Canadian Royal College Anatomic Pathology Exam

[canpath]

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Since some people showed interest in knowing more about this exam I thought I'd share my experience. I took it a few weeks ago and got a passing grade. We don't get actual grades though, it's just pass or fail. The pass rate for 2006-2009 is 86.5% (+/- 7% [SD]) for first-attempt candidates who completed the majority of their residency in Canada. Anatomic pathology residency in Canada is 1 year internal medicine/surgery clinical internship + 4 years AP (1 year of which being flexible, i.e. research, more AP or more clinical rotations). Evaluating the level of difficulty of an exam can't be judged solely by the pass rate though. And, unfortunately, rates for candidates trained out of the country are not published. I will take the ABP AP only exam later this month and will be sure to post my take on how they compare.

Given on two days the Royal College exam has 3 sections: written, practical and oral.

Written:

- 3 hours
- 28 topics with 3-4 subquestions in each
- all are short answer (from one word to 1 or 2 sentences)
- topics go from Robbins first chapters on general pathology (including very recent molecular biology stuff from most recent edition) to more practical stuff like what you find in CAP protocols, Bethesda cytology books and immunohistochemistry and quality assurance handbooks.
- a lot of emphasis is put on clinical knowledge, i.e. signs and symptoms, complications, treatment and prognosis, etc.
- many questions ask for lists of 5-6 elements which can be quite demanding.

- here's a few examples of questions:

• Vascular liver disease: list 3 classical signs of Budd-Chiari syndrome, 6 causes of hepatic vein thrombosis, and give the most common etiology of veno-occlusive disease.

• Lead intoxication: list 3 occupations with increased risk, give most frequent way of entry, give one clinical or histopathologic finding in each of: <link rel="File-List" href="file:///C:%5CUsers%5Cbellez%5CAppData%5CLocal%5CTemp%5Cmsohtmlclip1%5C01%5Cclip_filelist.xml"><link rel="themeData" href="file:///C:%5CUsers%5Cbellez%5CAppData%5CLocal%5CTemp%5Cmsohtmlclip1%5C01%5Cclip_themedata.thmx"><link rel="colorSchemeMapping" href="file:///C:%5CUsers%5Cbellez%5CAppData%5CLocal%5CTemp%5Cmsohtmlclip1%5C01%5Cclip_colorschememapping.xml">nervous system, gengiva, blood, kidneys, long bones.

• ER/PR in breast: list 3 pre- or post-analytic elements that could be verified in a QA program / accreditation review. List 4 analytic factors that can affect the intensity of staining. Give a reason why a clinician would ask you to do ER testing on a DCIS specimen. According to CAP/ASCO 2010 guidelines, what is the threshold of positivity for ER immunohistochemical testing.

• Fibromatosis: list 3 ddx of intra-abdominal fibromatosis. Give one positive immuno in fibromatosis (specifying the type of staining.) Name the syndrome. Give 4 more tumors associated with the syndrome.

• p53 and miRNA: give 2 ways p53 affects the cell cycle. describe the interaction between p53 and the mi34 family of miRNA. Name the syndrome associated with a germinal mutation of p53.

• Thyroid carcinoma: name 2 molecular markers of papillary thyroid carcinoma. Name the recommended treatment for a follicular neoplasm on cytology according to the Bethesda system. Name 2 benign ddx of papillary thyroid carcinoma on cytology.

Practical:

- quick microscope slides section (2 hours)

• 50 slides
• age and organ given
• short answer format: give the most likely diagnosis
• examples: glomus tumor, amyloidoma, amebiasis, hydatid cyst, chorangioma, angiofibroma, granulomatous prostatitis, oligodendroglioma, vulvar Paget, etc.

- cytology computer images (1 hour)

• 20 cases (1-3 images/case)
• age and organ given
• short answer format: give the most likely diagnosis
• examples: Warthin, LSIL, SCLC, lung carcinoid, metastatic adenocarcinoma in liver or pleural fluid, lactation adenoma, tricho, decoy cells, one esoteric soft tissue FNA, etc.

