: Standing”) and (“Defendants’ Sur-reply Re: Class Certification”), respectively. By letter dated October 24, 2001, Plaintiffs provided additional authority in support of their class certification motion (Doc. No. 864); Defendants responded by letter dated October 29, 2001 (Doc. No. 865). Oral argument was conducted on November 8, 2002. Based on the following, Defendants’ cross motion to dismiss should be GRANTED; alternatively, Plaintiffs’ motion for class certification pursuant to Rule 228(b)(3) should be GRANTED; alternatively, Plaintiffs’ motion for certification pursuant to Rule 23(b)(2) should be DENIED. FACTS Plaintiffs originally included 176 physicians who claimed to be eligible based upon prior experience in the practice of emergency medicine, to take Defendant American Board of Emergency Medicine’s (ABEM) certification examination, Second Amended Complaint, Exhibit A. Specifically, prior to June 30, 1988, ABEM permitted physicians to sit for its certification examination, consisting of both written and oral components, based upon completion either of an approved residency in emergency medicine or of 7,000 hours and 60 months of emergency room medical practice, with 2,800 hours accumulated within 24 consecutive months, and an accumulation of 50 hours of continuing medical education in emergency medicine deemed acceptable to ABEM for each complete year in practice after 1973 (“the practice track”). Second Amended Complaint ¶ ¶ 6, 7, 50. Upon passing both components of the ABEM examination, physicians are granted ABEM Diplómate status. Id. ¶ 3. After June 30, 1988, in order to qualify to sit for the ABEM examination, a physician who wished to obtain ABEM certification was required to successfully complete an approved residency training program in emergency medicine. Second Amended Complaint ¶ ¶ 6, 7, 50. However, special practice track eligibility for the ABEM examination remained available until 1995 to physicians certified by the American Board of Internal Medicine (“ABIM”) and who also served in significant academic positions. Second Amended Complaint ¶ ¶ 11, 71-73. Plaintiffs claim they represent a class of 14,000 physicians who but for the closure of the practice track would have applied to take the ABEM certification examination. Id. ¶ ¶ 23-24, 44(a). In addition to ABEM, Defendants include two members of ABEM’s board of directors, Henry A. Thiede, M.D. and Frank A. Disney, M.D., 28 hospitals which are alleged to offer residency programs in emergency medicine (“Hospital Defendants)”), Second Amended Complaint ¶ ¶ 4, 30, 31, 34, Exhibit B, and the Council of Emergency Residency Directors (“CORD”), an association of directors of residency programs in emergency medicine. Second Amended Complaint ¶ ¶ 32-33. It is alleged that ABEM, CORD, and the Hospital Defendants conspired unlawfully to close, and keep closed, ABEM’s practice track as a basis for eligibility to gain ABEM certification. Id. ¶ 34. Plaintiffs also assert that several professional organizations in the field of medicine, not named as defendants in the action, including the American College of Emergency Physicians, Society for Academic Emergency Medicine, ABIM, as sponsoring organizations of ABEM, are also co-conspirators. Id. ¶ 38. Plaintiffs further charge that other unidentified hospitals offering residency training programs in emergency medicine are part of the alleged conspiracy as well as the executive director of ABEM, 40 of its former officers and directors, and 17 physicians who served as directors of their respective emergency medicine residency programs. Id. ¶ ¶ 34, 41-43; Exhibits C, D. Plaintiffs claim Defendants conspired, among themselves and with the other organizations and persons not named as defendants, to restrain trade in and monopolize the national market for emergency medicine physicians certified by ABEM (“ABEM physicians”) and physicians who have qualified for the ABEM certification examination pursuant to the ABEM medical residency program requirement (“ABEM eligible physicians”), as offered by Hospital Defendants, the only means (except of the special practice qualification track for certain ABIM physicians) by which a physician can qualify to take the ABEM examination following closure of the practice track in 1988. Second Amended Complaint ¶ ¶ 3-4, 51, 91-92. For residency track applicants who began their residency training prior to July 1, 1997, ABEM required successful completion of 36 months of post-medical school training with 24 months controlled by an accredited emergency medicine training program; thereafter, 36 months of approved residency study was required. Id. ¶ 51. Plaintiffs allege Defendants have, through the conspiracy to close the practice track and keep it closed, artificially reduced the availability of ABEM physicians and ABEM eligible physicians in the national market for such services with a resulting noncompetitively created increase in the remuneration paid to such physicians. Id. ¶ ¶ 94-95. During the 12 year period of availability of the practice track, 8,000 physicians obtained ABEM Diplómate status of which 7,000 qualified through the practice track. Second Amended Complaint ¶ 7. As a consequence Defendants’ actions in relation to the practice track’s closure, Plaintiffs claim that Defendants’ restraint of trade, monopolization, and attempted monopolization of the market for ABEM physicians and ABEM eligible physicians caused Plaintiffs to “receive substantially less remuneration than ABEM certified physicians (in an average amount of less than $50,000 annually).” Id. ¶ 104. Plaintiffs also allege the loss of “increases in remuneration for which they would otherwise be qualified.” Id. ¶ 109. Additionally, Plaintiffs claim several other forms of damage including numerous disadvantages and impediments to their professional advancement, e.g., loss of the chance for increased professional prestige, research opportunities supported by financial grants