New request
Use this for your first request or for new or additional accommodations you have not had approved before. Include documents that support the new request.
Start here
You submit your request and documents through MyUSMLE after registering for the relevant Step exam.
1
Register for the exam
On your Step application, say that you plan to request accommodations. This places a hold on scheduling your exam.
2
Send the full request
Checking the box during registration does not submit your request. Log into MyUSMLE and upload the request and supporting documents.
3
Allow time for review
USMLE generally takes about 60 business days to review a complete file. An approaching exam date does not usually speed this up, so start early.
4
Schedule after the decision
After USMLE sends a decision, the scheduling hold is released and you can choose an exam date.
Which request type fits?
MyUSMLE has four paths. Choose the one that matches what you are asking for now.
Subsequent request
Use this only when you previously received USMLE accommodations and want the exact same ones again. New documentation is generally not required for this path.
Additional break time only
Use this when standard testing time works for you but you need extra breaks for a medical reason, such as diabetes care or lactation.
Reconsideration
Use this when your request was denied or partly approved. You can request one reconsideration for each active registration.
What do my documents need to show?
A diagnosis by itself usually does not explain why you need a particular accommodation. Your documents should connect your condition, what is hard for you during a long timed exam, and how the requested accommodation would help.
Think of it as a chain:
1. Condition or Disability2. ↳ Functional Limitation (What is actually impaired?)
3. ↳ Problem under standard testing conditions
4. ↳ How the requested accommodation addresses the problem
Depending on your situation and the current USMLE instructions, you may need:
- Personal statement: Your explanation of what happens during a long, timed exam.
- Professional documentation: A current evaluation from a qualified professional that explains your functional limits.
- Prior records: Records that are relevant and available, based on the current instructions and your history.
- CPTA form: A Certification of Prior Test Accommodations form completed by your medical school. You find it in MyUSMLE, have the school complete it, and upload it.
What accommodations might be available?
Options depend on your documented functional needs and the current USMLE process. Examples include:
- Additional testing time
- Additional break time
- Changes to the testing environment (e.g., separate room, reduced distraction)
- Assistive technology or accessibility modifications
- Permission for medically necessary items not on the pre-approved list
What about items I need during the exam?
Some medical and personal items are already allowed in the testing area without a separate request. Check the current USMLE pre-approved items list. If your item is not listed, follow the current USMLE/MyUSMLE instructions and get written authorization before exam day if required.
What if my request is denied or partly approved?
You can ask for reconsideration. Read the decision carefully and answer the reasons it gives rather than sending the same documents again.
- Write down the specific reasons in the decision.
- Provide new or clearer information that answers those reasons.
- Follow the portal instructions. Your registration must still be active.
Common things that cause problems
Explain the connection
- A diagnosis alone is not enough. Explain the specific testing barrier it creates for you.
- Connect every requested accommodation to that barrier.
- Make sure your documents tell the same basic story.
- If you ask for reconsideration, add information that addresses the decision.
Check the official information
MyUSMLE PortalSubmit your request hereUSMLE Test AccommodationsCurrent official guidanceMake a RequestOfficial documentation guidelinesNew Request Process UpdateAnnouncement of MyUSMLE transition
The official instructions control. Check USMLE before you submit a request because requirements and processes can change.