- gross pathology computer images (1 hour)

• 20 cases (1-3 images/case)
• specific questions asked (1-3/case)
• short answer format
• examples: image of fetus with cystic hygroma (give diagnosis and most common cause), mitral valve myxoid degeneration, osteosarcoma, placental infarcts, pdeudomembranous colitis, tesiticular tumor, etc.

- Forensic / autopsy pathology computer images (1 hour)

• 20 cases (1-3 images/case)
• specific questions asked (1-3/case)
• short answer format
• examples: images with various blunt force injuries (name all types of lesion present), image of cloudy CSF fluid being drawn (name 1 other gross finding, what 2 lab tests would you order), atypical entrance wound (give direction of bullet, etc.), incidental finding of a white peripheral lung lesion during autopsy (what do you do?), picture of massive hemoperitoneum (2 most common cause?), burn victim artefacts, etc.

Oral:

- next day
- 50 minutes to review 5 cases (10 minutes/case)
- one of the 5 cases can be cytology
- 1 slide/case for surgical pathology. 2 slides/case for cytology.
- cases are rarely straightforward and usually need ancillary studies to be fully resolved.
- 1 hour oral exam with 2 examiners
- typically, for each case, they could initially ask:

• a short microscopic description
• what you would put in your diagnosis heading
• critical elements to put in the report
• limited sets of most useful immunos
• list of differentials

- and start to digress on:

• clinical signs and symptoms
• prognosis
• expected EM findings, translocations, etc.
• what you tell the surgeon who asks what he should do with a specific specimen (e.g. infective endocarditis)
• what you recommend the surgeon to do if a margin is positive for a preneoplastic lesion (e.g. PanIN 3)
• what's your protocol for liver biopsies? sentinel nodes?
• how do you troubleshoot immunos/special stains?
• what do you do when you suspect a specimen mixup? a floater?
• what do you do if a resident is injured with a needle during an autopsy? Specific precautions for specific infectious agent, etc.

- they certainly evaluate your AP eye and knowledge, but mostly they evaluate how mature you are in solving day to day problems with your own cases and with technicians, surgeons, clinicians, administrators, residents, other pathologists, etc. Very in tune with the "future of pathology" / "physician actively involved on the patient care team" kind of stuff you hear from the CAP.

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At most 10-20% of the topics come back every year, but exact questions are never the same. About 30% of the cytology images and 20% of the quick microscope slides also come back.

Residents usually get 6-8 weeks off-duty to study before the exam, depending on where they train (using vacation/study/sick days pooled together).

Results are given on the web between 1-5 business days after the exam.

Certificate is valid for life with no need to recertify after 10 years. However, you need to pay your dues of around 1000$/year and follow a CME program.

More info on http://rcpsc.medical.org/

 

[Patho2009]

Since you have passed the Royal College exam, I am pretty sure you will pass the American Board. ABP exam is much easier than the Canadian one.

I took my ABP exam last year and then took the Royal College exam last month (May 2010) and I passed both. I found the Royal College exam, however, much more difficult and more "traumatic". The key of success of either one is to know how to approach the exam. While the Royal College mainly measures your ability of memorizing and lising things in wiritng as well as formulating your diagnoses, the ABP exam measures your unerstanding of concepts and criteria by testing your ability of selecting the best answer among other wrong ones. Doing some MCQs and going over the high yield topics (mainly of the RISE) is very important for the ABP exam.

 

[KCShaw]

The RC exam certainly "sounds" more painful, simply by having to come up with your own answer rather than choosing from a list which you know includes the correct answer. The former seems much more in line with a college course where everyone has been exposed to the same information, rather than when everyone has probably been taught slightly different things by different people at different institutions over several years. I just don't think I've heard of it (except for the oral component) in a national/board type exam setting in the last 20 years or so. Not that I would really know such things, heh.

 

[canpath]

The former seems much more in line with a college course where everyone has been exposed to the same information, rather than when everyone has probably been taught slightly different things by different people at different institutions over several years.

Quite the opposite, I would tend to think that short answer is more tolerant than MCQs for variations in training and divergent views on controversial topics. (as long as exam correctors are open minded!)

And although there's only roughly 30-40 new spots opening in AP every year in Canada (for a population of 32 million), teaching is (scaringly) very different from one place to the next.

