For the Irony Files: Medical Licensing Organization Tells Med Student Bathroom Is Suitable for Pumping Breastmilk During Exam

How is it possible that nursing mothers still have to battle for a safe and appropriate place to pump breast milk?  And because the ability to regularly express breast milk contributes significantly to mothers' and babies' health and well-being, how is it possible that the National Board of Medical Examiners, of all entities — which administers tests that every medical student in the U.S. must take —is still not addressing this basic need when it administers its licensing tests?

Like many women today, I wear multiple hats. In addition to being a wife and mother, I am also a medical student and just gave birth to my second child earlier this week.

Having finished my second year of medical school, I am scheduled to take Step 1 of my licensing exam on August 10, 2015. I knew that with a 7-8 week old baby at home, I would have to pump breast milk during the 8-hour exam to avoid discomfort and possible infection. I was pleased to find that NBME grants extra break time for this reason, and I quickly applied for and was granted this accommodation.

However, I was shocked to learn that the only location NBME and Prometric, the company that provides the testing centers where the exams are taken, could offer me in which to pump was the public restroom at the test center.

I find it ironic that a medical licensing organization like NBME would suggest that a bathroom is an acceptable location to pump breast milk at any time, let alone during a high-stakes, lengthy exam. Not only is a bathroom unhygienic, but it would be uncomfortable and non-conducive to the pumping process, which requires 15-20 minutes of pumping, a quiet environment, the ability to balance the pump and bottles, and may require an electric outlet. Sitting on a toilet while other test-takers do their business around me is far from a clean, quiet, or appropriate environment.

When I followed up with NBME and Prometric, I was informed that there was a private room that Prometric employees use for expressing milk, in compliance with the federal law protecting its employees, but was told that "[d]ue to security considerations, Prometric will neither extend a nursing station reserved for its employees . . . to exam candidates, nor is it required to do so." The Prometric test site administrator further advised me:


It is still up to you to find a place suitable to you to nurse; whether it is your car, a restroom, or any other public space accessible to you as an exam candidate


Needless to say, neither a public bathroom nor my car — in Maryland, in August, no less — is a suitable spot for pumping.

I also learned from my own research that this is not the first time that NBME and Prometric have done this sort of thing. In 2007, a medical student at Harvard, Sophie Currier, was denied accommodations for pumping and had to bring NBME and Prometric to court. She took her case all the way to the Massachusetts Supreme Court and won.

Since neither the NBME nor the Prometric test center would accommodate my request, I decided to contact the ACLU for help.  This week, they sent a letter to NBME and Prometric on my behalf and are prepared to take my case further if they don't back down.

My hope is that the NBME and the Prometric test center will change their policy regarding breastfeeding mothers, for me as well as for other future physicians, so that we can access the simple accommodations that basic hygiene, and basic human decency, require.

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Emily Yosh

I am in the process of scheduling Step 1, and my contact in Disability Services told me to contact Prometric regarding where I can pump. When I contacted Prometric, I was told that I may pump in the bathroom. At no point has the NBME advocated for me to be allowed to pump in an appropriate space, and judging by everything I have heard directly from other mothers, the NBME is not exactly making this a priority. These are high-stakes exams, and I would expect better from the NBME.

stephen h pollock,md

whoever made this decision should be fired.
there is a reason why physicians are pushing back against organizations like this.
Every member of the board should be fired or resign.


Im a second year resident and have completed my step exams, and I would absolutely love to bash the usmle/name for a lot of things including the corruption and rampant kickbacks they get. But with regards to this issue, you all are misplacing the blame. The NBME writes exams to license doctors. That's all they do. period. Pro metric administers those exams, and others mind you, including lsat, gmat, gre, etc. pro metric has taken over standardized test administration, and presumably Breast feeding mothers taking those other non medical exams (which of course have absolutely nothing to do with the NBME) would run into the same exact problem. AND YET no one really seems to be blaming prometric. You are blaming the NBME which is not responsible for and does not have the capacity to change this policy.


I had a very similar situation while taking Step 2 CK in 2014. I contacted the NBME, who told me that they could not provide extra break time to pump. They also told me that I would have to contact the Prometric test center myself for any space accommodations for pumping. When I contacted the center, they of course only offered me the bathroom. It took my crying on the phone for the staff to offer me their private break room when I needed it. I could not believe how much time, leg work, and emotion it took for me to find a private, clean place to pump during such a long exam. I was appalled.

Cheryl Marian

I would take a chair to the lobby if they don't have comfortable chairs or couch and pump there or go to the lunch room. Just as long as you have an outlet for your pump. No law against that.


Really? She could not change her test date to another day, say before she had the baby or several months later after she ix done breastfeeding? She cant go home and do that? After all she has extra break time.


I'm sitting in a Starbucks accross the street from a pro metric facility with a 6 day old child because they won't allow my wife to nurse at all during her 5 hour GRE... Glad to see things have changed /S


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