Has anyone ever requested accomodations from USMLE?

[theman1990]

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I'm curious as to whether anyone has ever requested accomodations from the USMLE for a Step 1-3? If so, how long was the process?

I am considering requesting for step 2, but not if it takes a year to do it (since I'm scheduled to take it in 2.5 months....) Specifically, I'm looking for the "ADHD" one.... 🙁 Yeah, I realize that numerous people here will get their panties all in a wad over it, but I suffered a head injury and loss of an arm just before STARTING med school (in between acceptance and starting...) so I think maybe it would be helpful... Given my distractability on Shelf exams and Step 1, I think it's reasonable to request it.

Anyhow, if anyone here has gone through this, please post here or message me and let me know what was involved. To those who have snarky comments, enjoy the anonymity of the internet...

 

[theman1990]

MODERATORS

Can you please move this back to the "allopathic" section? I posted it there since that is where most people "start" on here and I figure unless one is actively studying for STEP 1 or 2, they won't GO to those forums.

Since I'm asking about something that pertains mostly to people who have already taken the STEP, they'll never see it in here! Thank you!

 

[Rabbit Hole]

I'm curious as to whether anyone has ever requested accomodations from the USMLE for a Step 1-3? If so, how long was the process?

I am considering requesting for step 2, but not if it takes a year to do it (since I'm scheduled to take it in 2.5 months....) Specifically, I'm looking for the "ADHD" one.... 🙁 Yeah, I realize that numerous people here will get their panties all in a wad over it, but I suffered a head injury and loss of an arm just before STARTING med school (in between acceptance and starting...) so I think maybe it would be helpful... Given my distractability on Shelf exams and Step 1, I think it's reasonable to request it.

Anyhow, if anyone here has gone through this, please post here or message me and let me know what was involved. To those who have snarky comments, enjoy the anonymity of the internet...

Did you look on the USMLE website? I don't think you will qualify for special accommodations probably because you have never been diagnosed with ADHD.

Guidelines to Request Test Accommodations Overview and Instructions

I'm sure that medical students who actually have ADHD will appreciate your attempt to find a loophole.

Documentation for applicants submitting a request for accommodations based on an Attention-Deficit/Hyperactivity Disorder (ADHD) should contain all of the items listed in the General Guidelines section. The following information explains the additional issues documentation must address relative to ADHD.