Anyone knows about the British MRCPath? I heard it is the most difficult exam on the planet.. I think they have you do an autopsy and frozen sections in front of examiners.

 

[KCShaw]

(as long as exam correctors are open minded!)

I think that's pretty key. But unless the same single examiner is grading these every year, and even so, there's going to be subtle (but sometimes important) variations in scores even with the same answers. I just don't think the style is practical/well suited for exams in which there are large numbers of test takers. Point taken, though -- I vaguely recall a few questions on the ABP exam that I really thought were debateable among a couple of answers either by way of disagreement among practicing experts or lack of what I viewed as good evidence, while clearly whoever submitted that MCQ felt there was a definite "right" answer. In an oral exam or longish short-answer format perhaps one can better get across what they know or don't know. Personally though, I'll take multiple-guess over short-answer format pretty much any time.

 

[zao275]

Anyone knows about the British MRCPath? I heard it is the most difficult exam on the planet.. I think they have you do an autopsy and frozen sections in front of examiners.

I heard a rumor that you had to do the autopsy while wearing a white coat and could not get it bloody. Hard to believe, but even as a rumor it was enough to scare me!

 

[KCShaw]

Briefly perused the British RCPath website, and though I didn't get into the details it does indeed look like there's a day for autopsy pathology (including performing an autopsy in the morning, then writing it up specifically by hand), though I didn't see anything about a white coat. Then a separate exam to include general surg path, reading frozen sections, etc. Sounds like a pretty hefty oral component to them.

Also sounds like the autopsy component will eventually be phased out in favor of documenting autopsy experience during training via a logbook, somewhat akin to how ABPath does it.

 

[Gorlum]

I heard a rumor that you had to do the autopsy while wearing a white coat and could not get it bloody. Hard to believe, but even as a rumor it was enough to scare me!

No white coat but you have to complete it in 3 hrs and you do an entire evisceration. Writing by hand is ok cause most forensic places do write by hand - you'll be amazed how fast you can do it after a month.

 

[Gorlum]

Canpath, thanks for the detailed report! It didn't cheer me up though🙂. I took AP yesterday, and it wasn't difficult - I did all slides/images/q-s twice and still had time. But Royal College exam looks horrific in spite of the fact that I'm got used to manual writing and oral tests
Is the any lab management included in the Royal College AP? If yes, what source will you recommend for an american trained path resident? Thanks again!
PS. I took a practical part of CP as well - on a break now. Again, not so bad although there were q-s, which puzzled me🙂.

 

[canpath]

any lab management included in the Royal College AP? If yes, what source will you recommend for an american trained path resident?

No questions on regulation such as those on CLIA etc. that you get in the RISE exam. The only lab management questions you would get are in the oral, where they could ask very general stuff like: Your hospital chief executive tells you you spend too much money in your lab, what do you tell him? (seriously, I was asked this!!)

Basically, they want to know how you interact with the administration and hospital colleagues in general (rather than how well you know specific rules and regulations...)

The only specific Canadian thing that I think you might need to know are the guidelines for cytology that differ a bit from what is going on in the US. You can find some useful stuff there: http://cap-acp.org/cytology.cfm

 

[Gorlum]

The only specific Canadian thing that I think you might need to know are the guidelines for cytology that differ a bit from what is going on in the US. You can find some useful stuff there: http://cap-acp.org/cytology.cfm

Thanks a lot! This web-site has a guidelines for medicolegal autopsies in Canada - another aspect I was interested in. Any bone marrow biopsies on slide portion? The was one virtual slide on the AP part this Monday - not difficult but unusual to see on exam. To what extend is hemepath represented? Do they really count spelling mistakes as my Canadian buddy (GP) was telling me? He told that my Americanized writing ain't gonna fly and will be counted against me. I think I can convert back to British (I was taught it at school) but it's quicker to write "edema" rather than "oedema"🙂. Thanks again!

 

[Patho2009]

Any bone marrow biopsies on slide portion? No.

To what extend is hemepath represented? You will get hempath Qs but not that many (one written Q and one or two lymphoma slides on the glass slide portion)

Do they really count spelling mistakes as my Canadian buddy (GP) was telling me? They don't "count" spelling mistakes. I did some spelling mistakes and didn't affect me.


