Community Update: Support for Pregnant and Nursing Mothers
September is the American Medical Associations’ Women in Medicine Month, which serves to showcase the accomplishments of women physicians as well as highlight advocacy related to women physicians and health issues impacting women patients.
We are proud to say that, since 2015, ABIM has been able to assist more than 500 women physicians seeking accommodations as nursing mothers. In 2019, we sought the advice of advocates for women’s health and gender equity to help us review our policies and practices related to expectant and new mothers taking our exams. Most importantly, our desire to remove unnecessary burden for nursing moms led us to convene a group of diplomates who helped us gain a deeper understanding of what is was like to be a new mom in medicine.
Women in medicine talked to us about their experiences.
We met with a group of women physicians via webinar in December to hear about their experiences being new mothers taking an ABIM exam at a Pearson VUE center. Some physicians had never spoken to anyone about their experience prior to the webinar. It hadn’t occurred to them that other women were also struggling with balancing 80+ hour weeks of training, starting a family and potentially moving to a new community for a training or job opportunity. All of this on top of the physical and emotional stress a body goes through during pregnancy and following childbirth.
“I thought, ‘Am I weak? Women have dealt with this for years.’ I didn’t have anyone to talk to about this.”
“All of our program directors and people in academia are men. It didn’t even occur to them.”
“It feels isolating, because we just don’t talk about it.”
Physicians shed light on what it’s like to be a new mother taking a 10-hour, secure exam. This ranged from the discomfort of lactating to the anxiety surrounding childcare. While a physician pointed out that the new longitudinal option for MOC (through which diplomates can answer questions from home, at your own pace, on a mobile device, etc.) would eliminate most of these issues, the group offered some suggestions to improve the experience for those taking an initial certification exam, and those in MOC who will still prefer to take an exam at a testing center in the future.
Feedback the community provided improved our policies, processes and the way we communicate with physicians.
One of the most important takeaways from our webinar and other feedback we received via email and on social media was that the way we communicate about this topic is crucial.
“I feel like that fact that we’re asking, that we ‘need accommodations’ is somehow implying that we’re weak… or incapable.”
“Even as I was filling [the accommodation request form] out, I didn’t know if I was the right person… I felt like I was taking away from someone with a physical or learning disability. I kept second-guessing myself.”
“It’s definitely not a disability, and that needs to be taken seriously.”
Making the availability of resources for pregnant and nursing mothers more visible during the exam registration process—in official email communications, on our public website and on your secure Physician Portal—was the first major step to increasing awareness among our diplomates.
Check out how those changes look below.
Any diplomate eligible to take an exam receives this email.
This is the email a diplomate receives after indicating that they’d like to learn more about accommodations during the registration process.
Sidebar Menu now includes Pregnant and Nursing Mother Accommodations.
Pregnant and Nursing Mother Accommodations has its own page with updated language, informed by the community.
If you find yourself at the ADA Accommodations page, there is a call-out box to direct you to the appropriate place.
When first registering for a Certification Exam, registrants will learn about accommodations availability from the start page.
A registrant will respond to a question regarding whether they would like to learn more about how to request an accommodation.
For a physician who is already certified, this notification will appear in the “My Assessments & Certifications” tab whether you have an assessment due or not. It serves as a constant reminder, that resources are available to our community of internists.
Being a mother shouldn’t be a barrier to being board certified. So, we’re looking at our policy & processes to see where we can make improvements.
It’s important to us that nursing mothers be provided with clean, private spaces while taking our exams. To reiterate current policy, upon submission of the required documentation within the deadlines shown on ABIM.org, nursing mothers will have access to:
- 60 minutes of additional break time added to the standard pool of scheduled break time found in the specific exam (for a total of 160 minutes over 3 scheduled breaks), and
- a private space with an electrical outlet, that is not a restroom, for lactation
We will work directly with you to locate the best, most convenient option for you. We understand that being a nursing mother is already physically and mentally taxing enough and remain committed to working with you to improve your experience.
Additionally, ABIM will work with pregnant women on an individual basis to determine the best timing or comfort accommodation. We understand that your needs may vary, for example, if you’re 8 weeks pregnant and are getting morning sickness versus if you’re 8 months pregnant and need additional bathroom breaks. Simply contact accommodations@abim.org and our Special Exams Coordinator will provide any available options for your unique circumstance.
Advocating with our partners.
Last year, we initiated conversations with Pearson VUE about outfitting more of their test centers to provide appropriate space for all nursing mothers, no matter what exam they are taking.
Pearson VUE now provides private space for nursing mothers to express milk within their company-owned testing centers across the US as a standard space. Since these spaces are available on a ‘first-come, first-serve’ basis, ABIM’s accommodations process remains the best option for examinees to guarantee a space and request additional time for breaks within their specific exam.
In addition, Pearson VUE is working on streamlining the process online for nursing mothers who request more time or extra breaks via the accommodations process in effort to shorten timelines.
Unfortunately, COVID-19 continues to impact test center capacity and operations, such as limiting space and availability at some test centers, but Pearson VUE is optimizing its test center availability wherever possible – and always does so within the latest health and safety guidelines.
Pearson VUE has made it clear that they are committed to working with us to continue making improvements, and we’ll update the community on additional progress moving forward.
Your voice matters.
Thank you to those who gave your time and shared your experiences with us. We aren’t just working for more family-friendly policies in assessment but also for the voices of women physicians to be heard, to feel empowered to speak on your own behalf and on behalf of others like you.
Together, we can move health care forward.
