Please follow the instructions on the form specific to your type of request.

• New Request – You have not previously applied for test accommodations for the USMLE. Please be sure to clearly indicate what accommodations you are requesting, the basis for your request, and any prior history of accommodations.
   
• Subsequent Request – You have received accommodations for a previous USMLE Step exam, whether you are asking for the same accommodations or requesting something new. If you are requesting new accommodations, please clearly state what you are requesting and submit new supporting documentation.
   
• Reconsideration Request – You have received a written decision letter and would like your request to be reconsidered. Please review the guidelines for reconsideration requests.
   
• Additional Break Time Only Request – You want to apply for additional break time with standard testing time for the USMLE.
   
• Personal Item Only Request – You only want to bring a personal item(s) not on the pre-approved items list.

• Please provide a personal statement using the following prompts. Your personal statement is an opportunity for you to express in your own words how your reported impairment(s) impact(s) your daily life and your ability to take a standardized test, and how the accommodations you are requesting will enable you to take the USMLE in an accessible manner. It is unnecessary to repeat information that is already documented elsewhere in your submission. 
   
  • Section 1: History
    
    Prompt: Provide relevant background information about the history of your impairment(s). Please include information such as when symptoms were first noticed and when the impairment was first diagnosed, what the impact has been on your daily life inside and outside of academic and standardized testing settings, and, if applicable, any accommodations that were implemented as a result of your diagnosis.
     
  • Section 2: Current Functioning
    
    Prompt: Describe your current functional limitations, including specific information about your current symptoms and how your impairment(s) impact(s) your academic, occupational, social, and other important areas of functioning.
     
  • Section 3: Rationale for Accommodations
    
    Prompt: Include details about the accommodation(s) you currently utilize, if any, and how they mitigate the impact of your impairment(s) both inside and outside the academic and testing settings. Explain how the accommodation(s) you are seeking will enable you to take the USMLE in an accessible manner. If you do not have a history of using accommodation(s) or are asking for an accommodation you have never used before, please provide a rationale as to why it is necessary now but was not needed previously.
     
  • Supplemental Information
    
    Prompt: Please feel free to provide any other information you think is relevant to your request.

• The treating and/or evaluating professional should be licensed and have training and direct experience in the diagnosis and treatment of adults in the specific area of disability that is the basis for your request for accommodations.
   
• Documentation from the treating and/or evaluating professional should be comprehensive and provide specific evidence of impairment.
   
• Comprehensive documentation should include:  
   
  • A discussion of how diagnostic criteria are currently met and a detailed and personalized description of current symptoms (e.g., onset, frequency, severity, duration, etc.). If available, your supporting physician should provide the results from relevant assessments that were used in making the applicable diagnosis.    
     
  • A description of the full extent of your current functional limitations due to the disability in daily life activities as well as in the context of standard testing conditions.  
     
  • A recommendation for accommodations and a clear rationale for why each recommended accommodation is necessary to enable you to take the exam in an accessible manner. 

• Objective records of functioning should be submitted to demonstrate how a major life activity is substantially limited and to document the real-world impact of the disability.
   
• Examples of supporting documentation include but are not limited to:
   
  • Prior clinical evaluations, diagnostic reports, treatment plans, or other relevant medical records from professionals other than the treating or evaluating professional(s) who provided documentation in direct support of your request for accommodations on the USMLE.
     
  • Written feedback from teachers or supervisors.
     
  • Official academic records and transcripts.
     
  • Official score reports for nationally normed standardized tests (e.g., SAT, ACT, MCAT, LSAT, GRE, GMAT, professional licensing or certifying exams, etc.).
     
  • Performance evaluations from training programs, military service, or employment settings (e.g., part-time/full-time volunteer/paid jobs, clerkship/internship/residency, etc.).
     
  • Official records verifying approved accommodations from schools [e.g., Section 504 plans or Individualized Education Programs (IEPs)] or other testing entities, listing the specific accommodations approved and the dates they were provided.  
     
    • Additional information is provided below for specific types of impairments. Please also consult those guidelines, as applicable to your situation.      

A request for test accommodations on the basis of Attention-Deficit/Hyperactivity Disorder (ADHD) should include the following:   

1. A report of an appropriate evaluation, as determined by your qualified evaluating professional, containing:
    
   • A discussion of relevant background information, including (but not limited to) a history of your presenting symptoms and the impact of symptoms on functioning across environments, currently and historically. 
      
   • A summary integrating relevant background information, behavioral observations, and assessment results, if applicable, to support the diagnostic conclusion(s). 
      
   • A diagnosis and a recommendation for accommodations, with a clear rationale for why the recommended accommodation is necessary to enable you to take the exam in an accessible manner. For example, if applicable, why additional testing time is needed rather than additional break time or a separate testing area. 

2. Objective non-medical records of impaired functioning 

   • Documentation from school, work, or social settings demonstrating the nature and course of the impairment and its impact on a major life activity that is relevant when taking a standardized exam. Examples may include (but are not limited to): report cards, academic transcripts, Section 504 plans/Individualized Educational Programs (IEPs), employment evaluations, performance on prior standardized examinations, and relevant first-hand observations of how your impairment impacts your daily life functioning.  