He told that my Americanized writing ain't gonna fly and will be counted against me. I think I can convert back to British (I was taught it at school) but it's quicker to write "edema" rather than "oedema"

I wrote in the Americanized English (as I am US trained) and I passed. Therefore, they do accept either way, British or Americanized. However, my advice is to try to stick to the Americanized English.

 

[canpath]

Any bone marrow biopsies on slide portion? No.

Honestly, you can get pretty much anything... and bone marrow have come up in the past.

Rapid slides a pretty straightforward though, so if you do get a bone marrow in this section it will be a spot diagnosis.

If ever you get a bone marrow biopsy for the oral section the diagnosis itself wouldn't be worth much points anyway.. those slides are really just an excuse to start a discussion (that ends up having a much wider scope than you could ever expect!).

Really, though, don't be too worried about having to master any sub-specialty material in great detail... it is a general anatomic pathology exam.

 

[Gorlum]

Thanks, Canpath and Path2009! I have more questions (I hope it's the last bunch🙂
- are there any molecular questions? How "Invader" works or something similar? I know it's not AP but I read somewhere that they ask molecular as a "related" area.
-To Path2009: how did you deal with bringing a scope? Did you get a special permission to get it on a plane? Did it survive transportation well? I know that most programs in Canada arrange the scopes for their takers but I will have to borrow one somewhere.
- do remembrances really help as my GP friend says? He gave me a bunch from GP exams, but they were mostly CP...
Thanks!!

 

[greennature]

Canpath, thanks for the detailed report! It didn't cheer me up though🙂. I took AP yesterday, and it wasn't difficult - I did all slides/images/q-s twice and still had time. But Royal College exam looks horrific in spite of the fact that I'm got used to manual writing and oral tests
Is the any lab management included in the Royal College AP? If yes, what source will you recommend for an american trained path resident? Thanks again!
PS. I took a practical part of CP as well - on a break now. Again, not so bad although there were q-s, which puzzled me🙂.

It was not that easy for me, especially the CP part 🙁

 

[Gorlum]

It was not that easy for me, especially the CP part 🙁

It doesn't matter as long as you've passed both! I feel that I did good on both parts and I didn't struggle with CP (coag q-s were numerous and easy to my delight, and so was micro, and heme wasn't hard). I did good on RISE - 95th percentile - and knew I was prepared well enough for the boards. But we shall see. I might be punished for super-duper-confidence🙂).

 

[Patho2009]

- are there any molecular questions? How "Invader" works or something similar? I know it's not AP but I read somewhere that they ask molecular as a "related" area.
Yes.you will get molecular Qs on he AP exam.

-To Path2009: how did you deal with bringing a scope?
I bought one. It is costly indeed but I wanted to have a personal microscope anyway. You can borrow one from your dept.

Did you get a special permission to get it on a plane?
No. I put it in a microscope case and I took it with me on board as one of the two carry-on bags permitted for passengers.

Did it survive transportation well?
YES. On board, I asked one of the flight attendants to put it in place where it can be kept in upright position (instead to put it horizontally in the over-head shelves!!). You should get two spare bulbs in case the bulb is burnt or damaged.


I know that most programs in Canada arrange the scopes for their takers
YES you are right.
but I will have to borrow one somewhere. or buy one if afford it.

- do remembrances really help as my GP friend says? He gave me a bunch from GP exams, but they were mostly CP.
I do have recalls for the AP. They were greatly helpful. I wouldn't have passed without them. The GP recalls should be helpful if they contain adequate number of AP Qs.

 

[Gorlum]

or buy one if afford it.

Thank you! I will try to get a scope from my fellowship and/or ex-residency program. If not, I will have to get my own. Which scope did you buy and where? Thanks again!

 

[Patho2009]

My microscope is Olympus CX41 and I love it. Two of my colleagues bought Nickon E100 and they are happy with it. You can go for either one. Check the dealers (sale agent) of both Nikon and Olympus and ask them about the specific type I designated above.

