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Exam Format FAQ

Information around the making of the exam

The document aims to supply information about the process of the making and the format of the ECVP Board Exam. It also includes some questions from previous years and will be updated continuously. At the end is a list of tips (do’s and don’ts) for candidates with examples from the exam 2011 and 2013.

Board Exam Question sessions

The following downloads (pdf) you may find useful. (Note these have been discussed with the exam committee 2012)

All about the Exam – Powerpoint presentation (2015)

  The Exam - Berlin Meeting 2015 (1.5 MiB, 1,854 hits)

Q & A Session (2011)

  Questions asked and answers given (77.7 KiB, 4,446 hits)

All about the Exam – Powerpoint presentation (2011)

  Summer School 2011 Exam Lecture (107.7 KiB, 1,547 hits)

Some clues to prepare the ECVP exam – Powerpoint presentation (2011)

  Some clues to prepare for the exam (425.6 KiB, 1,771 hits)

Transparency Project

Direct Download:

  Transparency Project (1st Ed) (334.9 KiB, 1,193 hits)

1. Creating the exam

The members of the Exam Committee (EC) have to be ECVP diplomats and are chosen in order to represent various areas of expertise (eg. large animals, poultry or toxicological pathology), area of employment (academia or industry), and different European countries. Each exam section has a section leader (SL) who is responsible to put the final exam paper for this section together. During the year exam material is collected and at a 4 full day preparatory meeting in the fall all questions and cases are discussed amongst the EC members.

All diplomats are strongly encouraged to submit exam cases/questions to support the work of the EC and contributing to the quality of the exam. Submission is acknowledged by the EC and carries CPE points as support of the ECVP. For further information and proper format see our Example Question section..

Histology:

Each of the members of the EC submits 3 cases (30 H&E slides preferably with a block) with a board-type description including point distribution to the SL. The cases are deposited in a histology archive, from which the histology SL prepares a preliminary exam keeping an appropriate distribution between species, organs and disease processes in mind. Slides and point distribution are discussed and decided upon during the fall meeting. Every case carries 20 points, distributed between description, morphological diagnosis, etiology (where appropriate) and design of the description (style). The distribution between the different animal species is roughly 30 % large animals, 30% small animals and 30% remaining species (exotics, fish, lab animals, poultry).

Gross:

Each EC member submits digitalized gross photos including appropriate questions (eg. morphological diagnosis, cause/etiology, lesion in another organ, pathogenesis, and clinical signs) to the SL. The photos with a high enough quality (lesion should be in the centre, recognizable, good lighting etc) are placed into a gross slide archive. From this slide archive the gross SL prepares a preliminary version of the exam. Slides and point distribution are discussed and decided upon during the fall meeting. Distribution is roughly 30% large animals, 30% small animals and 30% remaining species (exotics, fish, lab animals, poultry) with an equal distribution between organs and disease processes.

General pathology:

Each EC member submits 7 multiple choice questions (MCQ) and 3 short answer questions (SAQ) including the references for each question to the SL. The SL prepares a first draft of the exam keeping in mind an appropriate distribution between disease processes (eg. immunopathology, tissue repair, neoplasia), questions taken from books and papers and difficulty levels. A first draft of the preliminary exam (including the references) is sent for review to 3 EC members. Taking their comments into account the SL prepares a second draft for the fall meeting.

Veterinary Pathology:

Three EC members submit 7 MCQ and 3 SAQ including the references for each question to the section leader. The vet path SLs are chosen according to expertise in this area (large animals, small animals, exotics, fish, poultry, lab animals or tox path). The vet path SL prepares a first draft exam keeping in mind an appropriate distribution between disease processes, organ distribution and species (eg. large animals between ruminants, pigs and horses). This first draft of the preliminary exam (including the references) is sent for review to 3 EC members. Taking their comments into account the section leader prepares a second draft for the fall meeting.

Comprehensive pathology:

Six EC members submit questions including the references for each question to the section leader, who prepares a first draft, which is sent for review to 3 EC members. Taking their comments into account the section leader prepares a second draft for the fall meeting.

