NBME Exams

The USMLE Step exams serve as a gateway to practicing in your chosen profession. It is a part of your journey as a student with a disability, to prepare in advance and understand the requirements for each individual exam. These exams serve as licensing, advancement/promotion or certification requirements in medicine. 

How do I apply?

As a student with a disability you should understand that requests for accommodations on the USMLE Step exams are made directly to the The National Board of Medical Examiners (NBME) and do not go through Medical Student Disability Services, although we do assist students with the process. The NBME sets their own requirements for requesting accommodations, including specifications for disability documentation, personal statements, and other required information for your application. The request process is outlined on the NBME's website.  Unfortunately, in some cases, particularly where the exam accommodation approval is governed by a state licensing board, the information will vary by state. This variance often necessitates a few phone calls, as well as close reading of a website to ensure you have all the necessary information about making your request.


It is important to note that each exam has an identified timeline for submitting a request for accommodations. The NBME sets a deadline for accommodation requests, generally about 60 days prior to the exam date, and provides guidance as to the expected turn around time for a decision. The process of getting ready to submit a request for accommodations, however, can take 3-6 months. Students must factor in time to develop a personal statement, collect documentation, and file appeals, should their initial request be rejected. Leaving sufficient time for the possibility of an appeal of decision alone can often take 3-6 months.  As such, students are highly encouraged to investigate the published timelines for decisions, and start applying for accommodations far in advance of the exam date to buffer for the possibility of an appeal process.  

Documentation Requirements

Students also need to provide some form of documentation of their disability status. This may be provided via a form in lieu of, or in addition to, a formal report. You should determine what is required well in advance of your identified submission date. The documentation you have on file with your school may not be sufficient to meet the requirements for the exam. You may need new or updated documentation of your disability that requires a new referral to a specialist, or appointments with your treatment team. This process adds to the timeline for requesting accommodations and highlights the need to begin the process early! The NBME documenation requirements are available on their website


The NBME also requests additional verification forms showing previous accommodations in institution of higher education. MSDS will help you determine iwho is deemed qualified to complete the form, as in some cases it requires that it be completed by your medical or mental health care provider (e.g., a psychiatrist, physician, psychologist, etc.), while other times the form can be completed by the office that approved your accommodation request at your school (i.e. disabilities office, dean of students office, office of student affairs). It is helpful to approach your provider with a summary of the requirements, along with your reasoning for the requested accommodations (i.e. barriers posed by the exam, functional limitations of your disability). This helps the provider best represent your needs. 
There is an additional form or requested letter of support from the MSDS office that confirms your approved accommodations. The MSDS office will offer to provide a more detailed letter in addition to the form. This letter might include additional information, not captured in other forms, about observations about your need for accommodations, how they determined certain accommodations, and specifics about you and how your disability impacts you in the academic setting.

Additional Records

Students may be required, or wish to provide additional information to strengthen their request for accommodations. Historical Evidence of accommodation, and need for accommodation, can bolster students’ chances of receiving accommodations. Students who have been diagnosed later in life should also provide examples of how their undiagnosed disability affected their early life and education.