from various funding sources, greater professional mobility, and academic appointments in the field of emergency medical practice. Id. ¶ ¶ 13, 88(a), (e), (g), (k). Plaintiffs further assert that Defendants’ closure of the ABEM practice track not only reduces competition in the market for the services of ABEM physicians and ABEM eligible physicians, but also misleads the public into a belief that emergency physicians who are not ABEM certified are less capable than ABEM physicians or ABEM eligible physicians. Second Amended Complaint ¶ 16. Plaintiffs contend that Hospital Defendants obtained benefits from the conspiracy through the increased availability of resident emergency medicine physicians to staff their respective emergency room programs at a relatively lower cost. Id. ¶ 14. Additionally, Hospital Defendants are alleged to benefit from the conspiracy through increased residency enrollments, greater federal funding and larger Medicare and Medicaid reimbursement rates, more research grants, and higher donations and greater opportunities for endowed teaching chairs. Id. ¶ 90. Plaintiffs state the putative class to be certified, pursuant to Rule 23 of the Federal Rules of Civil Procedure, include physicians who, in addition to the Plaintiffs, are physicians presently, or through passage of time could have, qualified for the ABEM certification examination under the practice track. Second Amended Complaint ¶ 44(a). Plaintiffs further allege that their claims are typical of those to be asserted by the class and that common questions of fact and law predominate over individual issues including the existence and effect upon Plaintiffs and the proposed class of the alleged conspiracy and anti-competitive conduct by Defendants and the other described coconspirators. Id. ¶ 44(d). Plaintiffs further allege that a class action is suitable and superior to other forms of adjudication in this case because the numerosity of the class renders joinder of individual plaintiffs impracticable. Second Amended Complaint ¶ 44(e). Plaintiffs also allege that identification of class members can be made based on readily available information and that the class size does not present unusual problems of judicial management or notice. Id. Additionally, Plaintiffs assert that because Defendants have refused to act to reopen the practice track as requested by Plaintiffs on grounds applicable to all class members, injunctive relief is proper against Defendants together with an award of damages. Id. ¶ 44(f). DISCUSSION I. Summary of Arguments on the Respective Motions. A. Plaintiffs’ Contentions in Support of Plaintiffs’ Motion for Class Certification. Each of the 176 originally named Plaintiffs in this action is alleged to be a duly licensed physician who has practiced or is practicing emergency medicine in the United States but none of whom has completed or is attending a residency program in emergency medicine. Plaintiffs’ Revised Memorandum of Law at 5. Plaintiffs claim that entry into and completion of a residency program in emergency medicine as the sole available means to qualify for the ABEM examination is burdensome and impractical. Plaintiffs’ Reply Memorandum at 41. Each Plaintiff is alleged to have met the prior ABEM practice track requirements or is currently practicing emergency medicine so that each Plaintiff will, with the passage of time, meet the prior existing practice track requirements. Id. Plaintiffs, as of 1994 when the Second Amended Complaint was filed, estimated that approximately 14,000 emergency physicians were then, or would become in the future, eligible to take the ABEM certification examination but for Defendants’ allegedly unlawful closure of the practice track qualification criteria. Id. at 5. As noted, Plaintiffs believe that figure is now approximately 10,000. Plaintiffs contend that the facts of this case satisfy the criteria for certification of a class as required by Fed.R.Civ.P. 23(b)(3). Plaintiffs’ Revised Memorandum at 25. Alternatively, Plaintiffs request certification pursuant to Fed.R.Civ.P. 23(b)(2). Id. at 34. B. Defendants’ Contentions in Opposition to Plaintiffs’ Motion for Class Certification and in Support of Defendants’ Cross Motion to Dismiss. Defendants argue that although the proposed class is admittedly numerous in nature, the representative Plaintiffs do not present claims typical of the class and that, because of differences in the reasons for the Plaintiffs’ inability to achieve ABEM eligibility under the former practice track, together with great variations in the potential damages incurred by class members, including representative Plaintiffs, alleged to result from the practice track closure, common issues of law or fact do not exist, or do not predominate over individual issues particularly in relationship to the elements of causality and damages. Defendants’ Memorandum at 4. Finally, Defendants assert that a class action is not superior to other methods for resolving the merits of the instant action. Id. On their cross motion to dismiss, Defendants contend, based on the allegations contained in the Second Amended Complaint as well as evidence developed in connection with Defendants’ opposition to Plaintiffs’ motion for class certification, that Plaintiffs lack antitrust standing requiring dismissal of the action. Defendants’ Memorandum at 6. Specifically, Defendants argue that because Plaintiffs seek to reopen the practice track and obtain ABEM certification to obtain higher levels of compensation expected to result from gaining the ABEM certification which Plaintiffs ultimately seek, Plaintiffs fail to allege an antitrust injury, a prerequisite to a private federal antitrust action under Sections 4 and 16 of the Clayton Act. Id. Additionally, Defendants argue Plaintiffs lack antitrust standing because they are not “efficient enforcers” of the antitrust laws. Id. While Plaintiffs’ motion for class certification preceded by several years