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Tue 11 Sep, 2007 07:38 pm
September 10, 2007
Nursing Mother Goes to Court for Exam Time
By ELIZABETH OLSON
One test stands between Sophie Currier and her Harvard medical degree and a prestigious residency.
But Ms. Currier says she runs a high risk of failing the test unless the National Board of Medical Examiners gives her additional break time to pump breast milk for her 4-month-old daughter.
The board has refused the request, and on Thursday, Ms. Currier asked a Massachusetts Superior Court judge to order it to give her extra time on each of two days of testing, plus a private room with a power outlet so she can express her milk in private with an electric pump. (The nine-hour exam, on clinical knowledge, allows 45 minutes for breaks.)
The case, to be heard on Wednesday, is a harbinger of what could be a growing problem. More women than ever are studying medicine, and they must take three exams to become doctors. At the same time, groups like the American Academy of Pediatrics strongly encourage breast-feeding for its health and developmental benefits.
Ms. Currier, 33, of Brookline, Mass., wrote to the medical examiners' board in June to request the extra time, saying she needed to pump milk to avoid painful breast engorgement and mastitis, an infection stemming from blocked milk ducts.
In a letter dated July 11, Catherine Farmer, the board's manager of disability services, responded that it could accommodate only conditions covered by the Americans With Disabilities Act. She added that Ms. Currier could spend some of her break time pumping breast milk in another testing room. Testing rooms are monitored and have glass walls.
Ms. Farmer said on Friday that the board's privacy policy prohibited it from commenting on individual cases.
Ms. Currier, who holds a doctorate in neuroscience from Harvard, has received some accommodation from the board for dyslexia and attention deficit hyperactivity disorder. She can take the nine-hour test over two days instead of one, but she is seeking an additional 60-minute break on each day.
Dr. Alison Stuebe, a physician at Brigham and Women's Hospital in Boston and a member of the Academy of Breastfeeding Medicine, supported Ms. Currier's request in an affidavit filed with the court.
"Forty-five minutes," Dr. Stuebe wrote, "is insufficient time for a nursing mother of a 4-month-old to eat, drink, use the restroom and to fully and properly express breast milk using an electric pump two times over the course of eight hours."
If Ms. Currier is forced to delay taking the exam, "it will cause her significant hardship" by delaying her ability to earn a living and to begin repaying school loans, and possibly leading to the loss of clinical knowledge and skills, Dr. Stuebe said.
Ms. Currier said she was already feeling pressure because she took the test in April, when she was eight months' pregnant, and failed it by a few points. She has been offered a residency in clinical pathology at Massachusetts General Hospital in November, but cannot accept it unless she passes this test, which she plans to take on Sept. 15.
"This should be as simple as ducking into the bathroom to pump the milk," said Ms. Currier, who is feeding her daughter breast milk exclusively.
NYTimes
The Breastfeeding Promotion Act, pending in Congress, would protect women from being fired or punished for pumping or nursing during breaks.
Something wrong with this candidate:
1. She had 2 kids in 2 years while an MD-PhD student
2. She has attention deficit hyperactivity disorder
3. She has dyslexia
4. She failed the board exam in April, while 8 months pregnant
5. Wants to enter a residency in clinical pathology but also
wants a research career.
If she wants to do research, why did she go to medical school
and moreover, why undergo a residency in clinical pathology?
Is mother's milk really the most nutritious, or is this just a fad? I thought goat's milk is superior to cow's milk, but there are more cows than goats around.
What ever happened to the older custom to have a wet nurse? And, what about the old expression: You can't dance at two weddings at the same time.
Regardless, if nursing mothers will have a law to allow them to nurse at work, then only big corporations/organizations will assuredly be able to comply with the needed "nursing accomodations", or even additional staffing (bus driver for example), I believe. Smaller companies that couldn't afford to have those accomodations and or additional staffing might then try to maintain a workforce that won't need "nursing accomodations"?
I think this will be challenged in the courts, since many states, I thought, have laws that allow hiring and firing at will. So, if a business deems that "nursing breaks" prevent a mother from doing her job duties, the business could say she is not doing her job effectively and therefore she and baby can start looking for work.
I'll easily grant the mother's milk is important. I'm not clear that it can't be saved in the evening after the exam day. (Perhaps people will inform me, one way or the other.) When I took my 3.5 days of boards (not in medicine, but, so what) they were ordinary hour days in the exam room, albeit stressful.
Well, let's say I don't know re how this should be ruled, and will listen re opinions. I'm thinking I don't agree with her, but I don't know enough to argue well.
