IMPORTANT UPDATE: USMLE Changes Breastfeeding Policy!!

Hey everyone! I recently posted about breastfeeding while taking the UMSLE step exams. As it turns out, NBME (the organization in charge of the USMLE exams) has changed their policy! They gave in and created a mechanism that allows nursing mothers an additional 60 minutes of break time during the exam. This is a separate process from applying for additional test time and does not give you any additional testing time, only additional break time. If you also require additional testing time, you will need to submit a separate request.


So, what do you need to know about the new policy?

  • You have to apply in advance for the extra break time. NBME recommends applying for your extra break time at the time that you apply to take the exam, or even before you apply for the exam. You can find more information about applying for test accommodations and extra break time here. They say it will take “at least 30 days” to process the request and you can’t schedule your test until your request is approved, so apply early. 
  • You need to fill out this form, found on the NBME website, giving more information about your condition. You will need to give your due date or date of delivery. They provide no information about restrictions related to due date – for example, are they only going to give extra break time to mothers of infants under one year old? They don’t say.
  • You have to have a doctor’s letter stating the medical necessity to pump. This must be typed, signed, dated, and on official letterhead, not a prescription pad. This seems like creating pointless extra obstacles to me, but hey, it’s still a big step forward from where we were just a few years ago.
  • Keep your originals. Send copies, per USMLE instructions. You never know when something might get lost.
  • You may have to submit pictures of your pumping equipment. These pictures need to be your own, not manufacturer pictures. My understanding of the bulletin is that you only need to submit photos if you are bringing equipment into the secure testing area for USMLE Step 2 CS, but please check with USMLE in advance!

They haven’t published any specifics as to what facilities or other resources they will provide (such as a private space to pump, a fridge, an outlet, a sink, etc). Still, this is a really impressive step forward for USMLE, and one that we should all be thankful for!

Happy pumping, mamas!


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  • Nikki

    Hiya! Do you know if they allow mums to breastfeed during the exam breaks? My bub will be 11 months even I take it and doesn’t take the bottle! We are aiming for the sippy cup but just in case! Ta!

    • Indy (admin)

      Sorry for the late reply! Last I heard, they were allowing people to breastfeed during the breaks. It is worth reaching out to your local testing center to confirm (they may want or need to reach out to USMLE to verify that it’s allowed, and you don’t want the stress of anyone giving you a hard time on exam day!)

  • Sarah

    Does anyone have a sample letter for the doctor? Also can the evaluating physician be an NP, or does it have to be a medical doctor? I recently moved between states and am unable to contact my old PCP and ObGyn (their offices can only be contacted through the messaging system available to members).

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