At the fall meeting the exam drafts are presented to all EC members and the exam is put together to a final draft, which than is reviewed again by another EC member for format and spelling errors.

2.The format of the exam

Histology:

The exam consists of 18 glass slides, 1 cytology smear and one print of an EM. Each of these carries 20 points, with the description of the lesion carrying the most points and fewer points for the morphological diagnosis and (where appropriate) cause/etiology, pathogenesis and/or name the disease and style. Total time frame is 4.5 h, one slide set has to be shared between 2 candidates.

Gross:

The exam consists of 60 photographs, which are presented via a digital projector. Each slide carries a total of 3 points. Time frame is 2 min/slide (Total time 2h).

General pathology:

The exam consists of 60 questions, 40 MCQ and 20 SAQ. MCQs give only one correct choice out of 5 possibilities. Each question carries 5 points. Total time frame is 4h.

Veterinary Pathology:

The exam consists of 3 subsections, two of which have to be chosen in specific combinations (see www.ecvpath.org/brochure/). In each subsection there are 20 MCQ and 10 SAQ. MCQs give only one correct choice out of 5 possibilities. Each question carries 5 points. The first two subsections are given in one session of 3h followed by a break and another 1.5h for the third subsection

Comprehensive Pathology:

The exam consists of five parts/questions, and could comprise the following topics: assessment of an abstract, evaluation of toxicological pathology data, provision of a second opinion, analysis of a scientific study, and/or assessment of clinical cases. Each part/question is equally valued at 100 points, hence a total of 500 points for the whole comprehensive exam. However, the time needed for each part may not be equal. Total time frame is 4.5hr.

  • The abstract is frequently put in the context of a grant application, a conference participation or article submission and comprises about 400-500 words. It usually contains mistakes that need to be identified and rectified. To fulfill this task background knowledge of general and/or special veterinary pathology shall be applied. Moreover, the candidate must approach this question as if they were a reviewer and in addition to observing obvious mistakes, points may be given to candidates who come up with creative criticism that is applicable to address the question.

  • The tox path part of the comprehensive exam consists of selected histo slides, gross or histo pictures, survival curves, organ weight tables, clinical pathology parameters, macro and/or microscopic incidence tables not only to be described but also interpreted. The candidate is asked to apply his knowledge of clinical and/or anatomic pathology findings in laboratory animals comparing treated and non-treated groups. A basic experience regarding the format of tox path data and the methodology as well as vocabulary of toxicology studies, though not compulsory, is highly recommended. Background observations and/or outlier values will have to be differentiated from test article-related findings. Conclusions or hypotheses regarding the safety of the test article, the dose-dependency of effects, and putative mechanism of action or additional refinements of the study protocol may be asked as well.

     

  • For the analysis of a scientific study basic knowledge on molecular pathology needs to be applied. In this part of the exam, original data in various forms (e.g. graphs, blots) are presented. Questions usually ask for data description and interpretation. In addition to the analysis of the provided data, there is usually a sub-question about a technique that was applied in the study. You should therefore know the basic principles of frequently applied techniques. Questions in the last years included techniques to analyze DNA (e.g. PCR, Southern Blotting, BrdU incorporation), RNA (quantitative RT-PCR, Northern Blotting), proteins (e.g. Western Blotting, tissue microarrays, immunohistochemistry, immunofluorescence, ELISA), epigenetic alterations (e.g. DNA methylation, modifications of histones), genetic modifications (e.g. transfection of cells, overexpression of genes, RNA interference, inducible expression, targeting of genes in mice), reporter assays (e.g. luciferase assays). Experimental details (e.g. the pH of a certain buffer) are not asked for. This part of the exam tests the basic understanding of techniques used to complement pathology findings. The candidates may also be asked for new hypotheses drawn from the data presented, and points are given for not only for one or multiple “correct” answers but also for creative ideas that make sense.

     

  • Regarding the second opinion, a forensic case or a clinical case can be chosen.  In this part, like for clinical cases, the candidate should apply diagnostic knowledge. Histo slides, gross slides, clinical data (including reference values) or special staining may be provided. A detailed description of histology is not asked for (this is addressed in the histo part of the exam and not in the comprehensive part) but morphological or etiological diagnoses may be required.

