While I cannot speak for everyone here regarding their level of empathy, I have plenty of the same for people with disabilities. However, Dr. Currier consistently distorts the facts and offers up red herrings in an effort to sway favor in her direction:
To Wit (bold quotes are from Dr. Currier's blog):
"Fifty years ago women were not physicians."
A grossly false statement, but since it doesn't have anything to do with the argument at hand, I'll let it go.
"I am not exaggerating the details. Perhaps the truth is you do not have all of the information."
"...during the 9 to 10 hour period in which I would be taking USMLE step 2,..."
It appears to me that Dr. Currier is exaggerating the details. The test is NOT 9-10 hours in length. The test is 8 (1) hour blocks for which she gets a 15 minute tutorial and 45 minutes in breaks. If you complete the tutorial before 15 minutes is up (and I would imagine anyone who has already taken the exam and knows how to use the mouse to point and click, doesn't need the tutorial) you can add it to your break time.
And guess what? She didn't admit she was being given TWICE as much time to take the exam until she found a lot of people striking out at her. Makes her argument even less compelling.
"Unfortunately we ran into some barriers I had never anticipated. I had never realized that nursing a child would interfere with completing my medical school requirement; namely taking the United States Medical Licensing Exam (Step 2, CK)."
She has already taken the test once. Therefore, she is clearly familiar with the structure of the test and the highly rigid parameters which are necessary to validate the test. In addition, one could also state that since she knew she would be nursing at the time of her second attempt, she would have investigated this earlier.
"Combined degree students in general face a serious problem of being in their mid thirties and thus wanting to have children before they have completed medical school or residency."
This is her choice and the NBME should not be making special accomodations for what amounts to a choice.
"Knowing that you can reduce the risk of serious infection and chronic disease like cancer in both the mom and the baby, women no longer have the choice. "
There are no randomized clinical trials which show these results. As a matter of fact, the NCI only reports that estrogen *may* be lower during breast feeding and this *may* reduce the risk of future breast cancer in women. They do not include breast feeding as a factor which can reduce breast cancer for the simple fact that there is no Level 1 evidence.
While it (breast feeding) may reduce the risk of infection in neonates via the early production of colostrum, there is no long term evidence in RCT that breast feeding produces children and adults with lower rates of infection and cancer.
"We HAVE to nurse our babies."
We CHOOSE to nurse our babies.
"That means pumping or feeding an infant every 2 to 3 hours for over 12 months."
Most women who breast feed for prolonged periods do not need to pump or feed every 2-3 hours as only neonates need to feed that often. Current standards for older children recommend longer periods between feeding and given the fact that Dr. Currier's youngest child will be 4-5 months of age during her exam, it is extremely likely that he/she will be able to go at least 4 hours without a feed.
"Even the National Medical Licensing Examiners are not willing to make accommodations for women to nurse their children during the USMLE."
The NBME is not in charge of the non-testing facilities at the testing centers. They only require certain standards for the actual computer room where the test will be administered. Breast Feeding is not an ADA problem, therefore the testing centers are not required to provide private (non-restroom) facilities for a breast feeding mother.
As the NBME notes, "breast feeding is not a permanent condition" and therefore, does not warrant special consideration. Why should breast feeding, a "condition" which is a choice receive concessions when the test taker with the flu, a migraine, a broken leg, UC flare, etc. do not? These individuals only have the option of rescheduling the exam...they do not have the option either of getting extra time to take the test because they may need to rest, use the bathroom, or take medications. Why should she?
"My exam is over two days, but each day will be 9 hours long. That is because of my slow reading I need 60 minutes to do 23 (other can read 46 questions in 60 minutes). "
She admits that the NBME has given her accomodations for her ADHD. While she provides numbers about the average reading speed, these are irrelevant for the board exam because we do not know the average for the physician taking the exam...it may be slower or faster than the average American.
This angers me less than the request for extra break time because if she has a documented disability (which it appears she does) that requires extra test time, then it is up to the NBME to decide whether this invalidates the results. I would venture that it may in fact do so, but am willing to give her concessions for extra testing time. It would appear that there are precedents for the same.