Defendants’ cross motion to dismiss, as standing “is essential to a [district] court’s ability to entertain any claim,” the analysis of the standing question raised by Defendants’ cross motion “precedes any determination under Fed.R.Civ.P. 23.” Kent-Cho-jnicki v. Runyon, 180 F.R.D. 237, 240 (W.D.N.Y.1998) (citing cases). Accordingly, the court will first address Defendants’ cross motion. II. Defendants’ Cross Motion to Dismiss for Lack of Antitrust Standing. At the outset, Plaintiffs contend that Defendants’ cross motion should be rejected as this court has previously sustained Plaintiffs’ Second Amended Complaint against Defendants’ prior motions to dismiss for failure to state a claim, Plaintiffs’ Reply Memorandum at 5, and that as such holdings represent the law of the case, Defendants’ cross motion to dismiss should be denied. Id. A. Law of the Case. Under the law of the case doctrine, “courts generally refrain from reconsidering matters previously determined absent ‘cogent’ or ‘compelling’ reasons.” Baden v. Koch, 799 F.2d 825, 828 (2nd Cir.1986). The doctrine is discretionary, however, and “does not constitute a limitation on the court’s power.” United States v. Birney, 686 F.2d 102, 107 (2nd Cir.1982). A careful review of the procedural history of this case reveals that Defendants’ standing argument, as a basis of dismissal, has not previously been presented to the court. In particular, in their initial motion to dismiss Plaintiffs’ Amended Complaint, filed February 7, 1991, Defendants argued that the Amended Complaint was insufficient because it failed to adequately allege (i) the required degree of impact on interstate commerce flowing from Defendant ABEM’s alleged unlawful practices, (ii) personal jurisdiction over defendants in that action, (iii) the putative conspiracy, and (iv) a product and geographic market. Defendants’ Memorandum of Law in Support of Motion to Dismiss Amended Complaint (Doc. No. 13) at 9-36; Daniel I, supra, at 917-27. In support of that motion to dismiss, Defendants contended, inter alia, that Dr. Daniel, then the sole plaintiff in the action, had suffered no antitrust injury based on a lack of notice of the scheduled closing of the ABEM practice track in 1988 citing in a footnote to Brunswick Corp. v. Pueblo Bowl-O-Mat, 429 U.S. 477, 97 S.Ct. 690, 50 L.Ed.2d 701 (1977). Doc. No. 13 at 5. However, at that time, Defendants did not argue, as Defendants do on the instant cross motion, that Plaintiffs had failed to allege antitrust standing because the object of Dr. Daniel’s lawsuit, as pleaded in the Amended Complaint, was to increase Dr. Daniel’s income through an antitrust challenge to ABEM’s closure of the practice track. Defendants’ first motion to dismiss the Second Amended Complaint was predicated on statute of limitations grounds and for failure to state a claim. Daniel II at 116. In that motion, Defendants also sought summary judgment based on immunity, lack of personal jurisdiction, and improper venue, Daniel III at 150; however, Defendants’ challenge to the Second Amended Complaint at that time did not include assertion of the antitrust injury doctrine as a basis to find Plaintiffs lacked standing. Thus, as the specific question now raised by Defendants as a ground for dismissal on Defendants’ cross motion, ie., a lack of Plaintiffs’ antitrust standing, has been neither previously presented nor addressed by the court, the law of the case doctrine is inapplicable to Defendants’ cross motion. Accordingly, the court turns to the merits of Defendants’ cross motion. B. Plaintiffs’ Failure to Allege an Antitrust Injury. A court first, “must assess standing to sue based on the.standing of the named plaintiffis] and not upon the standing of identified class members.” Kentr-Chojnicki, supra, at 240 (citing cases). Standing is to be determined on the basis of the pleadings and all material allegations of the complaint must be accepted as true and construed in favor of the complaining party. United States v. Vazquez, 145 F.3d 74, 81 (2nd Cir.1998) (citing Warth v. Seldin, 422 U.S. 490, 501, 95 S.Ct. 2197, 45 L.Ed.2d 343 (1975)). See also Associated General Contractors of California v. California State Council of Carpenters, 459 U.S. 519, 526, 103 S.Ct. 897, 74 L.Ed.2d 723 (1983); State of Connecticut v. Physicians Health Services, 287 F.3d 110, 114 (2nd Cir.2002). In applying the threshold requirement of antitrust standing, a court may consider other relevant information in the record. Antares Aircraft v. Federal Republic of Nigeria, 948 F.2d 90, 96 (2d Cir.1991) (court may consider evidence outside pleadings on motion to dismiss for lack of standing), vacated on other grounds, 505 U.S. 1215, 112 S.Ct. 3020, 120 L.Ed.2d 892 (1992). See Sanjuan v. American Board of Psychiatry and Neurology, Inc., 40 F.3d 247, 250 (7th Cir.1994) (considering on motion to dismiss antitrust claim not only the “skimpiness” of the complaint, but also plaintiffs’ failure to provide information responsive to district judge’s inquiry), cert. denied, 516 U.S. 1159, 116 S.Ct. 1044, 134 L.Ed.2d 191 (1996). In this case, Plaintiffs allege that Defendants’ “unlawful conspiracy in closing the practice track has precluded Plaintiffs and ... [other purported class members] from attaining ABEM certification or ABEM eligibility and thereby competing with ABEM certified and ABEM eligible physicians.” Second Amended Complaint ¶8 (bracketed material added). Plaintiffs further claim that both they and “the class they represent have been injured by defendants’ unlawful and anticompetitive acts ... [as] among other things, plaintiffs have been denied increases in remuneration .... Id. ¶ 13. Plaintiffs also charge that Defendants’ unlawful conspiracy “restricted output and reduced competition in the market for ABEM certified and ABEM eligible emergency physicians to hospitals and others.” Id. ¶ 92. According to Plaintiffs, “[t]he effect of [Defendants’] unlawful actions is to raise artificially