3. Passing rates

Each of the 5 sections is passed by reaching 60% of the total possible marks (e.g. 180 point for general pathology or 300 points for comprehensive pathology).

4.At the exam

The exam is usually early February in Ghent. It starts with histopathology Monday morning, followed by gross pathology Monday afternoon. Tuesday starts with general pathology followed by veterinary pathology in the afternoon.  Comprehensive pathology is on Wednesday morning.

Candidates will be randomly assigned a seat through a lottery process. Candidates have the possibility to set up their own or hired microscope the day before the exam. They may use pens or pencils; have food and drinks on their table. No other utensils, in particular noisy timers or mobile phones are allowed during the exam.  On the morning of the exam the candidates draw a number and their exam scripts are only identified by this number and not by name.  Dictionaries in various languages (covering the languages spoken by the candidates) are available at the front of the examination room. Candidates are not allowed to talk to each other under any circumstances. In addition, candidates are not allowed to take any exam material or notes out of the examination room. Contravention is regarded as cheating. Candidates are accompanied if they leave the room during the examination.

For consistency reasons each EC member marks a complete question (for example histology case 3) from all candidates. Every slide and question is marked independently by two EC members based on the scoring agreed by all members during the preparatory meeting. They then compare their marks (consolidation). If there is a discrepancy between marks, the answers are looked at again and the discrepancy is discussed until a final agreement is reached. All marks are registered in a computer program which calculates percentage of points reached per candidate, slide or question. The results from the first 4 sections are statistically analyzed at the Medizinische Fakultät der Universität Bern, Switzerland, Institut für Medizinische Lehre, Abteilung für Assessment und Evaluation for their quality and discriminatory power. All results are approved before disclosure of candidates’ names. A candidate has to have 60% of the total points possible in a section to have passed this section. ECVP council has the final decision about approval of the results. Candidates are usually informed of their results within a couple of days.

5. Do’s and dont’s
Examples are from the 2011 and 2013 exam.

In General

The following points are meant to help candidates to become better prepared for the questions and getting some ideas about what we expect during the exam and where problems are common. After not having been seen in the 2012 exam, some problems unfortunately returned in the 2013 exam.

Be prepared:

• If you are below the 50% rate you most likely sat the exam too early.

• The summer school is a valuable training experience, but 6 or 8 weeks at the summer school cannot replace at least three years of vigorous training and studying.

Be as precise as possible.


Histopathology

Write legibly:

• If we cannot read the question, it cannot get points.

• Work on your handwriting and test it on colleagues and friends!

• Train your speed, empty pages do not get you points

• Although filling pages is recommendable, non-useful information or repetition do not bring you additional points (all important information should fit in one page for the histology description or in the given lines for all other sections’ questions)

 

Know your anatomy/histology:

This was again a major problem in the 2013 exam: 13/36 candidates did not recognize a thyroid gland and 16/36 were unable to identify the mammary gland.

• The pituitary gland is not the pancreas.

• The adenohypophysis is not a pancreatic adenoma.

• Mammary gland is not the epididymis.

• The Harderian gland is not a salivary gland.

• Corpora amylacea are not bacteria or mineral deposits.

• The neurohypophysis is not the brain stem.

• Salivary glands are not mammary glands.

• Urinary bladder is not skin.

• It is very unlikely that in a cytological smear from a tracheal exudate, 70 % of the cells are fibroblasts.

• The nasal mucosa (including turbinated) is not intestine.

• Uterus is neither prostate, nor mammary gland.

• Primates have a uterus but not uterus horns.

• Intestine (large, small and try to specify segment) … be specific.

• A bird lung is not a bird liver.

• Osteoclasts are no protozoa.


Know specific variations of different species:

• Granulomas of reptiles are different than those from mammals.

• Reptiles do not have neutrophils.

• Fish do not have heterophils, they have eosinophils and neutrophils.

• Fish do not get bronchopneumonia.

Use correct terminology:

• Glomerular chamber or glomerular flocculus: what are those?

• What is an alveolocyte?

