USMLE with a Disability

[lala123doc]

Need some advice: I wrote the MCAT back in 2001, and in 2002 was diagnosed with a learning disability (compensated dyslexia, which means slower processing speed - the only real problem I have is with long passages and Multiple Choice questions). I'm getting ready to write the USMLE Step 1, and am not sure if I should apply for disability status. Right now the school I'm attending doesn't give extra time for students with disabilities so I haven't had to worry about it, but I'm aware that scores gets flagged to indicate that you've done the exam under different circumstances if you use extra time.

If it's flagged, my worry is that I won't be able to get into a moderately competitive residency programme. I could write without the extra time, as I did for the MCAT, but might do better with the extra time. Does anybody have any constructive advice as to what I should do? Does anybody know anyone who has applied for extra time, and succeeded in getting a good residency spot??

I know there's a lot of discussion about this regarding the MCAT, but i haven't seen anybody bring it up for the USMLE.

Thanks!

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[siimpleton]

I wish I could give you advice. However I am in the same position. I was just diagnosed with ADHD. I know that extra time would help me, but I also want to go into ER...a specialty that may be particularly critical about accomadations. If I find any advice I will post it. Good luck to you!

 

[Pox in a box]

I really sympathize with your situations. It must be tough to do an exam like the Step 1 or any similar focused exam for a long period of time if you have been diagnosed with any type of disability. I've heard of students receiving extra time and taking their exams in solitude. I'm curious to know what these students will do when they are faced with similar anxiety or scenarios to the Step 1 when they are faced with these in the real world as medical doctors.

Note: I'm in no way trying to be crude or harsh. I am only imploring as to how this type of scenario tends to play out. It would be nice to hear a story from someone who has overcome a disability and practiced successfully.

 

[OmahaMX80]

I'm curious to know what these students will do when they are faced with similar anxiety or scenarios to the Step 1 when they are faced with these in the real world as medical doctors.

Yeah, because Step 1 is completely representative of what to expect in the real world. In fact, one could say they're identical. I don't know about you, but I can't walk two feet without having to sit for a 350-question standardized test covering minutia; the relevance of which to medicine is arguable most of the time. If you can't tell, I'm being sarcastic.

 

[Pox in a box]

Yeah, because Step 1 is completely representative of what to expect in the real world. In fact, one could say they're identical. I don't know about you, but I can't walk two feet without having to sit for a 350-question standardized test covering minutia; the relevance of which to medicine is arguable most of the time. If you can't tell, I'm being sarcastic.

As an ER physician, one of the posters will definitely experience worse anxiety and stress. There's no extra time for ACLS.

 

[siimpleton]

As an ER physician, one of the posters will definitely experience worse anxiety and stress. There's no extra time for ACLS.

With regards to the ER I don't think I would have any trouble. My only difficulties in life really come when I am reading (a very mundane situation). I space out. When I am interacting with others I am just fine. In fact even studying next to a friend makes me much closer to normal. I actually think an ER is just what I need. So long as I am well stimulated I do not space out. I am one of those people that is always on the go an thrives on that and does well under pressure. My fear though is that an ER residency coordinator would simply see ADHD and write me off. Any suggestions? Thanks

 

[starwisher]

With regards to the ER I don't think I would have any trouble. My only difficulties in life really come when I am reading (a very mundane situation). I space out. When I am interacting with others I am just fine. In fact even studying next to a friend makes me much closer to normal. I actually think an ER is just what I need. So long as I am well stimulated I do not space out. I am one of those people that is always on the go an thrives on that and does well under pressure. My fear though is that an ER residency coordinator would simply see ADHD and write me off. Any suggestions? Thanks

If you have just been diagnosed I'm assuming you haven't needed accomodations in the past, so what makes you think you will need them for step 1? Also, considering you haven't gotten accomodations in the past will that make them less likely to approve you to have them now? I'm not sure about that stuff at all, but if it was me I'd probably wouldn't go for the accomodations since you don't know it will for sure be of any help and there is a possibility it might actually be harmful to your application. You might want to talk to someone at your school though, maybe they could shed some light on how other students have done in the past with their applications after getting accomodations for a disability on step 1.

 

[Pox in a box]

If you have just been diagnosed I'm assuming you haven't needed accomodations in the past, so what makes you think you will need them for step 1? Also, considering you haven't gotten accomodations in the past will that make them less likely to approve you to have them now? I'm not sure about that stuff at all, but if it was me I'd probably wouldn't go for the accomodations since you don't know it will for sure be of any help and there is a possibility it might actually be harmful to your application. You might want to talk to someone at your school though, maybe they could shed some light on how other students have done in the past with their applications after getting accomodations for a disability on step 1.

On the ERAS application, is there a checkbox for "Required special assistance on USMLE Step 1 and 2" or "has a psychiatric diagnosis"? I doubt you're going to have a "*" next to your 255/99. If they have no way of knowing, then why would it matter if you use these resources?

 

[siimpleton]

If you have accomadations made on the USMLE a note is put next to your score that is sent to residencies that accomadations were made. They can then call the USMLE to find out the reason for the accomadations.

With respect to my decision of whther to take accomadations, the last time I took a standardized test was the SAT and ACT (I was in and BA/MD program and did not have to take the MCATs) I did very well on the SATs and sent that score to colleges. I did the equivalent of 200 points lower on the ACTs because it was a more time intensive test and I was unable to finish the test. I do not know how time intensive the USMLE, but if it is anything like the ACTs I fear it would dramatically affect my score. Currently when I take tests at school many of my classmates take only 1hr 20min where as I always take the full 3 hours and have run out of time on a few occasions.

