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Testing Accommodations for ABIM Exam Takers with Disabilities

Introduction

Click here to download the Verification and Authorization to Release Form (pdf)

In compliance with the Americans with Disabilities Act (ADA), the American Board of Internal Medicine (ABIM) offers its exams in a place and manner that accommodate individuals with disabilities, which includes certain persons with learning disabilities.

A candidate who has a disability, but who nevertheless has completed requirements for Maintenance of Certification, may request assistance in taking ABIM's exams.

The Americans with Disabilities Act (ADA) defines a disability as a physical or mental impairment that substantially limits one or more of the major life activities of the individual. An individual is not substantially limited in a major life activity if the limitation does not amount to a significant restriction when compared with the abilities of the average person.

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Document Requirements for All Disabilities

All requests for accommodation of a disability, whether mental or physical, must be submitted in writing to ABIM and received by the close of the registration period. For specific information regarding the process and documentation or for a request for accommodation, please contact ABIM at 1-800-441-2246, extension 3595, or e-mail accommodations@abim.org.

Administration Deadline*
* Requests and all documentation must be received by ABIM prior to the close of the exam registration period.
Spring Maintenance of Certification Exams February 28
Summer Internal Medicine Certification Exam March 1
Fall Certification Exams June 1
Fall MOC Exams August 15

In order to apply for special testing arrangements to accommodate a disability, the candidate must submit the following information to Florence Mickens, Special Exams Coordinator, American Board of Internal Medicine, 510 Walnut Street, Suite 1700, Philadelphia, PA 19106-3699:

  1. The name, address and telephone number of all professional(s) providing reports that document the disability and a Verification and Release form signed by the candidate.
  2. The date and location of the assessment upon which each professional's report is based.
  3. The diagnosis of the disability using standard nomenclature.
  4. A description of the candidate's functional limitations due to the disability that the candidate contends interfere with the accessibility of the examination.
  5. A list and a copy of the standard instruments and assessment devices used to determine the disability.
  6. Reports of past accommodations, if any, the candidate received on examinations because of the disability and, if no previous accommodation was made, a detailed explanation of the reasons no accommodation was given in the past and the reason one is needed now.
  7. Copies of the evaluation report(s) on or accompanied by a letter on the evaluating professional's letterhead.
  8. Description of Treatment and Rehabilitation. Describe all treatment and efforts at remediation that the candidate has undergone and the results of the treatment. Also describe how disability is accommodated in daily life. In cases where the disability has been caused by traumatic injury or acquired illness, provide reports of assessment and treatments provided by relevant medical specialties (e.g., internal medicine reports for limitations associated with Epstein-Barr virus or Lyme disease).
  9. A description of the requested accommodation.

The required information, which is to be provided at the candidate's expense, must be received by ABIM by the examination application deadline. ABIM reserves the right to require a candidate to provide additional information to verify the existence of a disability and the need for any modification or aid. ABIM will not delay the examination pending submission of any missing documentation. Reapplication for special accommodation is not required for each examination administration, unless a new accommodation is requested.

In addition, ABIM reserves the right to require a second opinion. If, in ABIM's judgment, it is not clear whether the candidate is disabled or whether the requested accommodation is necessary, ABIM may seek the opinion of an outside expert.

Examinations for disabled persons will be proctored and given on the same day(s) as they are given nationally. To reduce the effect of the candidate's disability on his or her performance on the examination, disabled persons may be tested separately and may be given assistance in reading or recording answers. Auxiliary aids and services can be offered only if they do not fundamentally alter the measurement of skills or knowledge the examination is intended to test and if they would not result in an undue burden to ABIM. ABIM's examination is not a speeded test and it is designed so that candidates with average reading skills should have no problem completing it within the time allotted. However, time extensions may be granted to accommodate disabled candidates, if appropriate. Disabled candidates must agree to refrain from contact with other candidates for the duration of the examination. The location of the examination administration will be determined by ABIM on the basis of feasibility of providing necessary services and convenience to the candidate.

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Document Requirements for Learning Disabilities

In compliance with the Americans with Disabilities Act, (ADA) the American Board of Internal Medicine (ABIM) offers its examinations in a place and manner that accommodate individuals with disabilities, which includes certain persons with learning disabilities. The following protocol sets forth the procedural guidelines established by ABIM for use in evaluating the need for and, if appropriate, providing such accommodations to candidates who state that they have learning disabilities.

The definition of a "disability" under Title III of the ADA includes mental impairments, such as learning disabilities. In order for a learning impairment to rise to the level of a "disability" under the ADA, it must substantially limit one or more of the candidate's major life activities, such as seeing, hearing, speaking, learning or working.

If a candidate requests accommodation based on a learning disability, the ABIM must ensure that the examination results for that individual accurately reflect the individual's medical knowledge and clinical judgment, rather than his or her impaired mental capacities. In order to meet this objective, ABIM will consider a range of accommodations for learning disabled candidates including the following:

  • Changes in the length of time permitted for completion of the examination
  • The provision of auxiliary aids, such as taped examinations
  • Permitting the candidate to take the examination in a quiet room with minimal distractions

The accommodations that will be appropriate depend on individual circumstances. In evaluating a request for accommodation from a learning disabled candidate, ABIM will take into account the individual's specific limitations and needs. However, ABIM will not offer an accommodation that would fundamentally alter the measurement of the skills or knowledge that the examination is intended to test or that would result in an undue burden on ABIM.

Please provide this documentation in no event later than the examination application deadline. Failure to provide the required documentation will delay processing of the request for accommodation and may result in a decision not being made before the next scheduled examination. Address documentation to Florence Mickens, Special Exams Coordinator, American Board of Internal Medicine, 510 Walnut Street, Suite 1700, Philadelphia, PA 19106-3699.