• Acanthocytes are not the same as acantholytic cells.

• There is no such condition as a mammitis.

• Inflammation of the stomach is not stomatitis.

• Desmoplasia is usually associated with neoplasia not with inflammation.

• Melanomacrophages are found in the reptile-fish liver.


Look at all the tissue/whole slide:

• Brain sections usually have meninges (at least the leptomeninges).

• Lungs usually have some pleura.

• There is tissue around a neoplasm which may have some important changes and diseases that can be more relevant for the animal health (Leishmaniasis in a skin with hemangioma).

• A slide may contain two organs, which are anatomically attached to each other such as pituitary and rete mirabile.

• A kidney without glomeruli is very unusual: so either it is not a kidney or something is wrong about the glomeruli

• Stick to histology, one can usually not diagnose an enlarged uterus from a dog on a histology slide.
Make sure that there is a logical connection between your description and the morphological diagnosis.

• Normal appearing fibroblasts are not typical for a fibrosarcoma.

• There should be macrophages in a lesion when it is granulomatous.

• There should be inflammatory cells in a lesion called …itis.


Do not list inflammatory cells without a quantitative modifier:
This was again a common problem in 2013. Don’t do it, you will lose points!

• Many lymphocytes, fewer plasma cells, some neutrophils…

• Order of quantity.

• You will not get all points possible by just listing every inflammatory cell you know without any indication about how many there are (many, few, rare, plenty, abundant…) and where they are (white matter, subcutis, perivascular, lamina propria).

• Always: What, where and how many.


Read the question carefully:

• Malignant catarrhal fever is a disease, not an etiology.

• When asked for “list common viral causes of pneumonia”, do not answer Pasteurella, Haemophilus, Actinobacillus and so on

• Only give one answer if only one is required:

• Do not offer multiple etiologies, always the one most likely. If there are two possibilities, we will accept either but not both at the same time. If we want more than one, we ask for it. Questions are generally in plural (morphological diagnoses/etiologies); this does not necessarily mean that there are two etiologies. There may be just one or two, you cannot deduct this from the question, you have to look at the slide. Again, a returning problem.


Do not overuse your imagination:

• Urate crystals are not mycobacteria (size differences and stain!!!).

• Macrophages are no amoeba, especially in bird lungs.

• Mycobacteria are not seen in H&E stains.

• Do not invent cells, bacteria and/or parasites or giant cells.

• Invention will lead to loss of points!
Do not get fixed on a disease and make your description fitting this imagined disease:

• Do not describe multinucleated giant cells because you want to diagnose mycobacteriosis in a case of Mycoplasmosis.

• There are other disease processes than tumors and inflammation.

• Do not describe intranuclear inclusion bodies when there are intracellular inclusion bodies, because you want to diagnose a herpes virus infection instead of pox virus infection
Do not waste time to extensively describe normal inflammatory cells.

• It is enough to name them as for example „multinucleated giant cells (Langerhans type)“ or „epitheloid macrophages“. Doing this costs you only time and will get you no points what so ever!

• You will get no points for giving cell or nuclear size of such cells in µm.

• Cell sizes are given in descriptions of tumors and cytology preparations, they do not need to be in µm, but can be in ratio to erythrocytes or other standard sized cells.

• Abnormal cells need to be described.


Items you must always write:

• Firstly the tissue type (i.e. haired skin, urinary bladder (not just bladder)

• With tumors:

  • Location, demarcation, encapsulation, arrangement, stroma, tissue replacement, infiltration, cell density
  • Cell shape/type, size, cell borders, cytoplasm (amount, color, texture)
  • Nuclear characteristics (size, shape, number, chromatin pattern and nucleoli (size, number, prominence), location within cell.
  • Mitoses, number (MI or average/hpf), bizarre.
  • Know the difference between anisokaryosis vs anisocytosis.

• With inflammation:

  • Cell types, number in order, location (diffuse, multifocal, perivascular…)
  • Always: what, were and how much.


EM:

• Describe everything, including normal structures (correct terminology!).

• Know how to recognize tissue.

