No extra break for lactating exam taker

I felt a little bit a sympathy until I read that she already gets a big break- she gets to take the test over two days rather than one and she gets a private room during breaks.

http://www.boston.com/news/local/articles/2007/09/20/judge_no_extra_break_for_lactating_exam_taker/

Judge: No extra break for lactating exam taker
Student sought time to pump baby's milk
By Felicia Mello, Globe Correspondent | September 20, 2007

A Harvard medical student and new mother will not be permitted to take extra break time to pump breast milk during her licensing exam to become a doctor, a judge ruled yesterday.

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The board has offered to allow Currier to bring her breast pump into the exam room and to provide her with a private extra room in which to expel milk during her breaks.

Currier will be allowed to take the test over two days, instead of the normal one, because she has dyslexia and attention deficit hyperactivity disorder, and the board has agreed to give her 45 minutes of break time each day, the daily amount granted all test-takers. Currier wants an additional hour of break time each day.

But the board argued that it would be unfair to other test takers to allow Currier more time for a condition not recognized as a disability under the Americans with Disabilities Act.

"The national board thinks that breast-feeding is a fine thing to do, but it also thinks that having a standardized examination for licensure is also really important," said board spokesman Ken Cotton.

Nice.

I would probably just whip them out and punp away in the exam room. I might even make extra noise while I did it. God knows, I'd make them sorry about the whole affair.

It would be one for the books.

Her privacy was accommodated. As were her recognised disabilities, dyslexia and ADHD. She sought to claim a perfectly natural biological function as a disability in order to get significant extra time over other examinees. Min 25% on top of time already granted.

To put it bluntly she sought to gain an unfair advantage and IMHO serious consideration should have been given to penalising her the 2 hours she sought to gain.

that a non-lactating person would not need, especially for a mother of a very young infant, as she was -- who might need to pump every couple hours to keep up her milk supply.

I agree this woman already had a lot of extra time, but it would be a shame if her case set a precedent for other breastfeeding women.

If a woman has cramps and is bedridden and disabled for two to four days, thirteen times a year, during all of her reproductive years, 35 to 40 years or so, that's a helluva lot of time missed in illness.

I know. I wish American businesses had "menstrual days" like some Asian countries, where the women workers can take a day off a month because they might feel bad. Not all women have disabling menstrual cramps, but I did. I can't count how many times doctors told me "This will cure your cramps".....ha ha ha. What a sad joke.

But no, we're supposed to be JUST LIKE MEN and ignore it and act like we feel OK. Many's the time I had to go to work and act like I didn't feel like a dishrag that wanted to lie down and sleep for a few days, and was in tears. I had to hide them. And hide the pain too.

:banghead: :banghead: :banghead: :banghead: :banghead: :banghead:

What if a woman has a job where if she's absent she has to have a doctor's excuse? What would a woman do at the doctor's office? Pull her pants down and show the doctor her pad?
There is no objective test for the pain or the severe fatigue.

:banghead: :banghead: :banghead: :banghead:

Or alternately flexi-time. Or take it as sick time and put up with not being paid if you get the flu. Perhaps I could be persuaded to chip in to help you as a fellow taxpaying citizen. As one of perhaps only a handful of workmates (or as an employer of that small handful) I don't ruddy think so.


Hell I just got diagnosed with tendonitis in my left thumb extensor tendon. I might not have a job at all since I'm on casual rates. Let's just hope it's acute and I can muddle through the next week.


There has to be some sort of upper limit on what an employer (or examiner, or whatever) can be expected to adsorb on another's behalf. Because, ultimately that cost will be met by that person's workmates. If such subsidisation is to take place then the cost must be met by all from taxation revenues. Putting it on the individual employer is an unfairly levied stealth tax.

After all, she's breast feeding.

Seriously, I read about this earlier today, and I was amazed that anyone would even ask for such special consideration. With that much gall, she should consider law school.

how much time it takes?

Her case wasn't the best test case because, as someone mentioned above, she already had extra time. But a woman who only had the normal amount of time could have a great deal of difficulty managing an all-day test AND pumping, too.

According to what I read, other nursing moms taking the exam have had no complaints. And, yes, I have nursed two children. I am not totally clueless or not empathetic.

