1. It is a competition...

Out of curiosity, I checked out the way the exams work and how the scores are computed. The way in which an individual places relative to other test takers matters to the outcome. It's rolled into the final score. So it is a competition.

Even if it might not make any difference to her passing, it will probably make a difference to where she scores relative to other test takers.

I have no idea how the medical profession regards scores. If there are any doctors out there, can you tell us if the profession cares about the score or just if the individual passes/fails?

I think we all need more information on that. I wish the article would have provided it.

2. It should be a competition...

For exams in school as well as for exams certifying one in a profession, the nerve-griding stress is supposed to be part of the process. Having gone through it (for law), I personally don't want to see the stress taken out of the process because professionals such as doctors and lawyers need to be able to operate in high-stress, potentially no-win situations. If they can't perform under those circumstances, they've chosen the wrong profession.

Yes, there are areas of the law and medicine that aren't like that (where someone with severe ADD, dyslexia, etc. could function quite well), but they are the minority and the tests can't be geared toward the minority practice in the profession. It's both impractical and cost-prohibitive to do anything other than test to the majority view.

3. Will it matter to her outcome?

I can't say with absolute certainty how much difference her "extra time" would actually make for her final score.

Objectively, it makes rational sense that that in the most professions, that extra time would be critical. It's not because she's getting any extra time on the test itself or even that she'd have more time to prepare, but because she's getting extra time to recover from the stress. Even a few minutes of time outside the grind is beneficial.

I know the limited value of extrapolating from personal experience...however, I can tell you for my law school exams, I did so much better when they were scheduled further apart, than when they were close together, even though it made no real difference in the amount of time I studied in between exams as I was one of those individuals who prepped everything during the term and didn't study at all during finals week. So it isn't just time on the test and it isn't just ability to study more...it's the mental break.

(Most law schools recognize this and don't make you take more than one test a day).

For those of you who haven't taken these types of test, you've surely done something, (like deal with a screaming baby or an annoying coworker), where you just needed 5 minutes away to regain your composure....

4. Does she merit extra time?

I have no idea if she individually merits extra time or not, as I have not seen the details of her case and only know what the media is reporting. The "facts" the media has presented don't give me a clear enough picture of this individual or her situation. Some paint her as a whiner trying to get an advantage and draw out her past behavior, others present a picture of a truly disadvantaged individual...

I'd like to see what evidence she's presented documenting her need(s).

I would also be curious to see what her professors and classmates thought. That, to me, would be most telling. Generally, if you are in the foxhole with someone with that level of intellectual demand placed on you, you get to know the true character of the other...

5. Do individuals with handicaps or special circumstances merit extra time?

I think very few people would fall on the side of "no special accommodations ever". Given that, the disputes generally center on what should be covered and how much time should be given.

I'm not a doctor, I have no idea what conditions really should require extra time. I have no idea how much time an ADD patient really needs. I also have no idea exactly how closely the test does mimic what happens in the real world, so I don't know how much "slack" should be allowed.

I have no problem with breast-feeding being included. Even if it is a condition that's brought on by choice, it's arguably a socially-beneficial choice. (because we all benefit when children are healthier). That's what distinguishes it from another individual who's in pain during the testing because they chose to have elective cosmetic surgery.

6. Who should decide how to accommodate individuals with special needs? How should they decide?

I have a problem with this being a judicially-mandated standard. Personally, I think the judiciary can and and should say "cover breastfeeding" as an exemption requiring special time...How much time should not be dictated by the courts, but by a committee of other doctors (maybe even other female doctors who've breastfeed or OBGYNS who've got experience with breastfeeding mothers). It's their profession and their area of expertise. I simply don't think the court is competent to set a fixed-standard and I do think a fixed standard needs to be set...

I realize that every woman will be different on how long she takes to breastfeed, but as this is a standardized test, there is no way to evaluate each and every case...unless you want to see a massive increase in fees for the test. People often forget that when we invoke the law, things we do to aid one group often directly impact individuals in other groups. In this case, dealing with each and every individual as an individual would simply drive up the cost of the test, a cost that would be disproportionately harsh on the poor.

7. Unlikable Victims and People who Claim ADD

It's difficult for an outsider to really tell if someone has or doesn't have a condition. They can only tell how that individual uses the condition. I've know individuals with severe handicaps who never asked for extra assistance and individuals who invoked nonexistent conditions to get ahead. Yes, Virginia, there are people who claim X, Y or Z disability (frequently ADD) to get extra time because they know it is an advantage. One of my classmates in law school did this. She had one of her father's friends who was a physician to write her the requisite ADD letter.