 

[ed2005]

Canadian Royal College general Pathology old paper Exam neede please

 

[zao275]

Not to hijack this great thread, but since many Canadian residents are likely reading this, I wanted to post it here. We recently added all of the Canadian pathology training programs to the pathology wiki. If any of you have any pros/cons to share about your training programs, it would really help make the site more useful. My knowledge of the Canadian programs is very minimal, so I will leave it up to you guys up North to share your insider info. Thanks!

Jerad

http://pathinfo.wikia.com/wiki/Pathology_Fellowship_and_Residency_Directory#CANADA

 

[Gorlum]

I have a couple of questions to past the US takers:
-where did you guys stay? RC gives a measly discount in a couple of hotels but they are kinda far from the testing center (not a reasonable walking distance - 4.5 km the closest; I don't want to waste 30-40 min on morning stroll). The execution starts at 7 am - is it easy to get a taxi or a bus at that time of the day? I've been to Ottawa before but always walked - have no idea about ground transportation. Any comments/advice are appreciated.
- bringing a microscope: is it possible to arrange it through Royal College somehow? The idea of traveling with an old and heavy piece of junk doesn't fascinate me. Besides, my Canadian buddy tells me that the rules have changed, and we can't take it on board any longer. Of course I will check with a carrier...
Thanks!

 

[Patho2009]

I have a couple of questions to past the US takers:
-where did you guys stay? RC gives a measly discount in a couple of hotels but they are kinda far from the testing center (not a reasonable walking distance - 4.5 km the closest; I don't want to waste 30-40 min on morning stroll). The execution starts at 7 am - is it easy to get a taxi or a bus at that time of the day? I've been to Ottawa before but always walked - have no idea about ground transportation. Any comments/advice are appreciated.


The exam center is located in a relatively quiet distant area where no hotels exist (up to my knowledge). I and most of my colleagues stayed in hotels in downtown ottawa. This worked out very well as you need to have some restaurants and coffee shops around and within walking distance. Check the hotels around the Parliament as the area there is very active and has many shopping centers, restaurants, and cafes..etc.

You have to arrive very ealry at the exam center (around 7:30 am as I remember). It took me some time to reach the center as it is located among severeal buildings and I had difficulty finding the exact building. It was early morning and few people were around to ask. Therefore, make sure to have "safe time margin".

Taxis work 24 hrs in Ottawa. Hotels usually have taxis on the front. Arrange with the hotel receptionist the night before. You can also google (taxi Ottawa) and you will get plenty of taxi companies. Again, make sure to get enough "safe time margin" to allow the taxi to come to pick you up and take you there.

- bringing a microscope: is it possible to arrange it through Royal College somehow? The idea of traveling with an old and heavy piece of junk doesn't fascinate me. Besides, my Canadian buddy tells me that the rules have changed, and we can't take it on board any longer. Of course I will check with a carrier

It is mandatory to bring your own microscope. I took mine on board without any problem. Others were questioned about it and received sort of objection in the beginning but things ended as they wanted. It depends sometimes on the security officer as there are no rules about the microscopes themseleves but the issue is about their size. If it exceeds the allowable size, you won't be able to take it on board. The College has some spare microscopes but they keep them for certain situations such as when the microscope arrives broken or if it stops working while you are there. You will see their spare microscopes in the room where they ask the examinees to wait before the exam session starts.

 

[Gorlum]

Thanks, Patho2009!
If TSA makes a scene, I can always check this piece of junk in. If it breaks, RC will give me their extra one🙂. Also, I will ask my Canadian employers - if they want me to be RC-certified they can probably help with a scope🙂.

