The Breast-Feeding Medical Student Test-Taking Debate

One piece of clarification: Ms. Currier is not asking for extra time so that she can breast-feed her child; she wants to be able to express her breast milk to prevent engorgement. The controversy is not about whether breast-feeding is best for the child but rather whether the extent of her accommodations invalidate the test.

Furthermore, it's not just "a few minutes of extra time." The USMLE licensing exam is an 8 hour test with up to 60 minutes of break time to be taken as the test-taker wishes. If a test taker finishes a section early, he or she may add that time to the remaining break time. Moreover, the exam is offered every day year-round; Ms. Currier previously chose to take it when 8.5 months pregnant, failed, and had to be hospitalized.

Due to her ADHD, Ms. Currier will be taking it in a private testing room over 2 days, each with 60 minutes of break. She is suing for an extra 60 minutes on each day. In essence, she will be taking an 8 hour test with 4 hours of break, whereas all other students (breast-feeding or not) get only 1. The judge must consider whether this is fair to other medical students.

It is not surprising that so many women have weighed in against Ms. Currier. She has done more to hurt women's rights since Phyllis Schlafly.

I disagree with Caroline - it seems that plenty of women are unhappy with this ruling - several of whom are doctors and/or mothers. See, for example, the comments on the Wall Street Journal site:

http://blogs.wsj.com/health/2007/09/26/breastfeeding-med-student-gets-extra-time-on-test/

and

http://blogs.wsj.com/law/2007/09/26/judge-grants-breastfeeding-med-student-extra-time/

I've been following this story for several weeks now, including numerous sites with a provision for comments. It's my sense that far more women than men have weighed in during this time, many - including health professionals - with an unfortunate "if I had to suffer, so does she" attitude.

This story is less about a woman who failed to "make other choices available to her" - including feeding her child a pediatric fast-food based on the milk of an alien species - than it is about what is normal feeding behavior for the young of our species and how an entire society needs to contribute to its becoming ho-hum ordinary once again.



Appeals court Judge Katzmann cut to the heart of the matter, thereby demonstrating he understood the core issue: the few minutes of extra time were granted to place the appellant on an equal footing with the men and non-lactating women who take the exam. Breastfeeding is not a disability, and thus it should not be confused or compared with the provision made earlier for the candidate to accommodate her attention deficit disorder.



To borrow from a recent Slate article, I don’t see any of this as a manifestation of “stay-at-home moms … engaged in an apocalyptic battle with working moms”. Rather it’s a sign that the larger society, at war with itself, has not yet conclusively understood the health implications for women, children and thus the whole population across the entire life course of more or less breastfeeding; and the monumental impudence and fundamental folly of trying to pull a fast one on Mother Nature by routinely deviating from the biological norm for feeding the young of our species.

Sure, only women breastfeed, but being consistent with who and what we are as a species should also be understood as a "guy thing", including whether we were breastfeed (though we can't do anything about that now) and ensuring that our children most definitely are (men have a key role to play here, too).

Making breastfeeding the obvious choice and supporting it at every step does indeed have consequences, both immediate and longer term - significantly healthier children and women now and across the entire life course. That's something positive for humankind that we should all be able to support.

James Akre

Geneva, Switzerland