The following requested information is to be provided at the candidate's expense.

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Educational History

A. Provide the name, location and dates of all schools attended from elementary school to the present and copies of all available grade reports and all available test scores on standardized testing from elementary school through the present, such as SAT, MCAT, etc.

B. If an accommodation was received for the stated disability in the course of taking other tests or examinations, please identify the nature of the accommodation, the test or examination and the institution, if any, providing such accommodation. If an accommodation has been sought that has been denied, please explain the circumstances involved. If an accommodation has never been received, please provide a detailed explanation as part of the neuropsychological evaluation described below concerning the reasons no accommodation was given in the past and the reason one is needed now.

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Neuropsychological Evaluation

Provide a comprehensive neuropsychological evaluation conducted by a professional (psychiatrist or licensed psychologist) who regularly practices neuropsychology. The evaluation must appear on, or be accompanied by a letter on, the evaluating professional's letterhead. At a minimum, the requisite elements of a comprehensive evaluation are an intelligence test, an assessment of neuropsychological functions, an academic achievement test, and psychiatric/psychological history. For candidates seeking accommodations on the basis of attention deficit disorder or hyperactivity disorder, the evaluation must include a behavioral index. Each of these required elements is described in greater detail below.

In addressing each of the following required elements, the treating professional should include the name of each test administered, its date, a description of the candidate's performance in each of the areas of the test battery, a summary of test scores, and a complete diagnostic formulation in standard DSM-IV terminology utilizing all diagnostic axes. (DSM-III-R is acceptable for any evaluations conducted prior to 1995.)

Diagnostic formulations should integrate current testing findings with academic and psychiatric histories. Raw test data should be available upon request.

A. Intelligence Test

The Wechsler Adult Intelligence Scale-Revised and at the discretion of the evaluating professional other estimates of verbal and nonverbal intelligence, such as Peabody Picture Vocabulary Test, Raven's Progressive Matrices or Leiter International.

B. Assessment of Neuropsychological Functions

  1. A complete, integrated neuropsychological battery, such as the Halstead-Reitan Neuropsychological Battery or the Luria Nebraska Neuropsychological Battery (LNNB).
  2. Memory assessments utilizing an age-normed, standardized instrument assessing both verbal and nonverbal memory such as the Wechsler Memory Scale-Revised.
  3. Assessments of the specific cognitive and perceptual processes affected by the disability. Examples: in cases of auditory-verbal learning disabilities, include specific tests of phonemic processing. In cases of attention deficit disorder, include specific tests of sustained attentional resources, such as the Continuous Performance Test.

C. Academic Achievement Test Results

Standardized, comprehensive academic achievement test, appropriately normed for the candidate's age group, including assessment of spelling, arithmetic and reading comprehension.

D. Psychological/Psychiatric History

  1. Standardized psychometric assessment of personality and emotional functioning (MMPI-2 or MCMI-II).
  2. Standard diagnostic interview for presence of current psychiatric disorder.
  3. If the candidate has undergone treatment for a psychological or psychiatric condition within the past three years, provide a report, including diagnosis, from the treating mental health professional.

E. Behavioral Indices*

* Only for candidates seeking accommodations on the basis of attention deficit disorder or hyperactivity disorder: Standardized psychometric assessments of behavioral indices of attention deficit disorder, such as the Wender Scales or the Achenbach Scale.

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Description of Treatment and Rehabilitation

Describe all treatment and efforts at remediation that the candidate has undergone and their results. In cases where the learning disability has been caused by traumatic injury or acquired illness, provide reports of assessment and treatments provided by relevant medical specialties (e.g., provide internal medicine reports for mental limitations associated with Epstein-Barr virus or Lyme disease).

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Evaluation

Evaluation of Accommodation Request and Documentation

Learning disabilities, unlike many physical disabilities, are not readily observable. Moreover, the definition and etiological criteria used for diagnosing certain learning disabilities do not enjoy consensual validation in the medical and psychological communities. Thus, after the candidate furnishes the required documentation, ABIM will conduct a review, at its expense, of the diagnoses offered and the accommodation requested to determine if the request should be granted.

Upon receipt of the documentation and Verification and Release form, the ABIM staff will review the documentation. The review will entail an assessment of the following issues:

  1. Is the candidate disabled and, if so, what is the diagnosis of the disability?
  2. Will the disability interfere with the candidate's ability to take the examination and, if so, in what ways?
  3. Is the requested accommodation necessary to enable the candidate to take the examination? If not, what, if any, accommodation is necessary?
  4. Are there any alternative methods to accommodate the disability that ABIM should consider?

If, in ABIM's judgment, answers to these questions are not clear from the documentation presented, ABIM may seek the opinions of an outside expert in the field of learning disabilities. In that case, ABIM will send the documentation to the expert for review.

Decision to Grant or Refuse Requested Accommodation

Upon completing the review of the documentation and, if applicable, receiving the opinions of an outside expert, ABIM will notify the candidate in writing of its decision regarding the requested accommodation and the basis for the decision. If ABIM declines to accommodate the candidate because it has concluded that the requested accommodation either constitutes a fundamental alteration or an undue burden, ABIM should notify the candidate of any alternative methods of accommodation suggested by the expert which are acceptable to ABIM. If no such alternatives have been suggested, ABIM should inform the candidate of this fact and solicit the candidate's views as to alternatives.

Appeals

If the candidate is dissatisfied with ABIM's decision concerning his or her request for accommodation, the candidate may appeal the decision to ABIM's President by sending a letter to the President of the Board stating specifically, and in detail, why the initial decision was incorrect and providing all additional documentation that the candidate wishes to be considered. Any appeal must be presented to the President within 60 days of the date of ABIM's written decision concerning the request for accommodation. The President may grant or deny it or seek additional information.

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