 

[Pox in a box]

If you have accomadations made on the USMLE a note is put next to your score that is sent to residencies that accomadations were made. They can then call the USMLE to find out the reason for the accomadations.

With respect to my decision of whther to take accomadations, the last time I took a standardized test was the SAT and ACT (I was in and BA/MD program and did not have to take the MCATs) I did very well on the SATs and sent that score to colleges. I did the equivalent of 200 points lower on the ACTs because it was a more time intensive test and I was unable to finish the test. I do not know how time intensive the USMLE, but if it is anything like the ACTs I fear it would dramatically affect my score. Currently when I take tests at school many of my classmates take only 1hr 20min where as I always take the full 3 hours and have run out of time on a few occasions.

Out of curiosity, how long did it take you to type this post?

 

[siimpleton]

Out of curiosity, how long did it take you to type this post?

hmmm, I don't remeber. I wrote that last night. Writing is much more active though than reading. If I'm writing something short like that I don't think ADD would affect me. Though, this does remind me of a 4 page paper I wrote in 3rd grade. It took me all of Spring break to do it. Of course, it did involve some research. (My friend, however, finished it in a 2 hour car trip) I've got to believe that my efficiency has improved since then since I've made it to (and almost half way through) med school without accomadations

 

[siimpleton]

hmmm, I don't remeber. I wrote that last night. Writing is much more active though than reading. If I'm writing something short like that I don't think ADD would affect me. Though, this does remind me of a 4 page paper I wrote in 3rd grade. It took me all of Spring break to do it. Of course, it did involve some research. (My friend, however, finished it in a 2 hour car trip) I've got to believe that my efficiency has improved since then since I've made it to (and almost half way through) med school without accomadations

On a side note...its funny that I now go back to my report card comments even from kindergarten that mention distractability, not paying attention etc etc and yet no one ever mentioned that I might have ADD until my friend said it half-joking just this year.

 

[lala123doc]

Thank you Siimpleton, OmahaMX80 and and Starwisher for your replies. I haven’t yet received any constructive advice about my dilemma, but if I find anything out I’ll be sure to post it. Thank you, Siimpleton, in your replies – it’s good to know I’m not alone, and there are many more people who don’t want to speak out about it, for understandable reasons.

Pox in a Box: there are most definitely people out there who have written the USMLE with extra time, and who did make it into good residency programmes (Interventional Radiology, for example) and I’m now just waiting to hear back from them to see if they had extra time and how it played out for them in their application. I’m going to agree with OmanaMX80 here and say I don’t think there are many real-life situations like the Step 1, or any standardised test. The anxiety/stress and build-up to those exams is nowhere near practicing any type of medicine, I think. I’ll leave it at that.

Unfortunately my school won’t help me out on this one – I’m not studying in the States and there’s no disability office at the school. Another worry I have is that if the Step 1 is long enough as it stands, then I’m worried that extra time might just draw it all out too far, and I’ll be even more exhausted by the end of it all. Thoughts?

Thanks again!

 

[siimpleton]

Thank you Siimpleton, OmahaMX80 and and Starwisher for your replies. I haven’t yet received any constructive advice about my dilemma, but if I find anything out I’ll be sure to post it. Thank you, Siimpleton, in your replies – it’s good to know I’m not alone, and there are many more people who don’t want to speak out about it, for understandable reasons.

Pox in a Box: there are most definitely people out there who have written the USMLE with extra time, and who did make it into good residency programmes (Interventional Radiology, for example) and I’m now just waiting to hear back from them to see if they had extra time and how it played out for them in their application. I’m going to agree with OmanaMX80 here and say I don’t think there are many real-life situations like the Step 1, or any standardised test. The anxiety/stress and build-up to those exams is nowhere near practicing any type of medicine, I think. I’ll leave it at that.

Unfortunately my school won’t help me out on this one – I’m not studying in the States and there’s no disability office at the school. Another worry I have is that if the Step 1 is long enough as it stands, then I’m worried that extra time might just draw it all out too far, and I’ll be even more exhausted by the end of it all. Thoughts?

Thanks again!

I'm just curious as to what you want to go into. I would think that would make a difference in how they view the accomadation.

I am also curious, do you know if they USMLE will release your diagnosis or simply your accomadation (more time)?

As for the total length of time for the exam, I would imagine that extra time would mean coming back on a second day. I was actually curious about this myself and how that is handled. Do you happen to know? If not, that might be a good thing to find out in regards to the question of it being drawn out.

Also, I'm sorry that your school can't help. I may be talking to someone at my school in the near future, and if I do I'll let you know if I get any insight to the effect on residency placement.

Lastly, did you do well on the MCATs? And if so, as someone had asked me, why do you think this case would be different? Can you talk to older students at your school to see how MCATs compare to USMLE in terms of timing? Or even ask that on a forum? Also, can you take a practice exam and see just how much timing would affect your score. If you take it once timed, and once with extra time (maybe just a few sections worth, not the whole thing) then you could get an idea of how much better you would do with extra time. If it dramatically affects your score I would think you would be better off with the accomadations. If you decide not to take the accomadations I would suggest putting more time into practice tests than most people do. This will perhaps help to work out the kinks that others have not and maybe help you to compensate at least a little for the disability. This is what I did for the SAT back in high school. The first few times i tried it on my own I was no where near finishing on time. After practicing over and over I was able to get to a point where I could finish on time and then I did quite well. (Of course I did the same for the ACT - a more time intensive test - and eventually hit a plateau and never finished on time.) From what little I have seen of the USMLE it doesnt seem quite as bad as I would have expected time wise. More importantly, this is also a test where I think practice will help A LOT in cutting down time.