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There is an increase in medical students with long term conditions applying for accommodations in assessment. Medical school responses to such applications appear inconsistent, possibly reflecting insufficient guidance for policy. We aimed to inform an approach by developing guidance. Within a New Zealand and Australian context, we used a four-stage action research methodology: discussion with medical educators and survey of all 21 medical schools, including responding to 22 hypothetical scenarios; developing an approach; applying the approach to the hypothetical scenarios; and seeking feedback from stakeholders on the proposed approach. Current practice varied among the 13 responding medical schools. Medical schools were consistent in their responses for 10 hypothetical scenarios but inconsistent in 12. An approach based on a matrix of authenticity to practice, including regulatory and employment factors, and feasibility to educational institutions was developed. This was applied to the hypothetical scenarios and highlighted how consistency could be better achieved, and where further discussion between regulators and employers might be needed. This approach and the matrix based on authenticity and feasibility provides guidance to consider assessment accommodation applications. It highlights the need for discussions among regulators, employers, educational institutions and the disability sector.

Making accommodations for medical students’ long-term conditions in assessments: An action research guided approach