One problem with going that long though is engorgement. I had long meetings downtown about once a month when sozlet was an infant, and the train ride home was excruciating. If I'd had to go an hour or two longer I'm not sure I would've been able to stand it. (The total was about 6 hours from when I pumped before leaving -- to give her something to drink when I was gone -- until I walked in the door to a hungry baby.)
It also gets plain dangerous at that point. I forget all of the problems, something about duct infections or something.
That is, it can be less about nourishment for the baby than about relieving engorgement.
Oops, just re-read and it says exactly that:
Quote:Ms. Currier, 33, of Brookline, Mass., wrote to the medical examiners' board in June to request the extra time, saying she needed to pump milk to avoid painful breast engorgement and mastitis, an infection stemming from blocked milk ducts.
As in, the article's earlier characterization of the problem as being that she wanted extra break time to "pump breast milk for her 4-month-old daughter" isn't necessarily accurate -- she may dispose of the milk once it's out, but she needs to get it
out. (4-month-old baby, ouch -- small enough that they're exclusively breasfeeding and breastfeeding often, but big enough that they're causing a LOT of milk to be produced.)
Thanks, sozobe, that all makes sense then.
Quote:Is mother's milk really the most nutritious, or is this just a fad? I thought goat's milk is superior to cow's milk, but there are more cows than goats around.
Every species of mammal produces milk designed to feed the young of that species.
This ADD nursing mother seems to need a great many special considerations.
ossobuco wrote:I'll easily grant the mother's milk is important. I'm not clear that it can't be saved in the evening after the exam day. (Perhaps people will inform me, one way or the other.) When I took my 3.5 days of boards (not in medicine, but, so what) they were ordinary hour days in the exam room, albeit stressful.
Well, let's say I don't know re how this should be ruled, and will listen re opinions. I'm thinking I don't agree with her, but I don't know enough to argue well.
My written PhD exam was 8 hours, all day ( in one little room ) and the minors was 4 hours long. Th language exams were 3-4 hr long.
The first oral exam ( all topics ) was 3 hours and the 2nd oral ( defense of thesis was also 3 hr long ).
Quote:mastitis, an infection stemming from blocked milk ducts
Mastitis is more common in cows than in humans. I doubt that mastitis is acuired over a period of a few hours, unless the milk ducts were already infected with microbes.
sozobe wrote:One problem with going that long though is engorgement. I had long meetings downtown about once a month when sozlet was an infant, and the train ride home was excruciating. If I'd had to go an hour or two longer I'm not sure I would've been able to stand it. (The total was about 6 hours from when I pumped before leaving -- to give her something to drink when I was gone -- until I walked in the door to a hungry baby.)
It also gets plain dangerous at that point. I forget all of the problems, something about duct infections or something.
That is, it can be less about nourishment for the baby than about relieving engorgement.
Oops, just re-read and it says exactly that:
Quote:Ms. Currier, 33, of Brookline, Mass., wrote to the medical examiners' board in June to request the extra time, saying she needed to pump milk to avoid painful breast engorgement and mastitis, an infection stemming from blocked milk ducts.
As in, the article's earlier characterization of the problem as being that she wanted extra break time to "pump breast milk for her 4-month-old daughter" isn't necessarily accurate -- she may dispose of the milk once it's out, but she needs to get it
out. (4-month-old baby, ouch -- small enough that they're exclusively breasfeeding and breastfeeding often, but big enough that they're causing a LOT of milk to be produced.)
I wonder what this woman would do, if she were a surgical resident and her breasts were filled with milk?
I meant 8 hours for regular days... or, maybe 7, it's been a while. So, something like 24 + hours in four days time (for us, the orals were after the written boards were passed). I can see that all the pumping time plus the board exams themselves would leave one really stretched. Unless one would finish a given part of the boards early..
I don't know, without googleing, or rereading the article if it says, how long med boards are.
Let's say I'm much more sympathetic after sozobe's explanation than when I first read your story link.
She isn't the first, nor will she be the last woman MD who's had a baby and who's also taking the boards.
She made her bed...
Well, I can see they only have one set time for the different sections of the board. At least ours were rigorously monitored for cheating attempts, and I presume med boards are. Making all the other test takers take a long lunch break would be pretty nerve racking on the others.
I cant remember now about bathroom breaks; I think we had them individually allowed.
Court just ruled, she doesn't get extra time.
Miller wrote:Court just ruled, she doesn't get extra time.
She shuda gotten the extra time.
Y not ??
This whole thing is just getting silly at this point.