But do you want to err on the side of punishing those with legitimate conditions or err on the side of letting in a few fakers? And who do you think should be the judge? At present, most schools and institutions require only a letter from an outside doctor, which can be easily faked or bought (see above). It's fine to say that "objective" doctors should be used, but this presents a cost issue, as the institution providing the objective doctor would be paying, not the individual seeking accommodation.

The problem in this case really comes down to the fact that the "victim" here isn't really likable and may even be faking...but even so, the principle of extra time for the class of individual she represents seems to make sense. So even if you hate her, do you want to impute her characteristics to the whole class? If so, on what basis? Your view on ADD? Your view on breastfeeding? Your view on women who try and be both mothers and career women? Your view of women?

I personally feel that I lack the requisite information to form an informed opinion about this woman in particular or the ultimate issue of what standard makes sense for the class of "breastfeeding women".

Of course, I'm sure there are individuals out there who, though they don't know more about this woman, probably do know more about breastfeeding and this specific from their experience in the medical profession. I hope they weigh in.

Excellent post by the way, however I challenge with this - why not simply ask her to take the test later during the year? It was already proposed that she do that - and it was rejected on what I consider weak arguments.

Thanks.

As for delaying the test, I need more information to give you an answer. I can't simply say yes or no unless I know the content and context of the offer. For example:

1. What would be the impact of delay?

How much of a delay would she be facing in taking the test? (i.e., how long is she going to be in this "condition" and how often is the test given). It matters to me if she has to wait 3 weeks, 3 months or 3 years.

How much of a delay would she be facing in starting work? (I need to know more about the process after the test and about the offer from her future employer.)

How much of a monetary loss would this be? (i.e. What are her actual damages by delay?)

How long is her potential future employer willing to wait?

2. Were other alternatives offered and available?

Did the testing board simply say "no, take it later" or was there any negotiation between the parties to come to some compromise? Did they make an offer of a viable alternative that she rejected? Did she offer anything herself by way of compromise? (If they were both obstinate, that matters compared to one party trying to resolve the issue).

Would she have been willing to take the exam in a private room and use a hands-free pump if the support mechanism would have been provided? (Yes, this isn't ideal, but it's doable...and no more cumbersome on her than sitting in a room full of smokers and perfume wearers is for people with allergies or the lack of food available to diabetics or the treatment of people with religious convictions outside the mainstream religions).

3. What have other breastfeeding women done? Also, what did her med school do to accommodate her during pregnancy #1? (This bears on the feasibility of alternatives and how much accommodation is actually required to meet her needs)

I can see a major disadvantage to waiting. Would you like to finish law school and then wait for a year to take the test? With any major professional exam, the sooner you can take the exam after finishing your course work, the better off you are, don't you think?

Here's what the lower court said when it denied her motion for preliminary injunction. It includes the list of alternative arrangements offered by the board, which Currier rejected.

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Here is a link to the board's web page regarding the matter:

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Sadly, the main stream press have been very selective about the details they report on this case. The terms "fair and balanced" don't spring to mind.

Not necessarily. I took my EIT right after graduation and passed, but it wasn't simple by any means. I took my PE about 8 years after school (experience required regardless, so taking right after school isn't an option).

Don't get me wrong, I agree that you will retain the information far better right after taking the coursework, but by no means should you forget it all - you either learned it or you didn't. And given that she knows exactly what to study for I would think she would have a rather large advantage over her classmates.

Yikes! Is she just doing this to gain personal press recognition? Given the two statements, I don't see what she has to gain by pressing the matter at all. I think she needs to learn how to pick her battles.

1. Her upcoming employment is an internship/residency at Mass. General Hospital (pretty competitive and highly coveted position). In a way you're still a "student" so there is a year that has to be followed. It generally starts summer/fall and runs to the following year. If she doesn't take the test and have a grade by November they would have to replace her and she would have to take off a full year.

She would lose about 40,000 in salary (she shouldn't have any loans that she has to pay back so interest accrual isn't an issue.

However, I don't think money is an issue for her. Based on her upbringing, and where she lives with her husband, and the fact that she could afford having kids while in medical school - she's not in straits for money. PLUS she took 1.5 years off after medical school already by choice. One more would not kill her.