"Of course women can go with only pumping once in 9 hours, but it is in no way medically advisable."
Red herring...no one was suggesting that she go 9 hours without pumping. Rather we are suggesting she pump in the break time she has available. The risks of mastitis and milk duct stasis are real, but happen in the minority of women. For those that do experience it, the most vulnerable period is in the first 3 months post-partum. This does not preclude Dr. Currier from having another bout of mastitis and her risk is increased, but NOT "high" as she claims. I'm not sure what she means by "high" as it is not a medically defined term, but it certainly is not 50% nor is it even likely 25%. If she pumps every 4 hours her chances of developing mastitis, are extremely low, probably less than 10%. Milk duct stasis is a self-resolving issue, one that resolves with continued breast feeding and is generally over in 24-48 hrs and does not result in any long-term damage to the breats, so this should not be an issue.
"By the way- as far as failing the exam the first time, I would like to see you take 3 years off between 2 and 3rd year of medical school, complete a PhD, then come back, struggle with pregnancy/ nursing and doing medical school rotations, take another 1.5 years after your core rotations and then try to pass the exam at 8 months pregnant and so ill that you had to be hospitalized.
Lastly, as far as family planning goes, as an MD PhD I have been in school without any break since I was 2 years old. I am now 33. Residency is a very poor time to have children-- for many reasons. The only good time for MD PhDs to have children is either in 4th year of medical school or after residency (when you are >37). "
None of this has anything to do with her concerns. Her PhD was completed before she started her clinical rotations and it was her decision to register for the test when she was 8 months pregnant. I'm sorry she had to be hospitalized during her pregnancy but this emotional appeal does not change the issue at hand; it was her decision to get pregnant when she did and to register for the exam when she did. Like all other decisions in life, there are potential consequences which we deal with.
I don't disagree that residency is a bad time to have children, but her argument above trivializes the everyday actions of many other women who have completed the EXACT same route as she, but without the concessions she is asking for.
"I haven't slept more than 8 hours in 2 years."
Welcome to the real world of medicine. Besides, HER choice to have two children in two years.
Despite an Md-PhD (from Harvard and MIT we are reminded multiple times throughout her blog) she fails to recognize the concept of standardization of tests. Part of the struggle with the medical licensing exams is the stress and fatigue...for someone else to be offered an easier test schedule may result in higher scores or an unfair advantage. Finally, her claim that those of us posting don't know what she is talking about, there are plenty of licensed physicians posting here and in her blog comments who have BEEN THERE, DONE THAT.
I'm sorry but I am angry and I'm trying to be empathic but its hard when someone seems so unable to understand the complexities of what she is asking for.
Not for myself...I've taken the exams, passed them and like most people, had plenty of time to do so. However, if the NBME is going to allow such accomodations what is to stop them from allowing unfair advantages to people with other conditions? How will we standardize the exam if some are allowed to take twice as long to complete it? Good thing they are thinking of restructuring the exam because it will become a farce at this rate.
Furthermore her actions (ie, complaints that she needs extra time, suing the board, etc.) belittle the accomplishments of women AND men who have gotten through medical school, residency and work a full-time job while being parents, all without asking for extra concessions. Parents and especially women, will continue to be thought of as less hard-working when they continue to ask for favors that others do not get.
Believe me, as a surgeon I am extremely familiar with the common belief that females work less hard, ask for more time off, and generally shirk their duties. I and my colleagues had to work extra hard to make sure that those with these attitudes were chastened. If that meant coming into work post-op hour 36 or working until lab contractions set in, it was what we did. We didn't expect thank yous or extra concessions and we appreciated the work that the generation before us did that allowed us to be accepted in the medical field and in the operating room. It angers me to see some women like Dr. Currier attempt to use their biology and choices to curry favors and by doing so, recapitulate the belief that women aren't as good or as strong or as capable as men.
on this one.
