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United States · Licensing exam

USMLE test accommodations

If you have a documented disability, you can ask for test accommodations under the ADA. You can also ask for extra break time only, for example for diabetes or to express milk. Every request for USMLE accommodations goes through NBME’s MyUSMLE portal, whichever organization registered you, and a decision takes about 60 business days.

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Updated October 2026 · Written from official sources, listed at the bottom of this page

How do you request USMLE accommodations?

  1. Read USMLE’s guidelines and documentation rules before you apply for the Step.
  2. On your Step application, choose the test accommodations option. That puts a temporary hold on your scheduling permit.
  3. Log in to MyUSMLE, or create an account, and follow the prompts. Upload digital copies of your documents.
  4. If it applies to you, have your medical school complete the CPTA form for prior test accommodations.
  5. Watch for your written decision letter. If you already hold a standard permit, contact the organization that registered you to re-register and put it on hold for accommodations.

How long it takes

Allow about 60 business days for a full request, counted from when your file is complete and your Step application is done. Requests that are only for extra break time take about 14 business days. They’re handled in the order received and can’t be sped up.

USMLE’s own example: for a June to August eligibility period, send your request by early March.

Extra break time, and what doesn’t need a request

If you’re breastfeeding, you can test under standard conditions and ask in advance to bring a breast pump for your breaks, or ask for extra break time. Extra break time for expressing milk makes Step 2 CK a two-day exam and Step 3 a three-day exam.

A long list of items is pre-approved and needs no request, only a check by staff. It includes glasses, inhalers, insulin pens and pumps, glucose monitors and tablets, EpiPens, eye drops, braces and casts, hearing aids without wireless, wheelchairs and walkers, and religious garments.

Decisions and approval rates

You get a written decision, which may approve all, some or none of what you asked for, such as extra break time instead of extra testing time. You can ask for one reconsideration per active registration, and it needs new, objective evidence, not the same documents again.

USMLE says 90% of requests were fully or partly approved in 2025, out of 6,344, up from 76% of 1,720 in 2020. Questions go to NBME Disability Services at disabilityservices@nbme.org or 215-590-9700.

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OverviewThe USMLE examScoringHow USMLE scores workApply and scheduleHow to apply for and schedule the USMLECostHow much does the USMLE cost?What to bringWhat to bring to the USMLE, and your USMLE ID numberStep 1USMLE Step 1Step 2 CKUSMLE Step 2 CKStep 3USMLE Step 3Pass ratesUSMLE pass ratesTest centersUSMLE test centersResultsWhen do USMLE results come out?TranscriptsUSMLE transcriptsBiostatisticsBiostatistics on the USMLELab valuesThe USMLE lab values PDF and reference tableSelf-assessments and Free 120USMLE self-assessments and free official practiceInternational graduatesThe USMLE for international medical graduates: FSMB and ECFMGCOMLEX vs USMLECOMLEX vs USMLEIf you failFailed USMLE Step 1, Step 2 CK or Step 3? How retakes workContent outlineThe USMLE content outlinePractice testFree sample USMLE questionsWhere to learnUSMLE prep: where to studyStudy plannerYour USMLE study plan
Sources: USMLE and 2 more. Checked October 2026.

Rules and fees can change, so check the official site before your test.