2. Everything you mentioned was offered to her. She already has her own private room (something many testers would kill for as testing rooms are busy and often distracting). She is already being given twice as much TEST time because of her ADHD/dyslexia (18 hrs instead of 9 hrs). She was given the option to pump, eat, drink while taking the test. And its a computer test so it would be relatively easy to scroll and point and click with one hand while pumping with the other.

She was offered every concession imaginable.

3. Other breast feeding women deal with the breaks given. You get 45 minutes of break to use whenever you want, 15 min extra break if you skip the opening tutorial (which almost everyone does as it teaches you to point and click), and any time you finish a section early you may add to your breaktime to use whenever you wish during the test day. If you finish every section with 5 min to spare (this is VERY often done as there are only 46 questions per 60 min - 23 questions per 60 min in ms. currier's case). Then you have a total of 1 hr 40 min break - lets say 1:30 since the last two sections finishing early isn't very useful. So you have two 45 min breaks during which you pee, eat, drink and pump. Pump before the exam, take 3 sections, pump, take 3 sections, pump, take last 2 sections, go home and nurse. That is what other women have done and NBME gave Ms. Currier a suggested schedule of how it could be done - that wasn't good enough.

In med school Ms. Currier was in her 4th year when she gave birth/breast fed. This is a fairly easy year and she was simply allowed to pump during her rotations as needed.

And to the person who said she shouldn't have to wait because its best to take it asap after finishing school - she already didn't do that (took 1.5 years off) which is probably why she failed the test when she took it the first time in May. So that argument doesn't work in her case, another year wouldn't hurt her.

Again, my problem with the schedule give is that: 1) you should not have to count on finishing 5 minutes early (certainly not for somene with ADHD). 2) On average it takes "15 to 45 minutes to pump both breasts" with a machine. For women that are physiologically quick and can get done in 15 minutes, great! An hour is enough to pump four times! Good for you. But for women who are physiologically slow, it may only be enough to pump one time. Pumping one time in nine hours is simply not adequate. I am repulsed by the mere idea of the woman trying to pee and express at the same time, which is probably what she would have to do if she's physiologically slow. This should not be the standard. It's unconscionable.

The OPs question was WHAT DO OTHER WOMEN DO for this test...which is what I answered. Everyone I have every spoken to who has taken this test has finished many sections early. So yes for the average person its true.

And even if you take the maximum of 40 minutes to express, take your 5 min to pee, then eat and drink while expressing. Fairly simple, and completely practical. No one said she should express while peeing. Last time I checked few women spend more than 5 minutes on a toilet and since everyone is taking the breaks at their own leisure a line outside the bathroom wouldn't be a problem.

good thread.

w n c

Granted, you were responding to OP's question, and I was responding to the answer's broader implications. The top average express time stated was 45minutes (not 40). Even so, again, there is no maximum top time for breastfeeding. Some women take over an hour. I'm not saying giver her a 6 hour break. I am saying I think 45 minutes is not adequate. And I'm saying requiring an ADHD person to multi-task (eat while test-taking, etc.) is defeating the purpose of her other accomodations. Which, by the way, I would argue separating her probably benefits her just as much as the other test-takers. If I had to take a test with the sound of a pump whirring on and off at random intervals, I think I would make a noose with my mouse cord.

This post is just about ADD...so don't read it if you're not interested in ADD accommodations!! :)

I just wanted to comment on how people have been discussing the med student's use of ADHD to gain extra time and special accomodations It seems that in her case it only adds to her unlikability, and the fact that she has so many "obstacles"to overcome makes it seem as though she has fallen into a pattern of being a victim. What is troubling to me is that she does seem to be doing a disservice to people who have ADD.

I am a law student on a full scholarship to a good school, and I have ADD. I was diagnosed during my first year of undergraduate school. Girls aren't often diagnosed in K-12 if they are polite, and they tend to lack the hyperactivity that makes boys with ADHD so noticeable. I never applied for disability status in order to get accommodations, for three reasons:

1. It would not help. I can't see how most accommodations would help most people with ADD, at least at the college and graduate school level.

I think that it would help kids to have accommodations, and while I am not on medication, I think that is probably a helpful "accommodation" for people who can handle it.

People with ADD are actually good at multi-tasking because their brains require constant stimulation. Doing two tasks at once increases stimulation. Medication that treats ADD is essentially providing the constant stimulation to the brain which makes it easier to concentrate. Think of people who have ADD as needing constant "white noise" in order to really concentrate. I flip through magazines while I watch hockey games, etc. Probably breastfeeding while eating would make the act of breastfeeding less boring and vice versa.

