Mixed feelings. I felt that the more "specialized" modules (I took GU and heme) were fair. A couple of harder or confusing questions but in the context of 25 that is ok I guess. My big issue is with the "general" modules. Instead of asking a lot of basic questions about things, it seemed to somewhat randomly pick some challenging or confusing questions out of pretty strongly specialized areas. While the ABP gave you a list of the question topics beforehand, some of them are ridiculously vague (like "breast cancer" or "malnutrition"). And then it puts questions on there that are more the perview of subspecialized pathologists (like non-standard questions on breast or GI path, and a difficult skin lesion). As an example, the general module had three GU questions on it. All 3 of them were harder than anything on the GU module. And of those three, one was basically asking for a "diagnosis" but most of the answer options were not actually diagnoses. And another was a horribly blurry image. I am not sure how they are picking these questions, but I get the sense they are asking specialists to write lots of questions, then asking them to rank them, and picking out the ones that the specialists say are OK for a general exam. In some cases that worked, but in others it's just really random. You can't put a topic like "breast cancer" on there and then provide questions that are basically pulling one sentence out of a random spot in the middle of the WHO book on epidemiology. Do they realize that generalists don't really ever see pap smears? Don't you think that if you're asking a generalist about a pap smear it should be something that is common knowledge?
So I was pretty disappointed. I suspect I passed but it was far from the "straightforward exam" that they were promising. Like I said, the more specialized modules that you can choose from were much more representative of daily practice.