When I was a pathology resident, back in the dark days before the examination was given on computers at the American Board of Pathology in Tampa, I heard what felt like 10,000 different approaches to taking the boards. Some of the stuff that I heard was obviously whacked, like "I heard that one year they made every answer choice B!" Unfortunately, some of the other stuff kinda sorta made sense, and I had a hard time separating the crap from the good stuff. So, let me offer you the ten thousand and first set of pieces of advice on taking the exam and a general approach. This is just based on my own experience and that of others that I know and trust that have taken the exam. I am going to limit this to the Blood Bank portion of the CP part, but most of what I have to say would apply across the board. I'll write this in the form of the most common questions that people ask me.
"What do I study?"
Great place to start! As you know, there are a multitude of Blood Banking textbooks out there, ranging from really basic all the way to so advanced that many blood bank physicians would struggle to understand them. I really advise you to be smart about this. In my opinion, you need to get your hands on something that you can read easily and understand. Many of those advanced texts, quite honestly, "swim in the deep end of the pool" more than you need! For that reason, I always recommend that you start with the AABB Technical Manual. Now, I'll be honest: The Tech Manual isn't the easiest-to-read book in the world! However, it covers the basics in a pretty straightforward way, and it goes to a depth that should put you in pretty good shape for the exam (it actually reads much better now than it used to, by the way). Second, I recommend that you check out the latest version of AABB Standards. This is not a book designed for cover-to-cover light reading, but you won't find a better place to quickly review blood bank regulations. Finally, if you want an excellent and inexpensive blood banking textbook, I recommend Transfusion Medicine, 2nd edition, by Dr. Jeff McCullough. You can find it for about 60 bucks on Amazon.com (a bargain for a medical book!), and it is truly money well spent. This book covers the basics and some advanced concepts in a clear, very concise way.
"How does the test work?"
As I said above, I took my AP/CP exam in the old paper and pencil days, but I did take my blood bank boards on the computer at the American Board of Pathology headquarters in Tampa. I can give you a general idea, but for the most up-to-date info, you should go straight to the source, and check out the ABP's candidate information page. For the clinical path portion of the boards, there are sixteen different topics that are covered, of which blood banking/transfusion medicine is one. If the test holds true to form, there are about 360 total questions in clinical pathology, about half "written" and half "practical." You have your own workstation, where questions are posed to you on a computer monitor, and you answer them by clicking your choice with the mouse. No big deal!
"How can you do antibody panels on the computer?"
The first time someone asked me this, I thought they were kidding! But so many people have asked, I thought I'd address it. No, you don't have to bring a dry-erase marker to do cross-offs on the computer screen! I am told that the panels will be printed in a booklet where you can mark to your heart's content, and then click your answer on the screen. Again, no big deal!
"My friend said he heard that the boards were really hitting (fill in the topic) hard this year! Is that true?"
Ummm, no! Please do yourself a huge favor and don't listen to things like that! The truth is that there are 16 CP topics to cover, and they will, in general, ALL be covered in pretty significant detail. People coming back from boards or people who took boards in previous years are NOT going to be objective. First, they may secretly hate you and steer you wrong! Second, and (hopefully) more likely, memories are always skewed toward individual strengths and weaknesses. For example, after I took my exam, I would have told you in 100% seriousness that at least half of the CP questions were on Microbiology, and I would have said "the boards are really hitting micro hard this year!" The truth is that I HATED micro (still do), and I have always felt very weak in it. I loved blood banking from my first rotation as a resident, and my immediate recollection was that there wasn't a SINGLE blood bank question on my boards! Honestly, both memories were wrong. The truth was somewhere in the middle, of course. Incidentally, a friend of mine came up to me after the same exam that I had taken and was moaning about how hard the boards were hitting blood bank that year! True story!
"What if I don't know any of the answers?"
This one really just goes to test-taking skills. In my view, you need to go into this test understanding that everyone, and I mean everyone, who takes the boards has the feeling at one point or the other during the exam that they are a complete and total idiot, and that they are going to fail the heck out of this test and embarrass themselves and their training programs! You are not alone! All those confident-looking people around you are just really good at faking how they really feel! Everyone feels like puking when they take this test! Please, just stay calm. You do know some of the answers, and if you have put in the time to study beforehand, chances are pretty good that you know enough to pass!
"Can you tell me what is going to be on the exam?"
Nope, and neither can anyone else! As I said above, expect all topics, blood banking included, to be covered in significant detail. There are really no shortcuts to just putting in the work and time and studying as much as you can. Sorry! I have occasionally had e-mails from people who claim that none of what I cover in the review lectures was on the exam. That is hard to believe; not because I am great or because I have any special insight to the questions, but because there is only a limited amount of material to cover for blood banking. But, please understand that no one can predict with any degree of certainty what will be asked.
A final word
Let's be honest; there's just no way that taking the pathology board exam is going to be a pleasant experience for you (unless you are slightly mental!). If you are getting ready for boards, you are in for a period in your life that will be difficult and will stretch you to your limits and beyond. But, there aren't many things better than getting a skinny envelope from the American Board of Pathology that starts with the word "Congratulations"! Hang in there and don't give up! You can do it!
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