cp boards

[kathi eisner]

passed ap last year, have been practicing ap only & now need to get blankin' cp out of the way. how much of the first few robbins chapters are on cp, what cell biology stuff do i need to know? should have taken them together!

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[deschutes]

Here's a link to the most recent boards discussion:
http://forums.studentdoctor.net/showthread.php?t=541107
which in turn links to old threads. Alternatively you could do a search.

Most of them discuss AP/CP together though.

 

[listeriaismfb]

passed ap last year, have been practicing ap only & now need to get blankin' cp out of the way. how much of the first few robbins chapters are on cp, what cell biology stuff do i need to know? should have taken them together!

This is a good question, I took 'em together so they are a bit of a blur The first few chapters in Robbins were helpful for me, and the requisite cell biology stuff would be included in those early chapters.

Some people I talked to thought those early chapters of Robbins were a waste of time, so your results may vary.

 

[kathi eisner]

thanks guys. those links were helpful, but the beginning of robbins chapters are not mentioned by too many when it comes to the cp only discussions. it's just that now that each section of the board must be passed, i would hate to neglect the cell biology/inflammation/etc thinking it was for ap only & see it all over the cp exam.

 

[listeriaismfb]

Lots of hemostasis & thrombosis too

 

[LADoc00]

passed ap last year, have been practicing ap only & now need to get blankin' cp out of the way. how much of the first few robbins chapters are on cp, what cell biology stuff do i need to know? should have taken them together!

huh? taking em separately is the way to go. The material is totally different and testing totally differently.

go to a review course and get the outlines.

 

[kathi eisner]

oh, did not realize i was for once doing something brilliant by separating the two!
have osler material for both ap & cp, not sure where the division is between the two exam materials or how accurate that osler division is.
again, just want to know how much of those first chapters i need to re-learn (yes, immunopath, nutrition, environment i know, but what about neoplasia, genetics?)

 

[listeriaismfb]

oh, did not realize i was for once doing something brilliant by separating the two!
have osler material for both ap & cp, not sure where the division is between the two exam materials or how accurate that osler division is.
again, just want to know how much of those first chapters i need to re-learn (yes, immunopath, nutrition, environment i know, but what about neoplasia, genetics?)

You pretty much can't skip all of any section. Sorry It's not that much though, because there is a lot of overlap with AP in these early chapters. Use some discretion and omit the AP bits. For example, in the peds section you can skip the stuff about the pediatric tumors, but you can't skip the stuff about inborn error testing or any other neonatal/pediatric test. Know what I mean?

 

[kathi eisner]

was afraid of that answer

 

[yaah]

huh? taking em separately is the way to go. The material is totally different and testing totally differently.

go to a review course and get the outlines.

It's the way to go if you don't mind spending an additional $1500 or whatever it is, plus flying down there again and staying there again (you get a huge discount if you take both at once). I'm certainly glad I took both at once.

I personally don't think there was much of the first few chapters of Robbins on the CP exam. I would definitely flip through them - the immunodeficiency, hereditary disease stuff is important to know. The heme chapters in Robbins are also mildly helpful. But the best way to learn CP is to do a review course and review the notes.

As far as the "you have to pass every section in order to pass" statement that keeps coming up, I still have not heard solid evidence that this means you have to pass each subspecialty of CP. Reading the ABpath website, it seems you just have to pass 1) the written and 2) the practical. It doesn't say anything else. I haven't heard from anyone who failed to know whether it tells you exactly how you failed. It also seems as though certain aspects of the boards have changed in the past few years, so what was true 5-10 years ago may not necessarily be true now.

 

[green mantis]

As far as the "you have to pass every section in order to pass" statement that keeps coming up, I still have not heard solid evidence that this means you have to pass each subspecialty of CP. Reading the ABpath website, it seems you just have to pass 1) the written and 2) the practical. It doesn't say anything else. I haven't heard from anyone who failed to know whether it tells you exactly how you failed. It also seems as though certain aspects of the boards have changed in the past few years, so what was true 5-10 years ago may not necessarily be true now.

I may be able to provide some insight on this since I failed CP last year. Luckily, I passed it this year. Oddly enough, being a diplomate doesn't feel any different.