the price of ABEM certified and' ABEM eligible emergency physicians.” Id. As a result, Plaintiffs assert Defendants violated Sections 1 and 2 of the Sherman Act and, pursuant to Clayton Act Sections 4 and 16, seek a determination that Defendants have violated the Sherman Act, trebling of any actual damages Plaintiffs have sustained, an injunction allowing them to take the ABEM certification examination if qualified under the ABEM practice track criteria, and attorneys fees and costs. Id. ¶ ¶ 126, 130, 135, X. Assuming the truth of Plaintiffs’ allegations, Plaintiffs, who would have obtained ABEM certification but for closure of the practice track and, as suppliers of emergency medical services identical to those rendered by ABEM physicians and ABEM eligible physicians, state they are now entitled to treble the amounts of the extra compensation Plaintiffs have lost as a result of being unable to obtain ABEM certification based on eligibility for obtaining such certification under the practice track. Id. ¶ 135. However, applicable antitrust caselaw requires the court find that Plaintiffs lack standing to bring this lawsuit and that it should therefore be dismissed. “It is now well settled in order to have standing to prosecute private antitrust claims, plaintiffs must show more than that the defendants’ conduct caused them injury.” Balaklaw v. Lovell, 14 F.3d 793, 796 (2d Cir.1994) (citations omitted) (physician who lost exclusive service contract with hospital for anesthesiology service failed to establish antitrust standing). Rather, antitrust plaintiffs “must plead and prove that the injury they have suffered derives from some anticompetitive conduct and is the type the antitrust laws were intended to prevent.” (Underlining added). Todorov v. DCH Healthcare Auth., 921 F.2d 1438 (11th Cir.1991). See also Balaklaw, supra, at 796 (“Plaintiffs must prove antitrust injury, ... injury of the type antitrust laws were intended to prevent_”) (quoting Brunswick Corp. v. Pueblo Bowlr-O-Mat, Inc., 429 U.S. 477, 489, 97 S.Ct. 690, 50 L.Ed.2d 701 (1977)). In Brunswick Corp. v. Pueblo Bowl-O-Mat, Inc., supra, plaintiffs claimed as damages additional profits they lost because defendant had unlawfully acquired several failing bowling alleys in plaintiffs’ market which, but for defendant’s acquisition, would have closed for lack of profitability. Id. at 481, 97 S.Ct. 690. The Supreme Court found the essence of plaintiffs’ claim was that they could not obtain “profits they would have realized had competition been reduced.” Id. at 448, 97 S.Ct. 690. Because, as the Supreme Court stated, the “antitrust laws ... were enacted for the ‘protection of competition, not competitors,’ Brown Shoe Co. v. United States, 370 U.S. at 320, 82 S.Ct. 1502 ... [i]t is inimical to the purposes of these laws to award damages for the type of injury [the loss of windfall profits] claimed here.” Id. (italics in original) (bracketed material added). In the Court’s view, plaintiffs’ alleged losses of such profits flowing to plaintiffs from the expected reduction of competition would have resulted from the challenged merger between defendant and the prior owners of the failing bowling alleys regardless of whether defendant was financially capable of taking predatory actions against plaintiffs or had obtained new financing on their own thereby preserving their presence on the market. Id. at 487, 97 S.Ct. 690. Because plaintiffs’ asserted losses did not result from any antitrust misconduct by defendant, but, rather, from the prospect of continued competition from the merged bowling alleys, the Court found that plaintiffs’ injury “was not of ‘the type that the statute [Section 4 of the Clayton Act] was intended to forestall.’ ” Id. (internal citation omitted). Thus, the Court stated that a Section 4 plaintiff must prove antitrust injury, which is to say injury of the type the antitrust laws were intended to prevent and that flows from that which makes defendants’ acts unlawful. The injury should reflect the anticompetitive effect either of the violation or of anticompetitive acts made possible by the violation. It should, in short, be “the type of loss that- the claimed violations ... would be likely to cause.” Zenith Radio Corp. v. Hazeltine Research, 395 U.S. at 125, 89 S.Ct. 1562. Brunswick Corp., supra, at 489, 97 S.Ct. 690. Because in Brunswick plaintiffs could not establish that their asserted injury and damage — loss of extra profits based on reduced competition — was of the type antitrust laws were intended to protect or that such losses flowed from business actions rendered illegal by operation of the antitrust laws, plaintiffs’ damage claim was held not cognizable under Section 4. 370 U.S. at 488, 82 S.Ct. 1432. As the Court stated: “[W]hile respondents’ loss occurred ‘by reason of the unlawful acquisitions, it did not occur ‘by reason of that [predatory action against plaintiffs] which made the acquisition unlawful.” Id. at 488, 82 S.Ct. 1432 (bracketed material added). Thus, because plaintiffs sought to recoup profits lost through increased, albeit unwanted competition to plaintiff, competition, the Court found the injury one not proper for redress under the antitrust laws; The requirement that to have standing, an antitrust plaintiff should have incurred an antitrust injury was later extended to nonmerger cases. See J. Truett Payne Co. v. Chrysler Motors Corp., 451 U.S. 557, 562, 101 S.Ct. 1923, 68 L.Ed.2d 442 (1981) (for any antitrust violations “a plaintiff must make some showing of an actual injury attributable to something the antitrust laws were designed to prevent.”) In J. Truett Payne Co., supra, the Court held a Robinson-Patman Act plaintiff was “not excused from its burden of proving an antitrust injury.” 