Understanding Accommodations
Parts of an Accommodations Application
Types of Testing Accommodations
Dr. Moss' Resources & Advising
Resources & MCAT/USMLE/COMLEX Links
Embarking on the journey of applying for USMLE accommodations can feel overwhelming, but I'm here to share my experiences, insights, and resources to help you navigate this process smoothly. As a current PGY-2 psychiatry resident who has walked this path, I hope to provide you a roadmap to diminish the challenges ahead and empower you with the knowledge to advocate for yourself effectively.
I want to share some guidance on applying for accommodations on the MCAT/USMLE/COMLEX if you have a mental or physical health condition that impacts your ability to take standardized exams. I received Accommodations for Step 1, 2, and 3, and have worked with dozens of medical students through this process, I hope this guide can help you! The process can be daunting, especially if you've struggled with MCAT/STEP/COMLEX failures or academic challenges, but having a strong application can make all the difference.
Presentation I gave to Medical Students on Applying to Accommodations
My Story: Discovering Disabilities
Before medical school, I never saw myself as someone with a disability. But midway through, I was diagnosed with mental health and chronic pain conditions. This experience was eye-opening, revealing that disabilities can affect anyone—even aspiring doctors.
One of the hardest moments for me was failing USMLE Step 1 TWICE. It was only then, after a friend’s advice, that I considered seeking accommodations. I had spent years avoiding help, shaped by an early education system that lacked support. It took time, but I finally learned that accessibility is not about receiving special treatment—it’s about creating a level playing field.
Vlog Video of my Disability Story & Getting Accommodations in Medicine
Understanding Testing Accommodations
Accommodations remove barriers, allowing individuals to perform at their highest potential. They don’t provide an unfair advantage—they ensure fairness. That’s a truth I’ve come to embrace during my medical journey.
The Americans with Disabilities Act (ADA) protects these rights. If you're struggling, know that accommodations are not just an option—they are legally supported to prevent discrimination.
Every medical school "should" have an accessibility office that can assist with the process. A simple accommodations letter can make a huge difference, whether it’s allowing extra breaks, scheduling therapy appointments without judgment, or ensuring the test conditions meet your needs.
Key Components of Your MCAT/USMLE/COMLEX Accommodations Request:
✅ Letters: Clear Diagnosis & Documentation
- Your physician/therapist letter should include formal diagnostic criteria (ex: ICD-10 codes for health conditions, DSM-5 for mental health conditions)
- Medical documentation for physical conditions should outline how they impact test-taking.
- Can include labs, imaging, and specific exams (like Neuro-Psyc testing)
✅ Personal Statement: History of Challenges
- Even if your diagnosis is recent, document past struggles in education & standardized testing (AP, ACT, SAT, MCAT, ext)
- If you’ve had school test failures, standardized exam failures, school repeats, or needed informal accommodations before, highlight that!
✅ Both: Connection Between Diagnosis & Impairments
- Clearly explain how your condition affects cognitive, physical, or psychological function during exams.
- Examples: difficulty concentrating, needing more breaks due to pain, or requiring a distraction-free environment.
✅ Both: Specific Accommodations Requested
- Be VERY explicit: extra testing time (1.25/1.5/1.75/2), shortened exams chunks (20Q vs 40Q blocks), additional break time, separate testing environment, access to food/water/meds, etc
- Explain WHY each accommodation is necessary for your success
Understanding Your Needs and Expressing Them
It's crucial you recognize and thoroughly articulate your need for accommodations. Think deeply about your struggles and the impact they have on your academic performance and life. This is not a time to downplay your needs; embrace them and demonstrate how they affect you in tangible, specific ways. I've learned that framing your needs from the reviewers' perspective is vital.
When tackling your personal statement, remember that specificity is key. As you provide your diagnoses, include DSM criteria and billing codes to reinforce your case. This detailed approach not only highlights your seriousness but also presents compelling evidence of your needs.
Evidence and Impact of Previous Experiences
Evidence of your medical journey, previous testing conditions, and outcomes can significantly support your application. If you've experienced challenges without accommodations, such as failing an exam due to inadequate time, include these details. They demonstrate the potential positive impact accommodations could make and substantiate your request for additional support.
Some applicants choose to incorporate previous exam scores or feedback that highlight their struggles without accommodations. This practice underscores the necessity of support and paints a fuller picture of your academic journey.
Letters of support are critical components of your accommodation application. It's advantageous to include letters from MDs or DOs, as these often carry more weight due to the reviewers' trust in their colleagues' evaluations. However, don't underestimate the value of letters from therapists who have a thorough understanding of your ongoing struggles. Their unique insights into your long-term experiences are also instrumental.
If you're gathering multiple letters, consider prioritizing those that most directly pertain to your condition and requested accommodations. However, more varied perspectives can strengthen your case, so don't shy away from including supporting documentation from other healthcare providers relevant to your condition.
Be aware of the variety of accommodations you can request besides the commonly known extended time. Some alternatives include additional break times, shorter testing blocks, and testing over multiple days. Tailor your requests to your specific needs and conditions, and remain open to exploring new options they may suggest.
If you're navigating this process, you are NOT alone. Many students have successfully secured accommodations and gone on to pass their exams. Myself included! Through my USMLE Accommodations Workbook I’ve shared my FULL USMLE STEP 1-3 accommodations requests, templates to provide physicians, and workbook pages to help craft your personal statement.
Over the past couple of years I have helped dozens of pre-meds with MCAT accommodations and medical students with their USMLE/COMLEX accommodations. If you’d like have a 1:1 Advising meeting with me to discuss your unique situation and help with creating and editing your Testing Accommodations Application you can sign up here.
Your journey matters. You are capable and deserving of reaching your full potential. Don’t hesitate to seek help, use available resources, and celebrate every win—big or small!
Dr. Moss Resources & Journey:
Requesting Accommodations in Medical School
Requesting Accommodations for Step1on KevinMD
Disabilities Resource Collections
Navigating Medical School Hidden Curriculum E-Book
Podcast "Life as a Patient-Doctor"
Download my USMLE Accommodations Workbook
Medical School Workbook includes tips for Disclosure
Editing your Accommodations Request
USMLE UWorld Affiliate --> Use code: STEPH10 for 10% savings!
Testing Accommodations Websites:
NBOME: https://www.nbome.org/resources/test-accommodations/
USMLE: https://www.usmle.org/step-exams/test-accommodations
MCAT: https://students-residents.aamc.org/mcat-exam-accommodations/take-mcat-exam-accommodations
Docs with Disabilities Guide for USMLE