You can pass the written & practical sections separately. However, if you fail, you must repeat both. They give you a breakdown for each subspecialty, either lower, middle or upper 1/3. I was in the middle 1/3 for all but 1, where I was lower 1/3. I'm thinking if I had gotten 1 more question correct in that subspecialty, I would've passed. My overall score was 499, of which 500 is passing.


----- Antony

 

[sohsie]

I think you are better off taking both at once.

1) Its much better just to get it over with
2) You don't have to spend twice as many months studying
3) Taking both is $2200, taking one is $1800. It only costs you $400 to take the second test on the same day. At worst, you can just study for one, blow off the other, and you might get lucky and pass both anyway, and if not, now you know how to study for the re-exam. $400 is a small price to pay to for the potential to save yourself another 6 months-year of agony, $1400 in test fee money, plus the money you wont have to spend on another plane ticket and hotel room. I know one woman who just studied CP, did not spend one minute studying AP, and passed both anyway.
4) There is some (albeit small) overlap between AP and CP, so studying for one will help you with the other.

As far as Robbins goes, I read the first 8 or so chapters in my PGY3 year I think and it was a waste of time, and certainly for CP I wouldnt bother. They barely test that stuff anymore. For CP, make the Mais Compendium your constant companion, and you are 80% of the way to passing.

 

[yaah]

I may be able to provide some insight on this since I failed CP last year. Luckily, I passed it this year. Oddly enough, being a diplomate doesn't feel any different.

You can pass the written & practical sections separately. However, if you fail, you must repeat both. They give you a breakdown for each subspecialty, either lower, middle or upper 1/3. I was in the middle 1/3 for all but 1, where I was lower 1/3. I'm thinking if I had gotten 1 more question correct in that subspecialty, I would've passed. My overall score was 499, of which 500 is passing.

That's kind of what I thought - "passing all parts" just means passing the written and the practical. The breakdown is probably to see where you need to study more. What we really need to prove the contrary argument is for someone (who took the test in the past couple of years) who did really well on every subspecialty except one, and yet still failed. My current suspicion is that that does not happen. If a score of "500" is passing, that seems like a cumulative score, thus if you got in the upper third on everything except that one part which was in the lower third, you would have passed.

Congrats on passing the second time though. That must have been like a kick in the groin to find out you missed passing by one point. Probably was one question. I had a dream before I got my scores back that I failed by one point and it was because of cytology.

 

[kathi eisner]

thanks for all the comments.
now we need to get one of you elected/appointed to the abp to get in there & change things like: amount of $$$ for the tests, not knowing exactly when you will sit for the thing, terrible pass rates, i could go on,
but...
thanks for all your advice & sacrifice to the cp gods for me!

 

[yaah]

The terrible pass rates are not really a bad thing though - it makes it a difficult test but it also doesn't let certain individuals pass it.

As for the rest though, the organization of the ABP could use some work in terms of them notifying boards applicants about testing dates, receipt of materials, etc etc.

 

[lollydi]

I may be able to provide some insight on this since I failed CP last year. Luckily, I passed it this year. Oddly enough, being a diplomate doesn't feel any different.

You can pass the written & practical sections separately. However, if you fail, you must repeat both. They give you a breakdown for each subspecialty, either lower, middle or upper 1/3. I was in the middle 1/3 for all but 1, where I was lower 1/3. I'm thinking if I had gotten 1 more question correct in that subspecialty, I would've passed. My overall score was 499, of which 500 is passing.


----- Antony

Everyone I've ever known or heard about who failed the CP exam failed by one "point". (The quotes are there because who knows what these so called points mean?!? )

Including myself, and green mantis, i'd say that totals around 5 or 6 people.

And i've never heard of anyone failing by more than one "point". Has anyone else?

If there's other people out there who failed, or know of someone who did, and would care to share their margin of failure, I'd be very interested.

Also, is this option of splitting the exams new? I don't think it was available when I did it a couple years ago.

 

[yaah]

You know, that's interesting. I know of someone who also said they "barely" missed passing the CP boards. Maybe it was one point. That would be a pretty evil tactic though to have everyone failing by one point.