• Have an idea about relative sizes of structures and organisms. You need to know roughly how large a virus is in order not to mistakenly diagnose a bacterium.


Cytology:

• The cytology is the only exception where the organ and the sampling method (i.e. smear from an exudate, fine needle aspiration, impression from an organ) are given. This is important in order to figure out a list of differential hypotheses (disease processes) already before looking at the slide. By reading the organ and the sampling method, you should already know what you expect to see in the slide.

• Grossly examine the slide (gives a lot of information on the cellularity and on the background, i.e. calcifications, black pigment, blood and so on)

• You have to be able to classify the cells (normal, hyperplastic, neoplastic, inflammatory, mixed) and always remember to evaluate the acellular component of the slide (background, granules, crystals, etc).

• As in any other slide, the cells have to be recognized. Experience is fundamental in this case in order to distinguish different cell types. In cytology almost all cells are individualized and roundish and you cannot rely on architecture as you do when you read histology. However when clustered then you can often gain more information i.e. epithelial or mesenchymal. All cells have to be described and interpreted.

• The final judgment and the morphological diagnosis must be consistent with your previous description.
Gross:

Be specific:

• Bladder: which bladder?


Do read the questions carefully. Commonly asked questions include the following:

• Morphologic diagnosis: name the lesion in specific pathologic anatomic terms including all modifiers (severe acute multifocal ulcerative esophagitis, severe visceral urate deposition). Do not forget bilateral symmetrical etc, if appropriate.

• Etiology or likely cause: name the cause as specific as possible: Leptospira canicola, lead poisoning, genetic defect

• Name the disease: give the commonly used appellation of the case shown (visceral gout, canine distemper).

• Etiologic diagnosis: name the organ and the most likely disease process/cause (viral pneumonia, mycobacterial enteritis, uremic gastritis).

• Differential diagnosis: give one diagnosis for another lesion or disease that would resemble the first diagnosis (lymphadenitis – malignant lymphoma).

• Pathogenesis: list or describe briefly the series of pathogenetic events that resulted in the lesion or disease shown ( glomerular amyloidosis > proteinuria > hypoalbunemia > decreased plasma colloid pressure > generalized edema)


Do not overuse your imagination:

• There is no morphological change which can be appreciated grossly suggesting reliably the presence of inclusion bodies.


General pathology

Read the questions carefully:

• Immunohistochemistry does not relate to DNA analysis.

• Western blot analysis does not measure RNA


Veterinary Pathology

Start on time to study the material:

• Do not ignore the books.

• Do not ignore the pertinent journals: Veterinary Pathology, Journal of Comparative Pathology, Journal of Veterinary Diagnostic Investigation

• Emerging Infectious Diseases may be the source of question in ANY of the subsections, not only small and large animals!

• Do not assume that you can ignore one of the three sections and pick up those points in the other two, this usually does not work.

 

Read the questions carefully and use common sense to avoid unnecessary wrong answers:

• Dwarf goats are not breeds of sheep

• German Shepherd dog is not a gender of dogs

• Metaphyseal osteosclerosis through osteoblast impairment is highly unlikely

• Male cats fighting > greater risk of pancreatitis?

• Sheep are not small animals


Comprehensive pathology

Read the questions carefully:

• Be concise in your description and analysis! No points are given for the length of the text.

• When asked to describe and interpret some survival curves, do not interpret tumor incidences or any other data you are presented with.

• When asked to describe and interpret the incidence of neoplastic findings, do not waste time in describing non-neoplastic changes such as inflammatory and/or degenerative findings.

• When asked for a cytological interpretation without detailed description, do not write a detailed description without any interpretation.

• Briefly means succinct, precise and no logorrhea. Do not waste time to fill the pages beyond the offered lines. We assume that the space we provide is sufficient to answer the question (unless your hand writing is really large).

• Again, write legibly, if it cannot be deciphered it won’t get any points.

• Clearly distinguish between describing results (3 % decrease of survival rate) and interpretation (compound X administration does not alter survival rate after a 28-day study).

• When reading research papers look at graphs, figures and establish the results before you read the text.

 

 

Last Updated: March 23rd, 2016