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

Breastfeeding baby with mom at the laptop
Breastfeeding baby with mom at the laptop
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June 18, 2015

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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