Primary Exam Descriptions


Primary Exam Descriptions

The ABPath uses criterion-referenced tests for its certification examinations.

Criterion-referenced tests (CRTs) are intended to measure how well a person has learned a specific body of knowledge and skills. On a CRT, the passing or “cut-off” score is determined in advance by a committee of experts in the field. The candidate’s performance (i.e. mastery of the subject matter) is compared to the cut-off score and not to other test takers.

Theoretically, all candidates could pass or fail depending on how they performed relative to the passing score. Driving tests are an example of CRTs, because the goal is to see whether the test taker is skilled enough to be granted a driver’s license, not to see if one test taker is more skilled than another test taker. In contrast, norm-referenced tests (NRTs) compare test takers to each other. Scores are reported as a percentage rank with half scoring above and half below the mid-point. NRTs are designed to sort and rank students “on the curve,” not to see if they met a standard or criterion. The ABPath does NOT use NRTs for its certification examinations.

Special Note: ABPath would like candidates to please note the Revised 4th Edition (2016) WHO classification for hematolymphoid neoplasms will be used for the 2023 Primary and Subspecialty examinations. Starting in 2024, candidates will need to be familiar with both the 2022 International Consensus Classification system and the 5th Edition of the WHO Classification.

Anatomic Pathology Examination Description

For AP Only, combined AP/CP, and combined AP/NP certifications.

The Anatomic Pathology examination is a one-day, computer-based examination consisting of combined Written and Practical sections and Virtual Microscopy (VM) sections. There are no glass slides, only VM. All questions are multiple-choice and are in the one-best-answer format. The examination is administered as follows:

Anatomic Pathology ExamTotal Number of QuestionsTotal Time
 Combined Written/Practical Sections 2053 Hrs. 25 Mins
Virtual Microscopy904 Hrs. 30 Mins

Approximately 95% of the total examination is devoted to questions related to pathology of specific organ systems or multi-system disease. The remaining 5% of the examination deals with general pathology and laboratory management. General pathology topics include principles of cellular injury, inflammation and repair, physical and chemical injury, congenital and genetic diseases, molecular pathology, and infections. These topics may also be included in questions related to specific systems or diseases. Laboratory management questions may be related to quality assurance, safety, billing, inspection and accreditation processes, federal regulations, personnel issues, costs of running a laboratory, informatics, and other aspects of management. Questions on neoplasia are included in the organ systems and may refer to principles of carcinogenesis, etc., as it relates to a specific neoplasm in addition to diagnostic information. The number of questions related to a particular system or to a topic in general pathology is roughly correlated with the frequency with which the general pathologist receives specimens or encounters diseases in these areas. Although the majority of questions are related to surgical pathology, questions related to any topic may be placed in the setting of any area of anatomic pathology of adults and children including surgical pathology, cytology, autopsy, or forensic pathology. The examination also includes questions on hematopathology and molecular pathology. Cytopathology questions cover both gynecologic and non-gynecologic specimens.

Images used on the practical examination include gross specimens, histopathologic specimens, electron micrographs, karyotypes, pedigrees, and cytopathology specimens of various types (liquid based preparations, fine-needle aspirates, cell blocks, etc.). A variety of histochemical and immunochemical stains may be used as well as molecular pathology preparations. Please refer to the Exam Blueprint for the approximate percentage of questions in each topic.

Clinical Pathology Examination Description

For CP Only and combined AP/CP certifications.

The Clinical Pathology examination is a one-day examination composed of combined written and practical sections. Each section contains image questions, questions with graphs, charts, karyotypes, pedigrees, red cell panels, formulas, and other problem-solving exercises. All questions are multiple-choice and are in the one-best-answer format. The examination is administered as follows:

Clinical Pathology ExamTotal Number of QuestionsTotal Time
 Combined Written/Practical Sections 3306 Hrs. 36 Mins

The subject content of the clinical pathology examination includes blood banking/transfusion medicine (23%), chemical pathology and immunopathology/serology (20%), hematopathology (25%), medical microbiology (23%), and laboratory management (9%). Medical microscopy questions may be included in both chemistry and hematopathology portions of the examination. Questions on molecular pathology are included in all content areas of the examination and account for 10–15% of the examination. Questions from all content areas are found on both written and practical portions of the examination.

Individual topics included in the subject content areas of the clinical pathology examination include, but are not limited to:

  • Blood Banking/Transfusion Medicine: donor criteria; collection, processing, labeling and storage of blood and components; indications for use; blood groups; antigen/antibody detection and identification; compatibility testing; immune hemolytic anemias; tissue and organ transplantation; component therapy; adverse reactions to transfusion; apheresis; laboratory standards and regulations specific to blood banking/transfusion medicine.
  • Chemical Pathology: patient preparation and specimen collection, analytic methods and techniques, statistics, disorders of metabolism, electrolyte and acid/base disorders, serum protein abnormalities, system and organ diseases/conditions as reflected in testing in the chemical pathology laboratory (including immunopathology), chemistry of body fluids including urinalysis, amniotic fluid, toxicology, diagnostic applications of laboratory data.
  • Hematopathology: instrumentation and methodology; hematopoiesis; benign and malignant disorders of erythrocytes, leukocytes, lymph nodes, and spleen; coagulation and hemostasis; medical microscopy including semen analysis, and analysis of cerebrospinal fluid and other body fluids.
  • Medical Microbiology: collection, handling, and processing of specimens for microbiologic analysis; pathogenic mechanisms of infectious diseases; antimicrobial mechanisms of action and susceptibility testing; media, reagents, and stains; cultural and morphologic characteristics and infections related to aerobic and anaerobic bacteria, spirochetes, fungi, viruses, and rickettsia; morphologic characteristics and infections related to parasites.
  • Laboratory Management: quality assurance, safety, billing, inspection and accreditation processes; federal regulations; personnel issues; costs of running a laboratory; informatics.

Primary Exam Blueprints and Daily Schedules