 

[Gorlum]

I took and successfully passed RC AP exam at the end of my forensic path fellowship. I did pass AP/CP in the States a year before in case you are wondering. First question people usually ask is "which one is more difficult"? There is no answer for that &#8211; you have to compare oranges with oranges. The exams are totally different and cannot be related (IMHO, of course). There is no "multiple choice" on RC exam. All answers should be written by hand (which drove me crazy since I type faster than write and my handwriting is pretty bad).
First part: 3 hrs written test, 26 questions with multiple parts. Some questions can be answered with a couple of words, for some a shot "essay" must be written. There were two forensic questions on this part, both were easy. There were plenty of molecular question this year (I hate this subject), and for some I had to invent answers. I don't know if I got any credit for that🙂. I left 1.5 questions unanswered &#8211; there was nothing I could invent🙂. In spite of difficulties with writing (i.e., making my scribbles legible) I had time at the end and was adding extra stuff just for fun: for example, WHO grading of CNS tumors. We were not asked to do that but I was pretty bored.
Second part: 50 slides given in two portions in two hours: 25 slides per hour, and you have to share them with a "roommate". The exam takes place on a campus of the college, and dorm rooms are converted into examination quarters; hence, a "roommate"🙂. Mine was pretty good &#8211; we didn't bother each other. I had an hour left in total &#8211; slides were easy. Bad thing is that you cannot leave the room. So I was dozing in my chair under observation of a proctor, who clearly didn't know what to do with me🙂.
Third part: images; 20 cytology, 20 forensics, 20 gross. 1 hour 20 minutes is given, and you can do them in any order. Images are in power point, but again all answers should be written down. Nothing esoteric was asked but some forensic questions puzzled me. After the test we discussed them with the Canadian grads (none of them is a forensic trainee) and discovered that we gave different answers for the majority of them. It alarmed me a bit since they were thinking like regular hospital pathologists and I have been corrupted by my forensic training. Later on I had a chance to chat with the guy (my future boss) who wrote them. It's not a violation &#8211; he was eager to do this. Apparently, the entire new set will be produced for the next year, so it's ok to discuss prior exam. According to him, he wanted to see how people of different background think. In other words, a question had multiple correct answers.
Last part (administered next day): oral test; it was quite entertaining. You have 5 slides to preview in 50 minutes (all straightforward) and think about related questions they might ask. I knew I would be safe as soon as I discovered two GU cases &#8211; that's my hobby, and I know it cold. There was also a cervix with vacuities, a lung wedge and a colon resection slide. I had two friendly guys, who produced a number of additional images (i.e., EM, colloidal Hale stain, etc.) as needed. So it was pretty interactive. They did ask a lot of "quality control" ****, and even hated molecular questions. I navigated through this as best as I could and tried to compensate on topics I know very well (GU and non-neoplastic renal). At the end I had 40 seconds left and no questions to answer. We shook hands and that was it.
Now, the most interesting aspect: how the exam is scored. I've heard multiple rumors:
- you should answer correctly about 70% of questions on the written part. That means you can safely loose 120 points
- the slide part is the most important
- if you do well on day one oral test doesn't matter
- if you screw up on day one oral test can help you to pass
- if you are borderline on both a "FITER" is opened (it's an evaluation form filled by you PD; compulsory to be registered for the rest). Mine actually is quite good &#8211; my PD has shown it to me
In reality I don't know how much of the above is true. Before the exam I had two job interviews in Canada, and on both occasions I was told that the exam is "very fair". I tend to believe it since I have passed🙂.
There are annoying parts of the exam (apart from handwriting &#8211; we could have typed like we did on CS test): BYOM ("bring your own microscope") and tremendous waste of time on "sequestration". You are not allowed to leave if you are done earlier. You will be kept in a room for hours before the slide part and after the oral exam. It drove me crazy. I like the ABP set up better &#8211; get the hell out of the testing center whenever you are done and come to the next part on time.
Speaking of microscopes: I had a real piece of junk, which I assembled out of two at the beginning of my fellowship. I use it for everyday work, although it doesn't focus well and has only 3 objectives (5x, 10x, 40x). Other people made fun of me: they had 20.000 dollars piece of equipment from their residency programs packed in fancy trunks. I brought mine in a beer box🙂. Bottom line: don't be intimidated by other folks. Do your stuff and it the end it won't matter as long as you pass. Same thing is true about dressing up for the oral part. There were only few of us in "all stars" trainers but "it's not an examination in footwear" ©. If you don't want to put a suit on &#8211; don't. It doesn't matter. Impress them with your knowledge🙂.
A couple of words about preparation. I did NOT prepare the following: slides, forensics, gross images. I did look through cytology images (my co-fellow keeps all her residency books in the office), I went through Osler 2011 and ASCP 2010 and I read several times a set of remembrances from past exams (some of them were in French🙂). If you don't want to read Robbins, don't read it. I didn't. I hate this book. There was plenty of stuff from Robbins in the recalls I obtained (as indicated by the authors).
That's all for now. If you have questions, feel free to ask.