In my opinion, based on the newspaper accounts, way too much drama.

Also, I did acknowledge that she had already had a lot of extra time, and so she wasn't a good test case for the legal issue. But I think there could be other women in her position with a valid need for extra time.

She isn't a good test case, as you say, so I don't believe other women's cases could be influenced by this. And again, it just appears, on the surface that we can actually view, that she is a bit sensitive to her challenges and can be way into the drama. Perhaps she has spent so much time away from her babies that this is especially important to her. OK....so she is working to change the world. I wish her good luck with that. It can happen...up to a point, then things tend to level off a bit. I remember women is medical school and residencies during the 70's. Things have changed soooo.....much. It has actually been quite revolutionary. :)

She's trying to use her situation for an unfair advantage. I wouldn't want this woman for a doctor.

As for how much time pumping takes, a friend of ours had to pump at our house recently, and I don't recall it taking anywhere close to an hour.

We make decisions in life. It's as if we can't fathom the concept that our choices might mean not getting our way immediately on every thing in Life.

As Oprah said, "you can have it all, just not at once".

convenient for HER.
The ADA is irrelevant.

And the ADA is what determines maternity benefits -- a natural biological condition -- so I don't know why it wouldn't be relevant here.

The benefits that women receive for childbirth are whatever they have accumulated as disability benefits.

Do you mean nursing women are allowed to use what are commonly called "sick days"? That is not the same as calling motherhood a "disability".
I used "sick days" as a teacher when I had migraines or bad cramps, but I wouldn't be allowed extra Med School testing time because of them.

and we all need to find our priorities.

But then I see that she wants the rules BENT for her
because she's dyslexic and has ADD?

I'm sorry, but NO. If she really has those issues, there's
no way in HELL she should ever be given a medical license.

I am TOTALLY in favor of spending tax dollars to help people
with disabilities live their lives to the fullest. We are
a WEALTHY nation, and it costs us 1/2 percent of NOTHING
to do those tiny things that allow EVERYONE to contribute
to our society.

The pittance it costs to make buildings "wheelchair accessible"
and to put Braille on public notices is money well spent, from
both a moral and financial point of view, IMHO.

But the whole "people with disabilities can do anything" notion
only goes so far. It's a fine SLOGAN, but it's just not LITERALLY true.

Blind people -CAN'T- be Highway Patrol Officers.
Parapalegics -CAN'T- be "First Responders" in the Fire Department.

And dyslexic folks with Attention Deficit Disorder -CAN'T- be Doctors.

Maybe psychiatry?

I am a special ed teacher and I can assure you that people with ADHD can and do make excellent physicians. And they are capable of many other professions as well. This is just an outrageous attack on a group of people you obviously know very little about.

BTW, I don't agree this woman is being shortchanged by the med school. But your statement about ADHD is just completely over the top.

WHY any particular person fails the exam is irrelevant to me.

that puts people with dyslexia and ADD at a disadvantage with respect to their peers. The test is a clinical knowledge test. Adjusting the test (or the conditions under which it is taken) is perfectly reasonable so long as the examinee establishes that he or she possesses the clinical knowledge required to be a physician. I am pretty sure that clinical knowledge (or the ability to use that clinical knowledge on behalf of a patient) does not inherently include sitting at a desk for nine hours, reading and responding to question after question, and limiting oneself to a single 45 minute break minimal break during the nine hour period.

There are a wide variety of practice settings in which physicians can end up. Quite a few of those are compatible with the challenges posed by dyslexia and/or ADD. The structure of the licensing exam shouldn't, in and of itself, bar otherwise qualified individuals from entering this field.

I'm very much an advocate for disability rights, but this woman is going too far. The breastfeeding issue aside, she simply has too many issues going on for her to be an adequate doctor.

Physically healthy doctors can, and often do, make mistakes as a result of a overly large case load or work schedule. I'd rather have a doctor with these disabilities who can take more time with me and provide more personalized attention, than a tired worn out doctor who doesn't even remember my name.

... Then again, I don't know squat about breastfeeding, except on the consuming end - and that was decades ago.

I'll go with whatever female ob/gyn's consensus is.

Entitlement-culture whiner.

