The American Board of Internal Medicine (ABIM) recognizes the importance of a mother's decision to breastfeed her child and will consider requests for medically necessary testing accommodations to support nursing mothers. For example, candidates who are nursing may be afforded additional break time in order to accommodate their need to express breast milk when medically supported. Individuals who believe that they may require such an accommodation should follow the instructions below.
Important note: All candidates should review this policy in its entirety to ensure that they understand their rights and obligations when requesting a testing accommodation. Evaluation of requests for testing accommodations, including review of supporting medical documentation, can be a time-intensive process.
Therefore, candidates seeking a testing accommodation should pay careful attention to the deadlines and submit their testing accommodation request and supporting documentation to ABIM as soon as possible.
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Requesting an Accommodation
To request a testing accommodation, the request and the supporting documentation described below must be submitted in writing in a timely manner to:
Special Exams Coordinator
All requests and supporting documentation must be received no later than 60 days prior to the scheduled exam date. However, we recommend submitting your requests as far in advance of that deadline as possible. Some requests, once granted, may involve a substantial period of time to make the necessary arrangements while also protecting the integrity of the examination, particularly if it involves a special format.
Please note: In order to maximize the potential that an applicant will have access to private space in order to express breast milk during an ABIM exam, ABIM must receive a request for such space at least 30 days prior to the applicant's exam date. Space is provided on a first come, first served basis and is subject to availability. This could require a candidate to travel to a center that has availability of private space.
All requests should include the following:
- A nursing mother request form (pdf)
- Documentation from a medical provider demonstrating the need for an accommodation – ordinarily, a physician's letter stating the candidate's delivery date and the anticipated frequency/duration of sessions to express breast milk will suffice
ABIM prefers to communicate directly with candidates who request accommodations. When necessity requires, however, ABIM will communicate with a delegate of a candidate regarding ABIM policy and the status of that candidate’s request for accommodations. In such circumstances, candidates themselves must affirmatively state their intention to communicate through a specific delegate to ABIM. In all cases, communication between ABIM and a candidate’s delegate will not include the sharing of confidential medical information.
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Evaluation of Requests
After the candidate makes a request for a testing accommodation and submits the necessary supporting documentation, ABIM will conduct a review of the request. This review is conducted at no expense to the candidate. This review will entail an assessment of the following issues:
- Would provision of the requested accommodation enable the results of the applied-for examination to accurately reflect the candidate's medical knowledge or clinical judgment or other factors the examination measures?
- Would the requested accommodation fundamentally alter the measurement of the skills or knowledge the examination is intended to test, or would it impose an undue burden on ABIM?
- If ABIM cannot provide the requested accommodation, are there alternative accommodations that can be made available to the candidate?
Types of Accommodations
Upon submission of the required documentation within the deadlines as shown above, ABIM will provide lactating mothers with 60 minutes of break time added to the standard pool of scheduled break time found in the specific exam.
In addition, ABIM will provide a private space with an electrical outlet, that is not a restroom, for lactating purposes. Please note: Private spaces are subject to availability and could require a candidate to travel to a non-preferred test center.
Notification of Determination
Upon completing its review of a candidate's request for an accommodation and all supporting documentation, ABIM will notify the candidate in writing of its determination regarding the requested accommodation and the basis for that determination.
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 will notify the candidate of any available alternative methods of accommodation which it is prepared to offer. If no alternative accommodations can be identified by ABIM, it will inform the candidate of this fact and invite the candidate to identify any other form of testing accommodation that she wishes to be considered.
Requests for Reconsideration
If a candidate is dissatisfied with ABIM's determination concerning her request for accommodation, the candidate may request a reconsideration of the determination. To do so, the candidate must follow the same instructions and procedures used for Test Takers with Disabilities. See Evaluation of Requests – Requests for Reconsideration. Send reconsideration requests to firstname.lastname@example.org.