The USMLE Step exams serve as a gateway to practicing in your chosen profession. It is a part of the journey as a student with a disability to prepare in advance and understand the requirements for each individual exam. These exams serve as licensing, advancement/promotion or certification requirements in medicine. For official guidelines from the NBME, please visit: USMLE Test Accommodations Guidelines (external link). We also recommend reviewing the guidelines below, as they not only cover what to include, as outlined by the NBME, but also provide important information on what to avoid.
How do I apply?
As a student with a disability you should understand that requests for accommodations on the USMLE Step exams are made directly to the The National Board of Medical Examiners (NBME) and do not go through Student Disability Services, although we do assist students with the process. The NBME sets their own requirements for requesting accommodations, including specifications for disability documentation, personal statements, and other required information for your application. The request process is outlined on the NBME's website (link is external). Be aware, in some cases, particularly where the exam accommodation approval is governed by a state licensing board, the information can vary by state. This variance often necessitates contact by phone, as well as close reading of the online information to ensure you have all the necessary details for making your request.
Timeline *READ CLOSELY*
The process of preparing a request for accommodations can take 3-6 MONTHS (or longer). Example: if you are planning to test in February, you need to submit by August of the previous year. This means having your application completed PRIOR TO AUGUST. Students must factor in time to develop a personal statement, collect documentation, and file appeals should their initial request be rejected (which basically starts the wait over). It is prudent to allow 6 months for the whole process, to allow for the possibility of an appeal.
Documentation Requirements
Students must provide documentation of their disability status to NBME. This may be provided via a form in lieu of, or in addition to, a formal report. It is best to determine what is required well in advance of a submission date. The documentation on file with disability services may differ from what is required for the exam. It is not uncommon that new or updated documentation of your disability that requires a new referral to a specialist, or appointments with your treatment team. This process adds to the timeline for requesting accommodations and underscores the need to begin the process early. The NBME documentation requirements are available on their website (link is external).
Forms
The NBME also requests additional verification forms (link is external) showing a history of previous accommodations in higher education. SDS can help you determine who is qualified to complete the form, where in some cases it should be completed by your medical or mental health care provider (psychiatrist, physician, psychologist, etc.), while other times the form can be completed by the office that approved the accommodation request (disabilities office, dean of students office, office of student affairs). It is prudent to approach a service provider with a summary of the requirements, along with reasoning for the requested accommodations (barriers posed by the exam, functional limitations of your disability). This helps the provider best detail your needs.
The SDS office can provide a more detailed letter in addition to a form that confirms your approved accommodations. This letter will include additional information, not captured in other forms about observations of your need for accommodations, methods for determining certain accommodations, and specifics about how a student's disability impacts him/her in an academic setting.
Additional Records
Students may also be required, or wish to provide, additional information to strengthen their request for accommodations. Historical evidence of accommodation and need can bolster a student's case of receiving accommodations. Students who have been diagnosed later in life can also provide examples of how their undiagnosed disability may have affected their early life and education.
When Making Requests for Step Exam Accommodations:
- Read the USMLE General Guidelines to Request Test Accommodations and share them with your healthcare provider.
- Make a request as early as possible. (The process of preparing a request for accommodations can take 3-6 MONTHS (or longer). Example: if you are planning to test in February, you need to submit by August of the previous year.)
Quick Tips for an Effective Personal Statement:
- Be direct that you have a disability. They are looking for a diagnosis and your experience specifically.
- Highlight specific barriers and impacts in daily living currently If a disability was acquired, talk about timing.
- If it’s lifelong, talk about your experiences throughout your life including before college.
- Discuss barriers to test taking specifically.
- Explain why the requested accommodations are necessary to afford you ACCESS to the test (as opposed to optimize your results).
- Show that you’ve considered: do you need accommodations for the actual exam section time?, or longer breaks in between sections?, or both?; do you need the exam broken up over two days?
- Be direct (ie I require the following accommodations…), and avoid pleasantries that soften the necessity (“It would be helpful…” or “I can do my best if…” or “I would be more successful…)
- Be succinct, no more than 2 pages;
- Don’t hesitate to reach out for help! You can reach out to Tim, Clay and Jon in Student Disability Services: [email protected]
If you have any questions regarding your accommodations, please contact SDS by email or by phone, 415-476-6595.