Public Health and Equity: The Current Landscape and Opportunities in Lactation Accommodations in Professional Testing
By Sara Blair Lake, JD, CAE, Tom Granatir
Demand for professional testing accommodations for lactation, including allowance for space, time and privacy has been increasing.1 At the conclusion of the first article in this series published on Credentialing Insights in February 2022, I.C.E. took an informal poll of the professional credentialing community to gain a better understanding of where things currently stand in the industry.
While the survey respondents constitute a relatively small sample size (n=58), the data gathered yield insight into the current status of lactation accommodations for professional test takers, as well as areas of potential opportunity.
Most of the respondents were from certification bodies (69%), 14% from examination vendors, 3% from regulatory/licensure bodies and 14% who selected “Other,” indicating they were psychometricians, other consultants, or were affiliated with professional or trade associations.
The data indicated that primary accommodations offered included time allowed between examination portions (40% of respondents), access to a private room with an electrical outlet which was also used for medical accommodations (31%), access to the child for lactation between examination portions (23%), access to pump/milk expression between examination segments (23%) and access to a dedicated lactation room with an electrical outlet (19%).* Other responses included time for lactation being provided before the examination, during orientation and additional examination time being provided.
A full 50% of respondents indicated that their organization had no specific policies addressing lactation, but as previously noted, 14% of respondents identified as “Other” with several indicating they were psychometricians. Additionally, a full one-third of respondents indicated that they did not have policies/procedures regarding lactation accommodations on their website.
Yet even when credentialing organizations have strong lactation accommodation policies in place, candidates report that some testing centers do not fulfill requests for recommended accommodations. Some physician and other certification boards have shared with American Board of Medical Specialties (ABMS) staff that the availability of appropriate accommodations (private rooms with electrical outlets and access to running water) can be problematic when testing organizations subcontract to local testing sites that are not equipped to provide the privacy and resources that lactation accommodations require. A 2016 publicly accessible document from the American Institute for Architects (AIA) regarding lactation/wellness room design provides a wealth of best practices, including recommendations for privacy considerations, chairs, tables, sinks, lighting and HVAC, and accessories, as well as renderings and diagrams.2 While the focus in this reference is on best practices for lactation rooms in the employment setting, it provides significant food for thought for the testing industry.
While a relatively small sample, these data indicate that the professional testing industry and credentialing community have an opportunity a) to advance public health and equity more fully and b) to enhance candidate experience and satisfaction, by following through on lactation accommodations. Development of strong lactation accommodation policies that facilitate consistent access to space, time and privacy, along with advocacy efforts to ensure that these policies are fully implemented, are necessary to provide an equitable testing experience for all candidates.
*Respondents were able to select multiple choices so the total does not equal 100%.
- Nead KT, Hinkston CL, Linos E, Giordano SH, Wehner MR. American Board of Medical Specialties Board Examination Lactation Accommodation Policies. JAMA Intern Med. 2021 Oct 1;181(10):1397-1399. doi: 10.1001/jamainternmed.2021.2536.
- American Institute of Architects. Lactation/Wellness Room Design. http://www.cphi.upenn.edu/assets/user-content/documents/0908_Lactation%20Room_English.pdf