 

[mario2010]

Congratulations !! thanks for such a helpful post. What is the elegibility criteria for the AP exam in terms of years of training ? I looked at the official website and it says 5 yrs of training for canadian grads. AP only residency in U.S is 3 yrs, I was wondering how does it works ?

 

[Gorlum]

What is the elegibility criteria for the AP exam in terms of years of training ? I looked at the official website and it says 5 yrs of training for canadian grads. AP only residency in U.S is 3 yrs, I was wondering how does it works ?

You gotta have 5 years in total. First can be "internship" in any clinical specialty. If you don't have it, you have to use ACGME-accredited fellowships (if we are talking of 3y AP training). There is an assessment of training, which is done a year in advance. I used my prospective fellowship at that moment (provided papers from the program). Also, you gotta have a pediatric path rotation, at least a month. Most of us have it but if you don't for some reason, you are not eligible. All technicalities are on RCPS web-site. Funny thing is that you can use a fellowship to write AP and superficiality boards (if they are available) in Canada. In other words, you can use this year twice🙂. Doesn't make a lot of sense but that's the reply I've got: I can write forensics next year (had to pass AP first). Gotta do a formal assessment though (cheap - 200 CAD).
The assessment is time consuming and expensive (825 bucks), the exam is super expensive - 3750 CAD (which is even more in the US currency). If you are not planning on working in Canada, I see no reason to go through this hassle. I'm a Canadian PR, and I'm not planning on working in the US. I had had a job offer in Ontario before taking the test, but my employers were waiting for the exam results to seal the deal. Apparently, it's a big issue of being certified by RC even if you have the US certification. I have two more boards to take - FP in Tampa on Sep. 1 and FP (I guess, in Toronto) on Sep. of 2012 (I was late with the assessment for 2011).

 

[jaklin]

Congratulations for all who did it
Is there a lot of molecular, and not that much repeat question, is that true?

 

[Patho2009]

Congrats!

Do you think it is good to clear LMCC exams or no need for them? Thanks.

 

[DoctorMD1]

You gotta have 5 years in total. First can be "internship" in any clinical specialty. If you don't have it, you have to use ACGME-accredited fellowships (if we are talking of 3y AP training). There is an assessment of training, which is done a year in advance. I used my prospective fellowship at that moment (provided papers from the program). Also, you gotta have a pediatric path rotation, at least a month. Most of us have it but if you don't for some reason, you are not eligible. All technicalities are on RCPS web-site. Funny thing is that you can use a fellowship to write AP and superficiality boards (if they are available) in Canada. In other words, you can use this year twice🙂. Doesn't make a lot of sense but that's the reply I've got: I can write forensics next year (had to pass AP first). Gotta do a formal assessment though (cheap - 200 CAD).
The assessment is time consuming and expensive (825 bucks), the exam is super expensive - 3750 CAD (which is even more in the US currency). If you are not planning on working in Canada, I see no reason to go through this hassle. I'm a Canadian PR, and I'm not planning on working in the US. I had had a job offer in Ontario before taking the test, but my employers were waiting for the exam results to seal the deal. Apparently, it's a big issue of being certified by RC even if you have the US certification. I have two more boards to take - FP in Tampa on Sep. 1 and FP (I guess, in Toronto) on Sep. of 2012 (I was late with the assessment for 2011).

Thank you for sharing. 🙂My understanding that a clinical year internship in a must in order to be eligible. Is it true? Would a person with 4 y combined AP/CP + ACGME accredited fellowship be eligible? Can you apply for assessment during fellowship, meaning not yet completed 5 years of training? How is job market for dermatopathologists in Canada (I know that they do not have board certificatin in it). Your input will be very much appreciated. Thank you

 

[Gorlum]

Thank you for sharing. 🙂My understanding that a clinical year internship in a must in order to be eligible. Is it true? Would a person with 4 y combined AP/CP + ACGME accredited fellowship be eligible? Can you apply for assessment during fellowship, meaning not yet completed 5 years of training? How is job market for dermatopathologists in Canada (I know that they do not have board certificatin in it). Your input will be very much appreciated. Thank you

Please read carefully my prior post - there are answers for the majority of your questions there. As for the market for dermpaths, I have no idea. I'm a forensic pathologist!