Quote:Court: Breast-Feeding Mom Gets More Time For Test
Woman Wanted Extra Break Time To Pump Milk
POSTED: 1:15 pm EDT September 26, 2007
UPDATED: 4:30 pm EDT September 26, 2007
BOSTON -- A Harvard student must be allowed extra break time during her nine-hour medical licensing exam so she can pump breast milk to feed her 4-month-old daughter, a Massachusetts Appeals Court judge ruled Wednesday.
Sophie Currier, 33, sued after the National Board of Medical Examiners turned down her request to take more than the standard 45 minutes in breaks during the exam. She said she risks medical complications, including engorgement and inflammation, if she does not nurse her daughter, Lea, or pump breast milk every two to three hours.
A Superior Court judge last week rejected Currier's request to order the board to give her an additional 60 minutes of break time. Appeals Court Judge Gary Katzmann overturned that ruling, finding that Currier needs the extra break time to put her on "equal footing" with the men and non-lactating women who take the exam.
The board had cited the need to be consistent in the amount of break time given and said other nursing mothers who have taken the exam have found 45 minutes in breaks adequate.
But Katzmann said that amount of time was "insufficient" for Currier to nurse her baby, properly express breast milk, eat, drink and use the restroom over the course of the nine-hour exam.
Without extra break time, Currier would have to choose between pumping breast milk and ignoring her bodily functions or foregoing pumping and causing herself significant pain, the judge said.
"Under either avenue, (Currier) is placed at significant disadvantage in comparison to her peers," Katzmann wrote in his 26-page ruling.
Currier, of Brookline, plans to take the exam on Oct. 4 and 5.
"I think it's a big step for women, all nursing and working moms," Currier said. "I think it's a very important decision globally because it suggests that any woman who is nursing their child may need different accommodations because of the need to express milk and that that accommodation should be granted in order to put her on an even playing field with men and non-lactating women."
The board plans to appeal, said board attorney Joseph Savage.
"The board of medicine has to be able to rely on the results of these tests in determining whether someone is qualified to be a physician," Savage said. "If the tests aren't fair and comparable, the boards don't have the information they need to only license doctors who are properly trained."
The board, a Philadelphia-based nonprofit corporation, is responsible for administering the test, which is used by boards of medicine across the country to license physicians.
Currier, who also has a 22-month-old son, already has received special accommodations under the Americans with Disabilities Act for dyslexia and attention deficit hyperactivity disorder, including permission to take the test over two days instead of one. The board also offered Currier a separate testing room where she can express milk during the test or during break time, and the option to leave the test center to breast-feed during break times.
Brady had said Currier had other options beyond asking the board to change its rules for her, including taking the test under what she considers unfavorable conditions or delaying the test until her daughter no longer needed to be breast-fed.
But Katzmann said forcing Currier to put off the test was unfair and discriminatory.
"Requiring the petitioner to delay testing until her child reaches an age where breast feeding or the continued expression of milk is unnecessary unfairly impinges on the petitioner's opportunity to pursue her medical career in conjunction with the rearing of her child," Katzmann said.
Federal anti-discrimination laws do not protect nursing mothers. The Breast-feeding Promotion Act, pending in Congress, would protect women from being fired or punished for pumping or nursing during breaks.
I'm no medical expert but they had already split the 9 hour test into 2 2.5 hour days for her with 45 minute breaks during those days. I've looked at 3 or 4 reputable medical WWW sites and they all say 10-20 minutes to use the breast pump (per breast) and there are pumps that work on both breasts at the same time.
Is there something that prevents her from eating and/or drinking while pumping?
And now the board is going to appeal this ruling? Yeash!
fishin wrote:Is there something that prevents her from eating and/or drinking while pumping?
Lack of hands, mostly. I'll spare you the gory details, but no, you can't really do anything else while pumping.
I think there is a core case that is interesting and valid but something about this woman's approach makes me a bit... wary, maybe.
sozobe wrote:fishin wrote:Is there something that prevents her from eating and/or drinking while pumping?
Lack of hands, mostly. I'll spare you the gory details, but no, you can't really do anything else while pumping.
lol Ok! Thank you for filling that blank in. None of the stories being carried on it seem to mention that one way or the other.
She's on a crusade of sorts over all of this and I'm not convinced it is a valid one so far.
I heard her on a local talk show last week and one of the comments she made was that she had to take the test in October because she has a job offer pending and because of that, she has patients depending on her. (I find it hard to beleive that there are any patients depending on someone they've never met or even heard of before.) The 30 minutes she was on was pretty brutal.
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