 

[green mantis]

If there's other people out there who failed, or know of someone who did, and would care to share their margin of failure, I'd be very interested.

Someone who was retaking the CP boards w/ me this past spring supposedly got a 491.

I think the barely failing thing is another money making scheme for the ABP. Another fellow, who also got a 499, & myself chose to get our exams rescored for $50. Both of us got the impression that they didn't even do anything.


----- Antony

 

[yaah]

I didn't know about that rescoring for $50 thing. Why even bother? I thought that was why they took 6 weeks to score it, so that there wouldn't be any of these silly scoring mistakes that they overlook.

 

[raspberry009]

passed ap last year, have been practicing ap only & now need to get blankin' cp out of the way. how much of the first few robbins chapters are on cp, what cell biology stuff do i need to know? should have taken them together!

How are you practicing AP only when you applied AP/CP? We were told you couldn't unless you had enough AP credits (36 months I believe?? Someone correct me if I'm wrong).

Anyway, the president of the Board was just here this week and she said that the best text was Henry's, quickly followed by the disclaimer that she is not endorsing any specific text. (A little bit of light reading before bed, eh?) Our upper levels are studying ASCP Quick Compendium: Clinical Pathology.

 

[djmd]

I didn't know about that rescoring for $50 thing. Why even bother? I thought that was why they took 6 weeks to score it, so that there wouldn't be any of these silly scoring mistakes that they overlook.

I guess that is from pencil based scan-tron days...

 

[raspberry009]

I didn't know about that rescoring for $50 thing. Why even bother? I thought that was why they took 6 weeks to score it, so that there wouldn't be any of these silly scoring mistakes that they overlook.

Dr. Bennett, the president of the board, was saying that back when they scored everything manually they would see occational changes. But now that everything is done electronically she hasn't seen a single score change. So she recommended that unless there was something seriously wrong to keep your money and invest in study material to retake the exam.

 

[listeriaismfb]

There's an elephant in the room here...

Not everyone who gets into an AP/CP residency leaves fit to practice independently after 4 years. Sorry if that hurts anyone's feelings, but this is serious business. It's a fact that some programs are not good and some residents are not good....

 

[yaah]

I agree very much with that statement. Boards are not supposed to be easy by any stretch of the imagination.

 

[lollydi]

There's an elephant in the room here...

Not everyone who gets into an AP/CP residency leaves fit to practice independently after 4 years. Sorry if that hurts anyone's feelings, but this is serious business. It's a fact that some programs are not good and some residents are not good....

Likewise, not everyone who is certified by the ABP is fit to practice pathology, and the converse is also very very true.

The board exams should be focused on ensuring a basic level of competence, which would mean thoroughly evaluating one's facility with the multitude of variation on the common things, with a small proportion of the obscure thrown in. Say 3/4 common things, 1/4 less common-rare things.

With the common things, it's reasonable to expect someone to make the diagnosis on the spot. With the obscure things, it's not really important that you can diagnosis it off the top of your head, but just that you recognize it as abnormal, and then have a reasonable approach to investigate further.

Much of the ABP exams involve making guesses in the face of vastly insufficeint information, quite often dealing with some uncommon or rare thing. Making guesses, educated though they may be, is not good practice. Competent pathologists don't do that. They seek more information.

Of course it's much easier to make a multiple choice exam and fill it with odd ball stuff like the ABP does, that way ensuring a significant failure rate, and then pretend you're evaluating competence.

And that's what bothers me: The board that is supposed to be evaluating our compentence is incompetent at making an exam that really does that.

 

[UnsafePrune]

I agree with lollydi.

I'm not quite sure how important it is for me to know, off the top of my head, some of the obscure genetic translocations they want me to know for the boards. It's a running joke in my residency:

"Quick, Dr. Pathology, this patient is about to die unless you tell me the translocation for synovial sarcoma!"



I guess it's just easy-to-test material.

By the way, I've heard from other residents who've taken the exam that they not only want you to know CML is t(9;22) (obviously easy), but that it's t(9;22)(q34;q11). One resident said her exam had several choices that had t(9;22), but different actual sites listed. I'm assuming this may be true for other common translocations.