1. The evaluation must be conducted by a qualified diagnostician.
   • Professionals conducting assessments and rendering diagnoses of ADHD must be qualified to do so. Comprehensive training in the differential diagnosis of ADHD and other psychiatric disorders and direct experience in diagnosis and treatment of adults is necessary. The evaluator's name, title and professional credentials, including information about license or certification as well as the area of specialization, employment and state in which the individual practices should be clearly stated in the documentation.
2. Testing/assessment must be current.
   • The determination of whether an individual is "significantly limited" in functioning is based on assessment of the current impact of the impairment on the USMLE testing program. See General Guidelines
3. Documentation necessary to substantiate the Attention-Deficit/Hyperactivity Disorder must be comprehensive.
   • Because ADHD is, by definition, first exhibited in childhood (although it may not have been formally diagnosed) and in more than one setting, objective, relevant, historical information is essential. Information verifying a chronic course of ADHD symptoms from childhood through adolescence to adulthood, such as educational transcripts, report cards, teacher comments, tutoring evaluations, job assessments and the like are necessary.
     1. The evaluator is expected to review and discuss DSM-IV diagnostic criteria for ADHD and describe the extent to which the patient meets these criteria. The report must include information about the specific symptoms exhibited and document that the patient meets criteria for long-standing history, impairment and pervasiveness.
     2. A history of the individual's presenting symptoms must be provided, including evidence of ongoing impulsive/hyperactive or inattentive behaviors (as specified in DSM-IV) that significantly impair functioning in two or more settings.
     3. The information collected by the evaluator must consist of more than self-report. Information from third party sources is critical in the diagnosis of adult ADHD. Information gathered in the diagnostic interview and reported in the evaluation should include, but not necessarily be limited to, the following:
        • History of presenting attentional symptoms, including evidence of ongoing impulsive/hyperactive or inattentive behavior that has significantly impaired functioning over time;
        • Developmental history;
        • Family history for presence of ADHD and other educational, learning, physical or psychological difficulties deemed relevant by the examiner;
        • Relevant medical and medication history, including the absence of a medical basis for the symptoms being evaluated;
        • Relevant psychosocial history and any relevant interventions;
        • A thorough academic history of elementary, secondary and postsecondary education;
        • Review of psychoeducational test reports to determine if a pattern of strengths or weaknesses is supportive of attention or learning problems;
        • Evidence of impairment in several life settings (home, school, work, etc.) and evidence that the disorder significantly restricts one or more major life activities.
        • Relevant employment history;
        • Description of current functional limitations relative to an educational setting and to USMLE in particular that are presumably a direct result of the described problems with attention;
        • A discussion of the differential diagnosis, including alternative or co-existing mood, behavioral, neurological and/or personality disorders that may confound the diagnosis of ADHD;
        • Exploration of possible alternative diagnoses that may mimic ADHD; and
        • Age norms where available
4. Relevant Assessment Batteries
   • A neuropsychological or psychoeducational assessment may be necessary in order to determine the individual's pattern of strengths or weaknesses and to determine whether there are patterns supportive of attention problems. Test scores or subtest scores alone should not be used as the sole basis for the diagnostic decision. Scores from subtests on the Wechsler Adult Intelligence Scale - III (WAIS - III), memory functions tests, attention or tracking tests or continuous performance tests do not in and of themselves establish the presence or absence of ADHD. They may, however, be useful as one part of the process in developing clinical hypotheses. Checklists and/or surveys can serve to supplement the diagnostic profile but by themselves are not adequate for the diagnosis of ADHD. When testing is used, standard scores must be provided for all normed measures.
5. Identification of DSM-IV Criteria
   • A diagnostic report must include a review of the DSM-IV criteria for ADHD both currently and retrospectively and specify which symptoms are present (see DSM-IV for specific criteria). According to DSM-IV, "the essential feature of ADHD is a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequent and severe than is typically observed in individuals at a comparable level of development." Other criteria include:
     1. Symptoms of hyperactivity-impulsivity or inattention that cause impairment that were present in childhood.
     2. Current symptoms that have been present for at least the past six months.
     3. Impairment from the symptoms present in two or more settings (school, work, home).
6. Documentation Must Include a Specific Diagnosis
   • The report must include a specific diagnosis of ADHD based on the DSM-IV diagnostic criteria. Individuals who report problems with organization, test anxiety, memory and concentration only on a situational basis do not fit the prescribed diagnostic criteria for ADHD. Given that many individuals benefit from prescribed medications and therapies, a positive response to medication by itself is not supportive of a diagnosis, nor does the use of medication in and of itself either support or negate the need for accommodation.
7. A Clinical Summary Must Be Provided
   • A well-written diagnostic summary based on a comprehensive evaluative process is a necessary component of the assessment. The clinical summary must include:
     1. Demonstration of the evaluators having ruled out alternative explanations for inattentiveness, impulsivity, and/or hyperactivity as a result of psychological or medical disorders or non-cognitive factors;
     2. Indication of how patterns of inattentiveness, impulsivity and/or hyperactivity across the life span and across settings are used to determine the presence of ADHD;
     3. Indication of the substantial limitation to learning presented by ADHD and the degree to which it impacts the individual in the context for which accommodations are being requested (e.g., impact on the USMLE program); and
     4. Indication as to why specific accommodations are needed and how the effects of ADHD symptoms, as designated by the DSM-IV, are mediated by the accommodation(s).
8. Each accommodation recommended by the evaluator must include a rationale.
   • The evaluator must describe the impact of ADHD (if one exists) on a specific major life activity as well as the degree of significance of this impact on the individual. The diagnostic report must include specific recommendations for accommodations. A detailed explanation must be provided as to why each accommodation is recommended and should be correlated with specific identified functional limitations. Prior documentation may have been useful in determining appropriate services in the past. However, documentation should validate the need for accommodation based on the individual's current level of functioning. The documentation should include any record of prior accommodation or auxiliary aid, including information about specific conditions under which the accommodation was used (e.g., standardized testing, final exams, NBME subject exams, etc.). However, a prior history of accommodation without demonstration of a current need does not in itself warrant the provision of a similar accommodation. If no prior accommodation has been provided, the qualified professional and/or individual being evaluated should include a detailed explanation as to why no accommodation was used in the past and why accommodation is needed at this time.
   • Because of the challenge of distinguishing ADHD from normal developmental patterns and behaviors of adults, including procrastination, disorganization, distractibility, restlessness, boredom, academic underachievement or failure, low self-esteem and chronic tardiness or inattendance, a multifaceted evaluation must address the intensity and frequency of the symptoms and whether these behaviors constitute an impairment in a major life activity.

 

[theman1990]

Yah, I've read through that. Actually I have been diagnosed with it after extensive neuropsych testing etc, forgot to put it in the post though. During 1st semester of 1st year I was in danger of failing b/c I couldn't complete a paragragh w/o getting distracted etc...

Sucks, b/c before my crash I had an awesome memory, and was nearlt always the first one done w/ a test. Even on the MCAT I had scores of time and did very well. Now I never complete Shelf exams etc... Clinically it's not an issue, but give me a long book etc to read and I'm hosed... Carries over to recreational reading, too, so it's not simply an "interest" thing.

Thanks for looking that up and trying to help, though! It's appreciated!

 

[IMGUSMLEStep1]

Your best bet is to contact them directly. I don't think anyone on the forum will be able to provide you with any info because you're in a rare situation. Sorry, wish I could help.

 

[theman1990]

Yah that's kind of what I figured. I'm juat hoping saomeoe has at least tried and can give me a timeline. I'm currently working on getting this done, too. Appreciate it!

 

[dermpathdoc]

Yah that's kind of what I figured. I'm juat hoping saomeoe has at least tried and can give me a timeline. I'm currently working on getting this done, too. Appreciate it!

this sounds more like PTSD that ADHD maybe you needa rediagnosis and USMLE/NBOME would reconsider with that dx...if appropriate

 

[theman1990]

haha.... don't even get me started on PTSD lol... The VA rejected my claim for PTSD stating "We have reviewed your claim and have determined that the PTSD due to the loss of your arm is NOT related to your military service." Wait, what?

Anyhow, I'm hoping to get everything submitted next week and I'll try to remember to update the post here with the process in the unlikely event anyone else needs to try it.

Sadly, the PM's I've gotten so far don't bode well.... Apparently while the NBME HAS to OFFER disability services, they don't HAVE to qualify anyone for them... 🙁