HMS Mom Won't Get More Time on Exams

A Harvard medical student seeking extra break time to express milk into a bottle during a medical certification exam lost her bid in court yesterday.

Judge Patrick F. Brady of Norfolk Superior Court ruled that Sophie C. Currier, an MD-PhD student at the Medical School and mother of a four-month-old baby, would not be entitled to extra time for lactating during the nine-hour exam used by state medical boards to certify doctors.

Currier sued the National Board of Medical Examiners (NBME), which co-sponsors the exam and sets testing rules, because she argued that she would not have an adequate amount of time to express milk, eat, drink, and use the restroom during breaks.

"I believe any lactating mom who takes this exam does not have physically enough time to take care of her biological needs," Currier said in a telephone interview yesterday. "The problem is that many people don’t understand that when you’re a nursing mom, you have to empty your breast every two to three hours."

In his opinion, Brady pointed to a number of accommodations that NBME had offered Currier, such as a private room, multiple breast pumps, and the option to bring food or drink into the exam room.

But Currier said the NBME’s proposed remedies would not be adequate.

"It’s almost like telling someone, ‘We won’t give you time to go to the bathroom, but we will give you three urinals or three toilets,’ " she said.

Currier is appealing the decision in advance of her scheduled exam next week.

Not expressing milk every two to three hours can lead to medical complications, such as breast engorgement, fever, or infection, according to registered nurse Marsha Walker, who filed an affidavit on behalf of Currier. In addition, a nursing mother with a four-month-old child should express milk every three hours, Walker said in the affidavit.

Walker also wrote that "a nursing mother will require a total of twenty-five (25) to thirty (30) minutes per pumping session in order to properly express her milk."

The NBME typically permits 45 minutes of break time that can be used at the tester’s discretion between the eight exam blocks making up the test.

The test normally takes one day, but because Currier has dyslexia and Attention Deficit Hyperactivity Disorder (ADHD), the NBME said it would allow her to take the exam over a two-day period.

The NBME only permits additional break time for disabilities covered by the Americans with Disabilities Act, which does not specifically protect breast-feeding mothers.

"Maintaining the integrity of the exam is vital, so that requires consistent testing conditions," NBME spokeswoman Carol Thomson said. "The board cannot make ad hoc, one-on-one decisions."

According to Currier, both the dean of the Medical School, Jeffrey S. Flier, and Harvard’s dean for medical education, Jules L. Dienstag, wrote letters in support of her suit. Flier did not return a request for comment last night.

Thomson added that the NBME has not ruled out changing its policies at some point in the future.

—Staff writer Clifford M. Marks can be reached at cmarks@fas.harvard.edu.