 

[green mantis]

By the way, I've heard from other residents who've taken the exam that they not only want you to know CML is t(9;22) (obviously easy), but that it's t(9;22)(q34;q11). One resident said her exam had several choices that had t(9;22), but different actual sites listed. I'm assuming this may be true for other common translocations.

This is true. I think most residents have all of the basic translocations memorized, so this is one way to make the exam more difficult. You should also know stuff like the 2nd or 3rd most common translocation of a particular tumor, not just the primary one. The primary one is probably not going to be a choice.

In regards to the rescore, $50 isn't a big deal if you end up passing. It sure beats spending $2500 to retake 1 section. If Dr. Bennett doesn't think rescoring is worthwhile, there should be some mention of it in the FAQ. The FAQ makes no mention of what happens when you request a rescore.


----- Antony

 

[yaah]

I agree with lollydi.

I'm not quite sure how important it is for me to know, off the top of my head, some of the obscure genetic translocations they want me to know for the boards. It's a running joke in my residency:

"Quick, Dr. Pathology, this patient is about to die unless you tell me the translocation for synovial sarcoma!"



I guess it's just easy-to-test material.

By the way, I've heard from other residents who've taken the exam that they not only want you to know CML is t(9;22) (obviously easy), but that it's t(9;22)(q34;q11). One resident said her exam had several choices that had t(9;22), but different actual sites listed. I'm assuming this may be true for other common translocations.

The problem with this is that you could make take this argument to the extreme on everything - no piece of knowledge is really critically important to know, because you could always look it up. While knowing the exact breakpoints for 9;22 might be fairly trivial, at the same time one could argue that by forcing one to learn this, the boards emphasizes the impact of these "minor" issues on actual relevant information.

Personally, I would rather be tested on factual knowledge because at least you can study for this. Trying to test on "practical" problems is exceedingly difficult to test, and the more "practical" you get unfortunately the more vague and open to interpretation you get.

But don't get me wrong, I understand the argument that learning lots of specific details really doesn't make one a good pathologist. I just personally don't see of many better ways to actually accomplish trying to board certify hundreds of people annually. Open book tests? That would be a nightmare. Oral exams?

 

[pathdawg]

There's an elephant in the room here...

Not everyone who gets into an AP/CP residency leaves fit to practice independently after 4 years. Sorry if that hurts anyone's feelings, but this is serious business. It's a fact that some programs are not good and some residents are not good....

I do not agree with this statement at all. Here is the harsh reality, kids. Nobody is fit to practice independently after a 4 year AP/CP residency. I don't care if you have the highest board score in the APB's history and you're the greatest resident in the history of great residents from Fancy Pants University Hospital, you are not anywhere close to being ready to practice independently when you finish a residency (or fellowship for that matter).

It takes years of attending experience before one can practice independently, and even then, its risky. And when I say years, I do not mean 3 or 4. I mean more on the order of 7-10.

I am speaking from experience when I say that the adjustment from trainee to attending is the most difficult one you all will face in your careers. And the one from junior newbie attending to senior experienced one isn't much easier.

 

[pathstudent]

I do not agree with this statement at all. Here is the harsh reality, kids. Nobody is fit to practice independently after a 4 year AP/CP residency. I don't care if you have the highest board score in the APB's history and you're the greatest resident in the history of great residents from Fancy Pants University Hospital, you are not anywhere close to being ready to practice independently when you finish a residency (or fellowship for that matter).

It takes years of attending experience before one can practice independently, and even then, its risky. And when I say years, I do not mean 3 or 4. I mean more on the order of 7-10.

I am speaking from experience when I say that the adjustment from trainee to attending is the most difficult one you all will face in your careers. And the one from junior newbie attending to senior experienced one isn't much easier.

THis is another argument on why we should move to pure subspecialization in pathology. It takes 10 years of post-training practice to master AP, but if you just solely focus on one subspecialty like lung or renal or liver, you can be basically be a master in a couple years.

 

[mcfaddens]

THis is another argument on why we should move to pure subspecialization in pathology. It takes 10 years of post-training practice to master AP, but if you just solely focus on one subspecialty like lung or renal or liver, you can be basically be a master in a couple years.