A request for test accommodations on the basis of Specific Learning Disorder (SLD) should include the following:

1. A report of an appropriate evaluation, as determined by your qualified evaluating professional, containing:
    
   • A discussion of relevant historical background information, including (but not limited to) previous psychoeducational evaluations and the individual’s educational, developmental, and psychosocial history. 
      
   • Assessment data from a comprehensive battery of standardized, norm-referenced tests and measures and a summary integrating those results with the relevant background information to support the diagnostic conclusion(s).
      
     • NOTE: Academic difficulties as a result of limited English proficiency are not necessarily the result of SLD. A qualified evaluating professional should include consideration of this factor in the diagnostic conclusion(s) if English is not your native language.
        
   • A recommendation for accommodations and a clear rationale for why each recommended accommodation is necessary to enable you to take the exam in an accessible manner.

2. Objective non-medical records of impaired functioning 

   • Documentation from school or other relevant settings to demonstrate the nature and impact of the impairment on relevant major life activities. Examples may include (but are not limited to): report cards; academic transcripts; Section 504 plans/Individualized Educational Programs (IEPs); employment evaluations; and performance on prior standardized examinations.

A request for test accommodations on the basis of a psychiatric disorder should include the following:    

1. Documentation from a qualified treatment and/or evaluating professional (i.e., psychiatric or psychological evaluation and/or letter) completed within the past six (6) months, containing:
    
   • A description of your presenting problem(s), with details about the onset, history, and current frequency, severity, and duration of symptoms, as well as the corresponding impact on your current daily life activities (e.g., in school, work, home, social settings, etc.).
      
   • A detailed summary that integrates your clinical presentation, behavioral observations, relevant background and historical information, current functioning, and assessment data, if applicable, to support the diagnostic conclusion(s).
      
   • A recommendation for accommodations and a clear rationale for why each recommended accommodation is necessary to enable you to take the exam in an accessible manner.
      
2. Objective non-medical records of impaired functioning 
    
   • Academic records, employment/work records, or relevant observations from third parties of how your impairment impacts your daily life functioning, and other records demonstrating how the psychiatric condition substantially limits your ability to perform functions that are relevant to the specific examination for which accommodations are requested.

A request for test accommodations on the basis of a visual impairment should include the following:  

1.  A report of evaluation by a qualified vision professional that includes:

   • A detailed description about the health of the eye(s), distance and near visual acuities, visual fields, binocular functioning, accommodative functioning, oculomotor functioning, and other pertinent information.

   • Data from all tests, procedures, measurements, and scales administered and a summary integrating those results to support the diagnostic conclusion(s). 

     • NOTE: Monocular conditions, in and of themselves, may not cause a substantial limitation in the ability to read or perform other two-dimensional tasks at near distance. Requests based on such conditions should include objective examples of demonstrated impairment when reading or working on a computer.

   • A recommendation for accommodations and a clear rationale for why each recommended accommodation is necessary to enable you to take the exam in an accessible manner.

2. Objective non-medical records of impaired functioning 

   • Academic records, employment/work records, or other records demonstrating how your condition substantially limits your ability to perform functions relevant to the specific examination for which accommodations are requested.

* Please be advised that the USMLE is only offered as a computer-based examination.  

** Text and image magnification and reverse contrast options are standard user-adjustable display features at the test center. 

A request for test accommodations on the basis of hearing impairment should include the following:  

1. Documentation from a qualified professional (e.g., audiologist, otolaryngologist) including:  

   • A copy of the most recent audiogram or audiometric study that has been conducted. 

   • Any other relevant testing results.  

   • A discussion concerning the current impact of your hearing impairment on daily life functioning, therapies or interventions that are being used to treat or ameliorate the impairment, and how the impairment is expected to impact your ability to take the examination. 

   • A recommendation for accommodations and a clear rationale for why each recommended accommodation is necessary to enable you to take the exam in an accessible manner.

2. Objective non-medical records of impaired functioning.  

   • Academic records, employment/work records, or other records demonstrating how the hearing condition substantially limits your ability to perform functions that are relevant to the specific examination for which accommodations are requested.  

Assistive Devices 

Please note that assistive devices may not be connected (wireless or wired) to the workstation. If you require an assistive device, please review the information on the Pre-Approved Items List.

* NOTE: There may be a few items on each Step exam with sound. Visual representation of sound (a wave file embedded in the item that depicts the sound being played) is available as an accommodation. 

A request for test accommodations on the basis of a medical condition not addressed elsewhere in these guidelines should include the following:   

1. Documentation from a healthcare professional qualified to diagnose and/or treat your medical condition, containing:  

   • A clear statement(s) of the specific medical diagnosis, date of onset, current symptoms, current medication and any related side effects, and current impact on your functioning, particularly in relation to taking the examination.

   • A recommendation for accommodations and a clear rationale for why each recommended accommodation is necessary to enable you to take the exam in an accessible manner. 

2. Objective non-medical records of impaired functioning. 

   • Academic records, employment/work records, or other records demonstrating how the medical condition substantially limits your ability to perform functions that are relevant to the specific examination for which accommodations are requested.