Step Disability Accommodation Process

Guiding Medical Students Through the USMLE Accommodations Process

Requesting accommodations for the United States Medical Licensing Examination (USMLE) Step exams is an important step in ensuring equitable access for students with disabilities. While the process requires careful planning and documentation, you are not alone—our office is here to support you.

This guide is authored by the Docswithdisabilities(Link is external) (Link opens in new window) initiative and it provides a clear roadmap for requesting accommodations, including timelines, documentation requirements, and helpful strategies to make the process as smooth as possible.

1. Understanding the Process

The National Board of Medical Examiners (NBME) carefully reviews accommodation requests to ensure they are well-supported by documentation. Because this is a standardized exam, the NBME’s requirements may differ from those at Yale, even if you have received accommodations throughout your education.

The key to a successful request is clear, well-documented evidence showing how your disability affects test-taking conditions. The guide will help you prepare, gather necessary materials, and submit a strong request.

2. Creating a Timeline

Since this process can take several months, the guide recommends the following timeline:

9+ months before the exam: Schedule a meeting with our office to discuss your accommodations history and plan next steps.
6-9 months before the exam: Gather documentation, write your personal statement, and request letters of support.
4-6 months before the exam: Submit your application and confirm receipt.
2-4 months before the exam: Respond to any follow-up requests and, if needed, prepare an appeal.

Starting early helps reduce stress and ensures you have enough time to address any additional requests from the NBME.

3. Writing a Strong Personal Statement

Your personal statement is an opportunity to clearly explain how your disability affects test-taking and why accommodations are necessary. It should include:

A brief description of your disability.
How it impacts your ability to take standardized tests.
A history of past accommodations and their effectiveness.

4. Gathering Documentation

The NBME requires comprehensive documentation that supports your request. This may include:

A recent evaluation from a medical or psychological professional.
Evidence of functional limitations that affect standardized testing.
Documentation of past accommodations in school or on standardized exams.

5. Requesting Letters of Support

Strong letters of support from disability services, and medical professionals can strengthen your application. These letters should:

Confirm your need for accommodations.
Highlight the impact of your disability on standardized testing.
Show a history of accommodations and their effectiveness.

6. Navigating the Appeals Process (If Needed)

If your initial request is not approved, you may have the option to appeal. While this can feel discouraging, many students successfully receive accommodations through the reconsideration process.

Appeals often require:

Additional documentation or updated evaluations.
Clarifications or expansions on your personal statement.
Revised letters of support with stronger details.

7. Tips for Managing the Process

The accommodations request process may seem detailed, but with the right approach and support, it is completely manageable. Here are a few key tips:

✅ Start early to allow plenty of time for processing and follow-ups.
✅ Stay organized by keeping copies of all materials and emails.
✅ Reach out for support—our office, faculty mentors, and peers who have gone through the process can be great resources.
✅ Take it step by step—focusing on one part of the process at a time makes it easier to navigate.

Most importantly, remember that requesting accommodations is about ensuring fairness and access—not asking for special treatment. You deserve the same opportunity to demonstrate your knowledge and skills as every other test-taker.