I think you may have missed pathdawg's point completely. If you think subspec is the way to go, well, then you are just not in touch with reality. The song is the same for every other doc out there, do you really think internal med, or surgery, or ENT, or whomever feel that they are really ready to go out there and practice. NO and yes. Yes in that it’s not stopping anyone and no in that they realize that they aren’t the greatest doc in the world. So then why are you letting lack of experience get in your way? If you want experience then go get it. The best way to do that is to get a job. Hmmm. maybe that is why the market is so hard to break. No individual will ever master path, the real point of training is to learn your diagnostic limits and know when (even if you know the diagnosis) to ask for another opinion. You should know this going in to path otherwise you should stick with research or something.

 

[dermpathlover]

i passed CP boards and only studied remembrances. I remeber Dr. Miller at university of chicago said i had to read over 6000 pages of textbooks as part of my cp education, well i blew off every cp rotation and am now cp mother f boarded and i read zero pages. Remembranes are money.

I can't believe I am going to be ap/cp/hp/dp boarded

 

[Gut Shot]

I can't believe I am going to be ap/cp/hp/dp boarded

You're already db boarded.

 

[yaah]

i passed CP boards and only studied remembrances. I remeber Dr. Miller at university of chicago said i had to read over 6000 pages of textbooks as part of my cp education, well i blew off every cp rotation and am now cp mother f boarded and i read zero pages. Remembranes are money.

I can't believe I am going to be ap/cp/hp/dp boarded

Wow, you're just an amazing superstar stud, man. Tell you what, when you do finally finish all your training and look for a job, can you come back and tell us the details? I would like to compare my AP/CP only, non boarded fellowship offers to yours.

By the way, I passed CP boards without studying, and I walked out on the last section 2 hours early. I was also drunk.

 

[earmuff]

Wow, you're just an amazing superstar stud, man. Tell you what, when you do finally finish all your training and look for a job, can you come back and tell us the details? I would like to compare my AP/CP only, non boarded fellowship offers to yours.

By the way, I passed CP boards without studying, and I walked out on the last section 2 hours early. I was also drunk.

 

[Gut Shot]

I can't believe I am going to be ap/cp/hp/dp boarded

You're not the only one.

 

[Gut Shot]

I can't believe I am going to be ap/cp/hp/dp boarded

Can we add "water" to that?

 

[djmd]

Wow, you're just an amazing superstar stud, man. Tell you what, when you do finally finish all your training and look for a job, can you come back and tell us the details? I would like to compare my AP/CP only, non boarded fellowship offers to yours.

By the way, I passed CP boards without studying, and I walked out on the last section 2 hours early. I was also drunk.

I think he forgot to mention that he didn't study CP and doesn't even know what c and p standfor. He never even flew to Tampa, and his blood was 50 % EtOH, 50% antifreeze, and 50% PRBCs.
And he didn't just pass CP boards, he wrote the test.

 

[Nilf]

i passed CP boards and only studied remembrances. I remeber Dr. Miller at university of chicago said i had to read over 6000 pages of textbooks as part of my cp education, well i blew off every cp rotation and am now cp mother f boarded and i read zero pages. Remembranes are money.

I can't believe I am going to be ap/cp/hp/dp boarded

I know several people who will have AP/CP PLUS TWO MORE FELLOWSHIP BOARD CERTIFICATIONS. This trend worries me. Is it because (1) people can't find jobs and keep doing fellowships, or (2) there is so much to learn that people need fellowships, or (3) people are filling up time between the end of their AP/CP training and the start of the fellowship they truly want.

No, I don't want this thread to morph into another job market thread.

 

[mcfaddens]

Wow, you're just an amazing superstar stud, man. Tell you what, when you do finally finish all your training and look for a job, can you come back and tell us the details? I would like to compare my AP/CP only, non boarded fellowship offers to yours.

By the way, I passed CP boards without studying, and I walked out on the last section 2 hours early. I was also drunk.