While I can see how a separate test room is very helpful, I cannot understand how extra time can be helpful. People with ADD tend to procrastinate, and then do all of their work in one quick rush. This provides constant stimulation to the brain and this is what happens in a testing situation. Studying for the LSAT was pure torture, I was never able to finish a whole test in one sitting, however, during the test you get an adrenaline rush, which would help someone with ADD concentrate, and I did finish sections 5 minutes early. I can't imagine how twice as much time on an exam would be that helpful to someone with ADD since it would take away that spike of adrenaline. However, probably most other people given twice the time on the LSAT would get above a 170, so people faking the condition would really luck out with extra time on that test, while people who actually have ADD might not even be helped out that much! Perhaps she is getting most of her accommodations for the dyslexia because my law school does not even allow extra time on exams for people with ADD.

2. It seems that people who don't ask for time accommodations are conscientious of the fact that twice as much time in a professional setting would most likely amount to vastly decreased productivity. Yes, theoretically someone who needs extra time could stay in the office until 11pm every night in order to get enough billable hours but in practice that seems unrealistic and inefficient. It seems safer to stick to accommodations that you can stick to throughout your life and career (like popping Adderall or asking for a private room/cubicle).

3. Even if I wanted to get accommodations at my law school, it requires much more than a simple doctor's note. It is a multi-step, costly process that my school's health insurance won't cover, and they will not accept the diagnosis from my undergraduate school's psychiatrist. (I just wanted to point out that it isn't alwaaaays so easy to fake it!)

Once last thing...someone mentioned somewhere that he wouldn't want to see a doctor with ADD, but never fear, if you find out your physician (or lawyer) has ADD, odds are they have compensated very well for it to make it that far. If she zones out while you are talking to her, she will apologize and ask you to repeat yourself. At least someone who is diagnosed with ADD will realize they have it, and will be careful to recognize any inattentive behavior they have. I rarely have problems in a professional setting, though inattentiveness can really show up in my personal life. In addition, the disorder generally does not affect IQ, so your doc will still be intelligent. Chances are you will never have a clue your doctor has ADD, since most people are not as willing as Currie is to let it be widely known.

I'm sorry to ramble on about ADD since it is so seemingly unrelated to the breastfeeding issue, but it is irritating to see people have such disparaging comments towards people who have ADD, and it's irritating that Currie has used her supposed ADD in such a way that brings such negative attention to it. I think she really is bringing the same negative attention to the breastfeeding issue as well.

Thanks snowbunny for that clarification and explanation into ADD/ADHD. I was under the impression people with ADHD were BETTER at multitasking but since I'd never actually looked into it I didn't want to claim something that was patently false without being sure.

So that means she should have had no problem multitasking during the test and really had no need for the extra break time.

I'm really appalled at the mis-information floating about this forum. It seems the standard answer to anything is "I belong to X grounp, but I'm going to take Y stance that goes against X group."

First of all, you can say you are anybody online. Secondly, although people use it all the time... personal anectdotes are a poor way of supporting logical arguments (everyone learned this in college, right? No?)

Basically, because your case doesn't go for everyone. I'm glad that snowbunny11 can compensate for his or her deficiencies. I'm glad Cap'n has gotten so skilled at breast feeding that she can do it in 5 seconds flat. However, the reason these people feel compelled to back up their credentials, is perhaps because what they're saying wouldn't make sense for most people with their conditions.



Most ADHD people need more time, not less when they multi-task.

According to UCLA research:
"People with ADHD can multitask, according to Poldrack. “It’s just harder for them to switch back and forth from one task to the next,” he says. “They need more time to restart their new program.”

But sometimes, San Diego resident Andrea Tribolet can’t seem to remember what needs restarting. Whether it’s packing her older daughter’s lunch or warming up a cup of tea in the microwave, the 37-year-old, stay-at-home mom says she has trouble completing her chores. “If I'm on task, I can stick to it, but if I allow myself to get distracted, I have difficulty finishing anything,” says Tribolet, who was diagnosed with ADHD four years ago. “I just don’t deal well with interruptions.”"


Obviously, if ADHD people were better at multi-tasking, or needed less time to complete the exam there would be no argument for extra time or ADA provisions. This is not the case. Why do you think the ADA has granted thousands of students MORE time?


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In the end, I'm very saddened by this discussion--especially if its, like some say it is, coming from people in the health profession. It makes me think twice about the true "compassion" of my fellow workers. I thought this field was about patient care and patient advocacy.

It's too bad you can bullshit your way through that during med school interviews.