451 U.S. at 568, 101 S.Ct. 1923. In Matsushita Electric Ind. Co. v. Zenith Radio, 475 U.S. 574, 106 S.Ct. 1348, 89 L.Ed.2d 538 (1986), the Supreme Court found that plaintiffs’ claim for damages based on an alleged conspiracy to charge higher than competitive prices was barred under the Sherman Act because, as defendants’ competitors, plaintiffs “[stood] to gain from any conspiracy to raise the market price [for the relevant product].” Matsushita, supra at 583, 106 S.Ct. 1348, (citing Brunswick, supra) (bracketed material added). Nor, as the Court stated, can a competitor sue “to recover for a conspiracy to impose nonprice restraints that have the effect of either raising market price or limiting output ... [because] [s]uch restrictions, though harmful to competition, actually benefit competitors by making supracompetitive pricing more attractive [to such competitors].” Id. (italics in original) (bracketed material added). Because in Matsushita plaintiffs, as defendants’ competitors in the U.S. market and as potential competitors of defendants in defendants’ Japanese market, sought to challenge, in the Court’s view, conduct beneficial to them as competitors, the Court found plaintiffs had no “cognizable claim against [defendants] for antitrust damages.” Id. Thus, the Court held that as defendants’ competitors seeking damages pursuant to Clayton Act Section 4, plaintiffs could not challenge under the antitrust laws noncompetitive arrangements that benefited them as competitors. The requirement that an antitrust plaintiff allege it suffered a cognizable antitrust injury caused by a defendant as prerequisite to a request for injunctive relief pursuant to Section 16 of the Clayton Act was established in Cargill, Inc. v. Monfort of Colorado, 479 U.S. 104, 113, 107 S.Ct. 484, 93 L.Ed.2d 427 (1986). The antitrust standing requirement for private actions brought under Sections 4 or 16 of the Clayton Act seeks to “avoid overdeterrence resulting from the use of the somewhat draconian treble damage award,” available for Sherman Act violations. Todorov, supra, at 1449. “[B]y restricting the availability of private antitrust actions to certain parties, we ensure that suits inapposite to the goals of the antitrust laws are not litigated and that persons operating in the market do not restrict procompetitive behavior because of a fear of antitrust liability.” Id. The requirement of antitrust injury and standing, as a prerequisite to suit under Section 4 and 16 of the Clayton Act, has been extended to plaintiffs who as competitors in the market seek a professional credential that will enable them to charge higher prices for their services in that market, and a request for such relief in a federal antitrust complaint negates the existence of an antitrust injury and standing requiring dismissal of the complaint. In Sanjuan, supra, the Seventh Circuit held plaintiffs, psychiatrists who failed the oral portion of defendant’s board certification examination, lacked antitrust standing where damages sought allegedly resulted from plaintiffs’ inability to charge higher fees without such certification. As the court stated, “the claim that a practice reduces (particular) producers’ incomes has nothing to do with the antitrust laws, which are designed to drive producers’ prices down rather than up.” Sanjuan, supra, at 251 (citing cases). “Plaintiffs, who want to obtain a credential that will help them charge higher prices, have pleaded themselves out of court on the[ir] antitrust claim.” Id. at 252. Sanjmn thus extends Brunswick and Matsushita to competitors who challenge the granting of a competitive advantage to a competitor in order to increase the price of their services, a purpose not protected by the Sherman Act. Here, Plaintiffs do not claim that they were prevented from practicing emergency medicine; rather, Plaintiffs allege that because of the anticompetitive closure of the practice track they were unable to obtain the ABEM certification that would permit them to earn higher incomes as ABEM certified emergency physicians. As such, Plaintiffs’ alleged damages flow directly from Plaintiffs’ consequent inability to earn and benefit from a professional credential, ABEM certification, with which they expect to obtain greater compensation at a level resulting from the anticom-petitive conduct they seek to condemn; therefore, the deprivation of such an economic advantage, i.e., the ability to raise prices because of a competitor’s noncompetitive conduct, to a competitor or prospective competitor, is an economic consequence to which the antitrust laws are indifferent. Matsushita, supra; Brunswick, supra. Applying the requirement that a Clayton Act Sections 4 or 16 plaintiff allege a cognizable antitrust injury, courts have consistently rejected antitrust claims based on lack of antitrust standing including cases where physicians, as antitrust plaintiffs, have sought to confer economic advantage, in addition to board certifications, upon themselves by attacking business practices by competitors and purchasers of their services having the effect of excluding them from the market. Ba-laklaw, supra (plaintiff anesthesiologist lacked antitrust standing for action to cancel award of exclusive service contract by hospital to a competitor); Todorov, supra (radiologist who sought radiology department privileges to administer and read CT head scans in order to share in supercom-petitive fees charged by staff radiologists for same service lacked antitrust standing as plaintiff sought to “reap” that which the competing CT scan radiologists enjoyed); Salamon v. Our Lady of Victory Hospital, 1999 WL 955513 *2 (W.D.N.Y. Oct. 5, 1999) (plaintiff physician alleging restraint of trade based on defendant’s exclusion from referrals for her medical services lacked antitrust standing); Korshin v. Benedictine Hospital, 34 F.Supp.2d 133, 138 (N.D.N.Y.1999) (physician who lost exclusive services contract to provide anesthesiology services to hospital failed to allege antitrust injury); Ezekwo v. American Board of Internal Medicine, 18 F.Supp.2d 271, 277 (S.D.N.Y.1998) (physician seeking hospital admission privileges