Her baby is four months old, therefore her milk supply is well established.

WIth such a well-established milk supply, if her pumping sessions are spaced somewhat further apart than usual and/or are briefer than usual for only ***at most a 6-8 hour period over two days** , it's not like she is going to dry up or anything. She'll go home the night after the first part of the test and nurse her baby, which will signal the breast to continue to make plenty of milk. She'll take the 2nd half of the test the next day (under the special allowances they're making for her supposed ADHD and dyslexia). go home and nurse some more, then go back to her regular schedule - the breasts will compensate just fine. There should be no significant disruption to her milk supply.

Also, the test is given MULTIPLE times during the year.

And from the NBME website (National Board of Medical Examiners):
http://www.nbme.org/about/BF-USMLE.html

How long is Step 2 CK?
A computerized exam, Step 2 CK consists of eight testing blocks of up to one hour each, plus 45 minutes of break time and an optional 15-minute tutorial. Examinees may use their break time throughout the day as they choose (e.g., take multiple short breaks between blocks of the test or fewer breaks of longer duration).

Is it possible to express milk during the testing day?
Yes. Women may express milk during the 45 minutes for break time. If examinees complete the tutorial or examination blocks in less than the allotted time, they can add that time to their break time.

Have applicants successfully used their break time to express milk?
Yes. To our knowledge, many women have expressed milk during the standard allotted break time.

How have you responded to Sophie Currier’s request for extra time to express milk?
As the papers filed in court show, NBME offered Ms. Currier a variety of comfort measures and personal item exceptions, such as permission to bring multiple, assembled pumps to eliminate the time involved in cleaning, assembling, and disassembling them; permission to pump milk while taking the test and on break time, with privacy within the constraints of exam security, in the individual testing room that she receives on account of her ADA disability. We also provided her with a sample schedule demonstrating how an examinee can flexibly manage the time to take a 20- to 30-minute break every three hours.

Why have the requests of Ms. Currier for extra break time been denied?
This is a standardized examination and the stakes in passing it are very high for all the men and women who have been preparing so arduously for their medical careers. The stakes for the American public are even higher, as the USMLE is accepted by virtually all licensing boards as evidence of competence to practice medicine in the US. Because of the test’s importance to all examinees and to the public’s safety, maintaining its fairness and integrity is our priority.

Is there any chance the policies about break time will change?
The governing body of the USMLE is reviewing the amount of break time for everyone. The importance of fair, consistent standards means we cannot make ad hoc individual decisions.

How easy is it to schedule a Step 2 CK exam around personal needs?
The exam is offered at testing centers in the United States and abroad, five to six days a week year-round, except for a limited period in January. Because it is given so often, most people are able to take their exams on a schedule convenient to them.

Who can qualify for additional break time?
Test-takers who are covered under the Americans with Disabilities Act (ADA) may be legally entitled to receive additional break time or other accommodations, such as a separate testing room. The Guidelines to Request Test Accommodations can be accessed at www.usmle.org.




FWIW, I'm a big supporter of breastfeeding, nursed two kids of my own (under pretty difficult circumstances with the first one, who was VERY difficult to get to latch on and had a weak suck), and I'm a pediatrician.

(I wonder how much special treatment this woman supposedly with ADHD and dyslexia is going to demand during residency and practice. I'm not sure I'd want to be in the same intern/residency class as her, especially if she's going into a patient-contact field and not something like radiology or pathology.)

... "doctor" who was given a jillion special accomodations just to make sure the person passed the test?

I don't think it's wrong of someone to have a problem with that.


EDIT: I already mentioned that I'd settle for the considered consensus of a bunch of female ob/gyns though.

so she takes some extra time in the office. who hasn't had to wait for the doctor?

i don't see how dyslexia affects a doctor's ability to treat people. take a written test, maybe, but not practice medicine.

:rofl:

Now read up on dyslexia and tell me why I shouldn't trust a doctor with it.

This is what I'm assuming:

If she's made it this far in her studies, she's found a way to adapt to her disability.

Sometimes this requires extra time.

As a student she's on her own. As a physician, she can hire help AND take a patient-load she's comfortable with.

I'm also assuming that people with learning disabilities can overcome them and function just as well, professionally, as everybody else - even if they have to use unconventional methods to do it.