 

[Gorlum]

Congrats!

Do you think it is good to clear LMCC exams or no need for them? Thanks.

Thanks!
I don't think that taking LMCCs is practical. Number one, it's a lengthy process; expensive too. Number two, what is the purpose? We (American residency grads) are not eligible for a full license anyway cause we don’t have LMCCs and we lack at least a year of Canadian training/clerkship. So by taking LMCCs you are not gonna solve the problem. The best way (IMHO) is to get whatever license they give (“pathway 4” in Ontario) and convert to a full one is 12 months. That’s what I’m gonna do. Don’t feel bad about not having full license in Canada right away – guys from Quebec are not eligible either🙂).

 

[JPR22]

It's not really that useful for grads from canadian residency programs to take the RCPSC, given that most don't end up practicing in Canada, or don't end up practicing pathology. There's really not very many openings. I cant see why americans would waste time and $ taking the exam.

 

[Gorlum]

[
Is there a lot of molecular, and not that much repeat question, is that true?

Let's put it that way: there were more molecular question than I anticipated. And you are right, they were not repeat questions - I had a decent set of remembrances.

 

[Gorlum]

It's not really that useful for grads from canadian residency programs to take the RCPSC, given that most don't end up practicing in Canada, or don't end up practicing pathology. There's really not very many openings. I cant see why americans would waste time and $ taking the exam.

Right. There were about 50 people this year, and I was the only one American residency grad. I have plenty of acquaintances in different residency programs across Canada, who introduced me to some other people - we had a decent chat about this and that. Clearly, all of them were taking the test just for fun. Like me, they wanted another fancy title after their last name. It was not for a license, and neither of 'em had a job offer (in Canada) or a fellowship ahead (mostly in Canada). You know, everyone has whimsies: taking expensive tests in various English-speaking countries is one of 'em.

 

[DoctorMD1]

Please read carefully my prior post - there are answers for the majority of your questions there. As for the market for dermpaths, I have no idea. I'm a forensic pathologist!

Thank you for your reply.😀 I did read your prior post and also RCPSC website very carefully. My understanding is that they require one clinical year. Would you please clarify that? Did you have a clinical year?
Thank you very much.

 

[Gorlum]

Thank you for your reply.😀 I did read your prior post and also RCPSC website very carefully. My understanding is that they require one clinical year. Would you please clarify that? Did you have a clinical year?
Thank you very much.

Nope, I had 4 years of AP/CP + 1 year of forensic path fellowship. I did verify it with 'em a couple of years ago. They said any ACGME-accredited fellowship in AP will do. If you had 3 years of AP only you will need two fellowships one one 2-year fellowship (like neuro). But it must be ACGME-accredited as I mentioned.

 

[DoctorMD1]

Nope, I had 4 years of AP/CP + 1 year of forensic path fellowship. I did verify it with 'em a couple of years ago. They said any ACGME-accredited fellowship in AP will do. If you had 3 years of AP only you will need two fellowships one one 2-year fellowship (like neuro). But it must be ACGME-accredited as I mentioned.

Thank you very much. Good luck.🙂

 

[Fan Erick]

I am training in US now. I am a foreign graduate. I am going take anatomic Path. Exam in April and May. I am reading Rabbins pocket book now as freinds recommended. Someone told me that I only need read first 10 chapters, then read book such as "differential diagnosis of surgical pathology". My problem is that I totally no idea about this exam. All advices I got here (US) sounds correct to me, but most people I know they didnt take Canadian borad before. I just find this site. I realy appreciate that someone can give me accurete advices, such as books need to read and share your experience, thank you. My last question is: is there anywhere that I can find or buy some practice questions or used test questions of Canadian anatomic Path Exam. Never take oral or written exam!!!!! I am so nervous! Thank you very much!!!