and participation in an HMO failed to allege sufficient facts demonstrating injury to competition and market area and thus no antitrust injury sufficient for standing), aff'd, 173 F.3d 844 (2nd Cir. 1999); Ginzburg v. Memorial Healthcare Systems, Inc., 993 F.Supp. 998 (S.D.Tex. 1997) (physician’s alleged inability to successfully practice medicine at defendant hospital, based on defendants’ refusal to refer patients, declining to provide cross-coverage and black-listing, failed to allege an antitrust injury); Finkelstein, supra, at *5 (alleged coercive provisions imposed by combination of hospitals and insurance carrier upon plaintiff-physicians’ decision making authority in care of patient-insureds failed to allege an antitrust injury). See also Appraiser’s Coalition v. Appraisal Institute, 1999 WL 89663 (N.D.Ill. Feb. 12,1999) (real estate appraisers seeking special qualification designation from defendant trade organization made up of competing appraisers failed to allege antitrust injury). A fair reading of the Second Amended Complaint, Plaintiffs’ Revised Memorandum, Plaintiffs’ Reply Memorandum, and consideration of discovery related to Plaintiffs’ class certification motion demonstrates that Plaintiffs have failed to plead any cognizable antitrust injury sufficient to confer antitrust standing under either Section 4 or 16 of the Clayton Act. Specifically, the Second Amended Complaint alleges that Defendants’ conspiracy caused them to be denied “increases in remuneration” based on their inability to obtain ABEM certification. Second Amended Complaint ¶ 13. Further, according to Plaintiffs, they and members of the alleged class “receive substantially less remuneration than ABEM certified physicians (in an average amount of no less than $50,000 annually).” Second Amended Complaint ¶ 104. Additionally, Plaintiffs claim the loss of “increases in remuneration for which they otherwise would be qualified” if they were able to sit for and pass the ABEM certification examination through the practice track. Id. ¶ ¶ 88(a), (e), (g), (k); 109. Plaintiffs’ legal argument reinforces Plaintiffs’ compensation enhancing purposes. Specifically, in connection with the allegations in support of class certification, Plaintiffs include among the common issues Plaintiffs assert exist with respect to each proposed class member “• The purpose and effect of defendants’ conspiracy to restrain competition and increase the economic and other professional benefits associated with ABEM certification; * * # * * * • The artificial elevation of the prices paid by the public for the services of ABEM-certified and ABEM-eligible emergency physicians caused by defendants’ actions; • The artificial reduction in the earnings of plaintiffs and proposed class caused by defendants’ actions in unlawfully withholding eligibility for ABEM certification from plaintiffs and the proposed class.” Plaintiffs’ Revised Memorandum at 19 (emphasis added). Further, in contending that both Plaintiffs and members of the proposed class suffered an injury in fact caused by the Defendants’ alleged antitrust violations, Plaintiffs stated that Defendants’ “conspiracy has prevented all Plaintiffs from obtaining the higher salaries that ABEM certified and ABEM eligible emergency physicians command .... ” Plaintiffs’ Memorandum at 26 (Doc. No. 70) (underlining added). Such allegations do not describe “an injury the antitrust laws were intended to prevent” and do not “flow[ ] from that which makes defendants’ acts unlawful.” Brunswick, supra, at 489, 97 S.Ct. 690. See Balaklaw, supra; Sanjuan, supra; Todorov, supra. Additionally, the testimony of individual Plaintiffs obtained through discovery manifests Plaintiffs’ primary objective in this lawsuit as that of increasing their income based on obtaining ABEM certification. For example, Dr. Daniel, the lead Plaintiff, acknowledged that obtaining ABEM certification would enable him to “command a higher hourly rate” by achieving “parity” with ABEM certified physicians who receive higher compensation. Daniel Deposition at 135-36, Appendix to Defendants’ Memorandum of Law Vol. II, Exhibit K. Dr. Timmons, another Plaintiff, testified that as a result of receiving ABEM certification in 1996, upon qualifying under the special track available to ABIM members with academic credentials, he successfully negotiated a “significant” salary increase. Timmons Dep. at 11. Dr. Timmons also stated that he is seeking $279,000 in damages for the period 1990-1994 representing the higher compensation he believes he would have earned had he then held ABEM certification during that period. Timmons Dep. at 51. Further confirmation that such enhanced compensation upon achieving ABEM board certification based on practice track eligibility, as the goal of the instant litigation, is provided by other Plaintiffs. For example, Plaintiff Dr. Ian Cummings testified that if he were ABEM certified, he expected to be paid more by his group practice organization. Cummings Dep. at 44, 51, 70. Dr. K. Michael Keil, another Plaintiff, testified that with ABEM certification, his group practice organization for emergency services could have placed him at a hospital which paid $10 more per hour than his current hourly rate. Keil Dep. at 201. Plaintiff Dr. Phillip LaStella testified that with ABEM certification it was conceivable that he could earn more than his present income of about $500,000 per year. LaStella Dep. at 109. Dr. Douglas Middleton, another Plaintiff, testified that he is confident his annual income would have been as much as $100,000 to $200,000 higher, depending on the hospital at which he had been hired, if he then held ABEM certification. Middleton Dep. at 51-55. According to answers to Defendants’ interrogatories, Dr. Mu-ran’s compensation as an emergency physician without ABEM certification was between $70,000 to $100,000 per year lower than it would have been with ABEM certification. Muran Answer to Interrogatory