Minor Thoughts from me to you

Should nursing mothers get longer breaks on tests?

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.)

I don't know what's fair in this situation. Students have a strict time limit to take the test and consider their answers. Giving this mother extra time might give her an edge through extra time to consider answers or relax. Then again, is it fair to give up all chance of a career because of a welcome but ill-timed pregnancy. So, I don't know what the answer is.

I do know this. The National Board of Medical Examiners is the only organization that can license students to practice as doctors. The NBME has a state monopoly on licensing and accreditation. As long as they have this monopoly, no other licensing organization can offer tests with different rules or opportunities. Students are limited to the options offered by one, inflexible organization. Is this any way to run a healthcare system?

I'd like to see multiple, competing accreditation organizations. Students would be able to choose who to take test from. Employers would be able to choose who to accept licenses from. If one organization proved to be unfair or inflexible, both students and employers would have a choice to use someone else's services.

Wouldn't that be the more American way to run healthcare?