Yes he is the stud man, funny havent heard from him in a while, guess he was busy racking up another hard to get fellowship. But yet the DP lover has not gotten a single job offer. Maybe he paid his med school debt by makin woppers at the local burger king while he studied for his dermpath boards. He probably saved money on the flight to tampa by flapping his arms really hard and flew there himself.

 

[Nilf]

Yes he is the stud man, funny havent heard from him in a while, guess he was busy racking up another hard to get fellowship. But yet the DP lover has not gotten a single job offer. Maybe he paid his med school debt by makin woppers at the local burger king while he studied for his dermpath boards. He probably saved money on the flight to tampa by flapping his arms really hard and flew there himself.

There used to be a poster on this forum, whose name was was Dermpathchick...

What happens when Dermpathlover meets Dermpathchick?

 

[Gut Shot]

There used to be a poster on this forum, whose name was was Dermpathchick...

What happens when Dermpathlover meets Dermpathchick?

I'm rooting for a spontaneous abortion.

 

[mcfaddens]

I'm rooting for a spontaneous abortion.

I dont know about that, getting with a member of the oppsite sex may prove harder than we think for the DPlover. I have a funny feeling Dermpathlover will probably die a virgin.

 

[deschutes]

I know several people who will have AP/CP PLUS TWO MORE FELLOWSHIP BOARD CERTIFICATIONS. This trend worries me. Is it because (1) people can't find jobs and keep doing fellowships, or (2) there is so much to learn that people need fellowships, or (3) people are filling up time between the end of their AP/CP training and the start of the fellowship they truly want.

Betwixt all the dp love, just wanted to say - my guess is that all three are true, with modifications:
In (1), "people can't find jobs they want, or haven't gone looking".
In (2), maybe take out "need" and replace with "want".

 

[yaah]

In general, people who are doing multiple fellowships are doing them before they look for jobs, so it isn't because they can't find a job. Fellowship applications occur, on average, 18 months prior to the start of fellowship, so if you are waiting until you can't find a job there won't be many left anyway, since job search and acquisition occurs generally 9-12 months (or less) prior to start of job.

It may because they think they won't find a job without the extra fellowship, but that's sort of a self-fulfilling prophecy. Personally, I don't think doing the extra fellowship beyond whatever you were doing improves your application by a ton anyway. If you can't get the one you want in the first cycle, then go for it again the second time around, that's another story. I think a lot of people have this latter reason for doing multiple fellowships.

There is also a segment of the population for whom one of the following two statements is/are true:
1) Want to keep training perpetually, kind of like the perpetual grad students in social science academia.
2) Feel like having more credentials is always preferable to sticking with the ones you have. Similar to the people in the premed forums who ask questions about the feasibility of doing two residencies in two different specialties.

I don't know what the most common reasons are - probably differs in every individual situation. I know quite a few people who planned to do two fellowships, however. Most of the reasons they give tend to be more on the "I want more experience and training" angle rather than the job angle. It also seems to depend a lot on the area of fellowship. Seems like most people doing surg path fellowships + something else say that want the experience and training. Most people doing cytopath + something else say that they want to be more competitive for jobs.

 

[dermpathlover]

I ain't trying to brag. I am only saying that remembrances are key and are sufficient in order to pass boards

I did multiple fellowships because I had to burn a year before I was scheduled to DP. It's no big deal. Being quadruple boarded is kind of cool, but will I retake all the exams every ten years? Maybe, maybe not.

 

[Nilf]

I ain't trying to brag. I am only saying that remembrances are key and are sufficient in order to pass boards

I did multiple fellowships because I had to burn a year before I was scheduled to DP. It's no big deal. Being quadruple boarded is kind of cool, but will I retake all the exams every ten years? Maybe, maybe not.

Could you elaborate what you mean by 'remembrances'? Semantics aside, most of things what I've been learning past 8 years are, well, remembrances.

 

[raider]

I never understood why people have to study for the boards?

 

[DrBloodmoney]

Could you elaborate what you mean by 'remembrances'? Semantics aside, most of things what I've been learning past 8 years are, well, remembrances.

What other people 'remember' from the test. Collect as many as you can.

 

[KeratinPearls]

What other people 'remember' from the test. Collect as many as you can.

Where do I find these remembrances?