No. 17(a) dated May 28, 1999, Yol. Ill, Exh. K to Appendix to Defendants’ Memorandum of Law in Opposition. Plaintiff Dr. Kurt Papenfus estimated, without particulars, his annual compensation loss from his lack of ABEM certification to be about $1 million over a 10 year period. Papenfus Answer to Defendants’ Interrogatory No. 17(a) dated July 10,1999. Id. Plaintiffs’ expert, Dennis W. Carlton, Ph.D., who holds a doctorate in economics from the University of Chicago, in the course of deposition testimony explaining the rationale for his multiple regression analysis to support Plaintiffs’ request for class certification, discussed in Section III, infra, also confirmed that Plaintiffs’ ultimate objective in bringing this lawsuit is to benefit themselves economically through increased compensation by obtaining ABEM certification: Q. Isn’t it true that the plaintiffs in this case are seeking a credential that will help them charge higher prices? A. I think plaintiffs are seeking a credential to which they believe they’re entitled by virtue of their qualifications that would be reflected in the marketplace as a higher price than they are currently earning. Q. In other words, they believe that if board certified, they’ll be able to make more money ? A. Correct. * * ^ * * * Q. And you believe that if the members of the class do get the ABEM credential that they would then be able to charge higher prices than they’re currently charging for their services? A. Yes, I believe that. Deposition of Dennis W. Carlton, Ph.D., Carlton Dep. at 334-36 (underlining added). “Indeed, if certification did not typically result in higher wages, it is not clear why individuals [including Plaintiffs] would have an incentive to become certified.” Reply Affidavit of Dennis W. Carlton, Ph. D., dated July 12, 2002 (Doc. No. 798) (“Carlton Reply Affidavit”) ¶ 14 (bracketed material added). Thus, based on the allegations presented in the Second Amended Complaint, Plaintiffs’ supporting legal memoranda, and the record on Plaintiffs’ motion, through the relief Plaintiffs request, they seek to qualify for ABEM certification and damages for being prevented from obtaining ABEM certification, for the purpose of obtaining higher prices for their services in the market for ABEM physicians and ABEM eligible physicians and, but for the alleged wrongful closure of the practice track, damages representing the loss of such higher income as they have pleaded. As prospective competitors of ABEM physicians or ABEM eligible physicians who seek higher income based on ABEM certification, Plaintiffs’ requested relief is not recognized as a permissible objective under the antitrust laws, and, as such, Plaintiffs lack standing. Sanjuan, supra; To-dorov, supra. Plaintiffs advance several grounds to defeat Defendants’ cross motion. First, Plaintiffs contend that the requirement of antitrust injury as an element of standing should be resolved at trial. Plaintiffs’ Reply Memorandum at 7-9.' However, there is no merit to this contention as courts frequently dismiss complaints in antitrust actions prior to trial for insufficient allegations of antitrust injury and standing. See Sanjuan, supra (dismissing complaint for lack of standing based on absence of showing plaintiff had suffered antitrust injury affirmed); Korshin, supra (same); Sala-mon, supra (same) Finkelstein, supra (same). See also Balaklaw, supra (granting summary judgment against plaintiff who failed to demonstrate antitrust injury and therefore lacked standing); Todorov, supra (same); The Appraisers Coalition, supra (same). Cf Matsushita, supra (recognizing on motion for summary judgment unavailability of Sherman Act remedies based on suit by plaintiff competitors challenging conspiracy to raise prices in defendant competitors’ domestic market). As noted, standing issues are to be determined based on the material allegations in the complaint. Vasquez, supra; Finkel-stein, supra. Hence, it is proper to determine Plaintiffs’ antitrust standing at this stage of the proceedings. Second, Plaintiffs argue that sellers and producers including “injured competitors” against whom the antitrust misconduct was directed have been held to have standing to enforce antitrust laws. Plaintiffs’ Reply Memorandum at 10 (citing cases). Plaintiffs’ cited authorities do not support such a broad generalization and are, in any event, inapposite. For example, in Full Draw Productions v. Easton Sports, Inc., 182 F.3d 745 (10th Cir.1999) trade show operators’ claims of group boycott by suppliers were found to establish standing based on the rule that group boycott claims do not require that plaintiffs and defendant competitors operate at the same market level. Full Draw, supra, at 745 (citing cases). In Crimpers Promotions, Inc. v. Home Box Ojfice, Inc., 724 F.2d 290 (2d Cir.1983), plaintiff had standing to challenge defendants’ effort to induce boycott of plaintiffs trade show which was sponsored by plaintiff to increase competition against defendant for cable TV programming. Crimpers Pro motions, supra, at 294. Radovich v. National Football League, 352 U.S. 445, 77 S.Ct. 390, 1 L.Ed.2d 456 (1957) also involved a boycott claim based on an alleged blacklisting of plaintiff, a professional football player. In Municipal Utilities Board v. Alabama Power Co., 934 F.2d 1493 (11th Cir.1991) the court found municipal electric suppliers had standing to challenge a state sponsored retail market allocation scheme to benefit retail electrical cooperatives which competed with plaintiffs. Here, the Second Amended Complaint contains no group boycott or market division allegations. As Plaintiffs do not allege a group boycott or an unlawful market allocation scheme among competitors, the caselaw upon which Plaintiffs rely fails to establish that Plaintiffs enjoy antitrust standing. Moreover, unlike the instant matter, in none of these cases did plaintiffs seek to gain an economic advantage the would enable them