A Step-by-Step Guide to Acquiring USMLE Test Accommodations

Navigating the USMLE is not an easy task in and of itself. Add on to that a need for testing accommodations, and it may well feel impossible. While the process can certainly be difficult, it’s not impossible. This blog offers a few simple steps to help you navigate the process of obtaining testing accommodations. 

Unfortunately, there’s no guarantees that the USMLE will accommodate your request. Just because your school provided accommodations does not mean the USMLE will. Make sure that you dot your “i”s and cross your “t”s when submitting your request. A thorough application is the best way to increase your chances of being approved. 

1. Complete Your Step Exam Application

You cannot submit any documentation or request for accommodations until your step exam application has been submitted. Make sure that you have submitted your application for the exam prior to beginning any application for accommodations.

2. Understand Eligibility Requirements

Before applying, verify that you have a documented disability as per the Americans with Disabilities Act (ADA). The disability must substantially limit one or more major life activities. Be aware that even with a documented disability, the USMLE has full discretion as to who does and who does not get accommodations.

3. Prepare Your Personal Statement

USMLE requires a personal statement as part of your request for accommodations. This statement is your opportunity to tell USMLE why you need the accommodation and how you think it can help you in this journey. In the first part of the prompt, you will provide a brief history of your impairment. The second part of the personal statement should detail your current functioning. The final part of the personal statement  should describe your rationale for your accommodations. Be brief, clear, and logical for each of these responses. Clearly identify your disability and illustrate how accommodations will help you succeed.

4. Prepare Documentation

You need thorough medical documentation of your disability. The documents must include:

• A clear diagnosis
• Specific details about the functional limitations caused by the disability
• Results of tests and evaluations (if applicable)
• Recommendations for the specific accommodations you’re requesting
• Information about the evaluator who provided your diagnosis including their credentials, address, email, and phone number
• Any prior history of accomodations

The documentation should be current, typically within the last three years, although this may vary based on the condition. An updated doctor’s note within a year would be helpful to have as well! You want to make sure that you submit everything they may need (and more!).

5. Request Specific Accommodations

When requesting accommodations, be as specific as possible about what you need to succeed during the exam. Common requests include extended testing time, extra breaks, splitting the test day into 2 days, and a separate testing room. Many of these options are detailed in the paperwork provided by the USMLE.

Ensure your documentation of your disability directly and explicitly supports each accommodation you’re requesting. For example, documentation for dyslexia might mean a request for extra time testing. Documentation for ADHD might mean a request for a private testing room to help with distractions. 

6. Submit Your Request Early

You must apply for accommodations through the USMLE’s online portal. Submit your request as early as possible—preferably when registering for the exam—to avoid delays. Accommodations cannot be retroactively applied to previously taken exams. Once the test is taken, the score is submitted!

7. Review and Response Timeline

Once submitted, the National Board of Medical Examiners (NBME) reviews your request. This process can take several weeks or even longer if additional documentation is needed. This is why you must submit early! You will be notified of their decision or their need for more information via email.

8. Prepare for Possible Follow-Up

If the NBME requests more information, act quickly to provide what’s needed. Delays in response can slow down the decision-making process. In some cases, the NBME may deny your request if documentation is insufficient or if your accommodations aren’t clearly justified. If they ask for follow up, do your best to respond quickly and thoroughly.

9. Reconsideration of Accommodations Decisions

If your request is denied, you have the right to appeal the decision one time. Carefully review the feedback and gather any additional documentation to strengthen your case before submitting an appeal. Here’s how the process works:

• One Reconsideration Per Registration: You can request reconsideration once during your eligibility period for the same USMLE Step exam.
• Submit New Evidence: Provide new documentation that wasn’t included in your original request. Re-submitting the same information won’t be enough. If you resubmit the exact same information, you can expect the exact same response.
• Follow the Process: Complete the “Reconsideration Request Form” and await a confirmation email from the USMLE.

For more details, visit USMLE Reconsideration Guidelines.

10. Accommodations During the Exam

If approved, your accommodations will be arranged directly with the test center. Ensure that all details are correct before the exam day and communicate with the testing center if you have specific concerns. You may wish to call the testing center to ask any further questions regarding the accommodations that you will have. For example, if you are given a private room, you may want to ensure that the testing center has a private room that will be available for the day you test.

Frequently Asked Questions

• How long does the process take? Reviews can take up to 60 days, so early application is crucial.
• What types of disabilities are eligible? Disabilities covered under the ADA include physical, mental, sensory, and learning disabilities.
• Do I have to reapply for every USMLE Step exam? Yes, you must submit a new request for each Step exam, even if accommodations were granted previously.

This guide ensures a smoother path to receiving the support you need. Be proactive in your approach and ensure all documentation is detailed and up-to-date to improve your chances of approval. For full details, you can visit USMLE Test Accommodations Guidelines. You can find all the necessary forms here.