I assume you're assuming she'll make a terrible mistake. I say that if she wasn't worried about that, she wouldn't have asked for extra time in the first place, but she knows what she needs to do to succeed. She's answering the same questions as everybody else is. Nobody's giving her the answers, so in the end she'll be showing the same level of knowledge as everybody else.

Which probably doesn't happen very often at Harvard, since the same test is given to all med students across the country.

it happens.

Depends on the type of doctor (maybe not a surgeon) but I'd have no problem with a disabled doctor versus others I've encountered.

I breastfed AND I worked a waitress job. I will tell you that if you do not relieve your breasts every x amount of time, your breasts will get so full that they will actually cause you pain. Yes, they can be so full that they will hurt!!!! Also, they will start to leak and even with pads, in your bra, you will still be wet and uncomfortable. These guys are schmucks and unless you have been in pain like I have (because of full breasts) then they should allow more time/breaks.

She's getting to take the test over 2 days instead of 1. The board says that in the past that 45 min was plenty of time for mother's breastfeeding. What does she think her residency is going to be like? The board exams are offered multiple times a year, she can take it at the next time offered.

She can take it another time. She's already getting special dispensation to take it over 2 days instead of the 1. It's widely known to ALL medical students what they're up against for all board exams. It's not like this is a surprise. Plus it's the second time she'll be sitting for it anyways.

She should wait for another exam period.

Sounds like a crybaby to me.
See another article, from Wednesday's Boston Globe, linked to in the article mentioned in the OP: http://www.boston.com/news/local/massachusetts/articles/2007/09/19/new_mom_denied_breast_feeding_time_during_doctor_test/

It doesn't say what special accomodations she received the first time.

Also, it's nice to know (from the article linked above) that she's going into a clinical pathology residency -- ie, no direct patient care, and then plans to do research.

Sounds to me like there's other shit involved, here.

work, not having a halfway decent designated spot to pump, etc. IMHO, any woman who can pull off breastfeeding an infant for a full year in this society is a champ. It's far more complicated than "put boob in baby's mouth. Rinse. Repeat."

And I have no patience for the prunce-faced uptight shit-for-brains who get their noses all out of joint at the sight of women breastfeeding in public. I agree with Bill Maher a lot of the time, but on this issue? He can go fuck himself.

But having read about this particular case, I have to say that I think this woman has other things going on beyond the need to pump. I don't think it's a question of her not being accommodated. IMHO, she should wait and take the test later.

that isn't available to any other student there. I've worked with quite a few working mothers who pumped enough milk so they could work all day with no problem. Most mothers also tell me that they supplement their milk with a formula. I would sure expect a medical student to know that!

She knew when she would be coming up for board exams, why not wait and have a baby after that?

(see my post above, with link to BG article)

...who gave birth during our 1st year. One got through exam week with no accommodations (most law schools give you one shot to make a grade, a final exam). The other was from wealthy family, and she had a nanny bring in the baby during nursing times. As for bar exams...they're more grueling than med boards, as they're only given 2X per year, and you're at a disadvantage if you take the winter exam (examiners assume you already failed the summer exam, so there are lower passing rates). Generally the bars last 2-3 days, with 10-15 minute breaks between sections, and an hour for lunch.

I've specialized in disability rights law, and I'm all for accommodations. However, this woman's "disability" could have been planned a little bit better, particularly given that she's in the medical field, so I HOPE she knows how pregnancy happens, and what she could've done to prevent one. I have no problem with her getting accommodations for her ADD. IMHO, accommodations for pregnancy and breastfeeding at a job, is a little different than for a test. Kind of a right v. a privilege.

Our society is not friendly to mothers/primary caregivers.

The test is given all the time, she can take it at another time.

She's already taken the boards once and failed, while she was pregnant.

The standards for the USMLE is known to all medical students, including the break time allotted.

The 45 minutes can be broken up or used all at once. She's already getting to take it over a 2 day period, 45 minutes each day.

This is the exam that allows doctors to get a medical license. The exam rules should be stringent.

is breast-feeding, she's getting it because of other disabilities. And lots of people fail exams and have to take them again, so I don't see how that's even relevant.