to charge higher prices. Nor does Plaintiffs’ reliance on Blue Shield of Virginia v. McCready, 457 U.S. 465, 102 S.Ct. 2540, 73 L.Ed.2d 149 (1982) and Calderone Enter. Corp. v. United Artists Theatre Circuit, Inc., 454 F.2d 1292 (2d Cir.1971), Plaintiffs’ Reply Memorandum at 14, 15-16, support Plaintiffs’ motion. In McCready, the Supreme Court upheld antitrust standing for a subscriber of health care insurers’ coverage challenging the insurer’s arbitrary refusal to pay for a licensed psychologist’s therapy services while allowing reimbursement for psychotherapy services by psychiatrists. As such, the Court found plaintiffs standing depended on a finding of direct financial harm to plaintiff deriving from her position as a consumer not as a supplier of psychotherapy services but which was the necessary result of the conspiracy to withhold payments to the psychologists as competitors of the psychiatrists. McCready, 457 U.S. at 483-84, 102 S.Ct. 2540. No similar direct harm to Plaintiffs following from an arbitrary restriction on competition is alleged here, rather, Plaintiffs seek to raise the price for their services as they gain professional competitive parity with ABEM physicians and ABEM eligible physicians. As such, McCready provides no support to Plaintiffs’ efforts to establish antitrust injury and standing. In Calderone, supra, a landlord sued for decreased rental income caused by defendants’ conspiracy to force the showing of “inferior” films at plaintiffs’ movie houses thus reducing the landlord’s rental revenue. Calderone, 454 F.2d at 1294. Applying Second Circuit precedent, the court in Calderone found plaintiff lacked standing under Section 4 of the Clayton Act as plaintiff was not within the target area of the antitrust conspiracy, “i.e., a person against whom the conspiracy was aimed, such as a competitor of the persons sued.” Id. at 1295. However, in Crimpers, supra, the Second Circuit held that following holdings of the Supreme Court subsequent to Calderone, as to the scope of Section 4 of the Clayton Act, “courts in this circuit should start their analysis of standing under Section 4 with the Supreme Court opinions rather than engage in extensive parsing of Billy Baxter [Inc. v. Coca-Cola Co. 431 F.2d 188 (2d Cir.1970) ] and Cal-derone.” Id. (citing authorities criticizing the “target area approach” to determinations of antitrust standing applied in Billy Baxter and Calderone). Crimpers, supra, at 292 (Friendly, J.) (bracketed material added). “[C]ourts of this circuit ... are compelled, to follow approaches adumbrated by the Supreme Court ... without concern whether the results are consistent with language in earlier Second Circuit cases.” Id. Accordingly, Plaintiffs’ assertion that because Defendants’ alleged conspiracy was directed at them, even if true, is in itself insufficient to establish standing unless Plaintiffs’ allegations also comport with more recent and relevant Supreme Court holdings, discussed supra, propounding the prerequisite of antitrust standing for Section 4 cases. See Balak-law, supra (analyzing antitrust standing issue as to physician’s boycott and concerted refusals to deal claims based on Supreme Court cases without reference to prior Second Circuit standing caselaw considering whether antitrust plaintiff was ‘target’ of alleged antitrust conspiracy). Thus, Calderone’s application of the ‘target area’ test for antitrust standing provides no support to Plaintiffs as such approach is inconsistent with the Second Circuit’s later decision in Crimpers, supra. Third, Plaintiffs seek to distinguish San-juan on the basis that plaintiffs in that case, unlike Plaintiffs, failed to allege an unlawful exercise of market power, a reduction in output, or exclusion from competition in that, in Sanjuan, plaintiffs, who continued to practice in their specialty, were not precluded from taking defendant’s certification examination, rather, they were unable to pass it. Plaintiffs’ Reply Memorandum at 10-11. Plaintiffs further argue that this court has previously sustained the Amended Complaint and Second Amended Complaint against Defendants’ attempts to dismiss. Id. at 11 (citing Daniel I, supra and Daniel II, supra). However, as explained in connection with the court’s consideration of Plaintiffs’ argument based on the law of the case doctrine, Discussion, supra, at 13-14, the court has not previously been presented with the specific ground for dismissal now interposed by Defendants, i.e., that Plaintiffs lack standing based on a failure to allege a cognizable antitrust injury sufficient to permit recovery or injunctive relief pursuant to Sections 4 and 16 of the Clayton Act. Thus, while the court has sustained the Amended and Second Amended Complaint against Defendants’ earlier motions to dismiss on grounds other than asserted here by Defendants, it does not follow that Plaintiffs can avoid scrutiny for failing to allege the existence of any cognizable antitrust injury and standing. Likewise unavailing is Plaintiffs’ effort to distinguish Sanjuan on the ground that because in Sanjuan plaintiffs were found by the court to be defendants’ competitors the court’s finding that plaintiffs lacked antitrust standing is inapplicable to Plaintiffs’ allegations. Plaintiffs’ Reply Memorandum at 11. Particularly, Plaintiffs contend that they are not yet in competition with ABEM certified or eligible physicians because they have not gained the opportunity to obtain ABEM certification (by qualifying through the practice track to take the ABEM examination), and thus cannot be said to compete with ABEM certified or eligible physicians. Id. at 11-12. Plaintiffs reason that because Plaintiffs are not competitors who challenge an anticompeti-tive practice that if engaged in by them will allow them to charge higher prices, the reasoning of Sanjuan — holding that competitors who challenge anticompetitive practices beneficial to such competitors lack antitrust standing — as