Fred T Bosman

University Institute of PathologyLausanne

➢ How much teaching, how much in service training?

➢ Case numbers (of biopsies, autopsies etc.) ➢ Duration➢ Defined technical, educational and

management skills required?➢ Any focus on ‘attitude’?➢ Research experience➢ Certifying examination

Bosman FT, van den Tweel JG.Unison or cacophony: postgraduate training in pathology in Europe.

Virchows Arch. 2009;454:497-503.

Bosman FT, Van den Tweel JG Virch.Arch.2009;454:479-503

Bosman FT, Van den Tweel JG Virch.Arch.2009;454:479-503

Bosman FT, Van den Tweel JG Virch.Arch.2009;454:479-503

=Training curricula are

heterogeneous!

➢ Open to ‘all’ residents in Europe➢ Identical test for everyone, regardless of

experience acquired➢ Not individual scores but progress and peer

comparison count➢ Can test knowledge➢ Can test some diagnostic skills

➢ Can not test many of the general competencies(attitude, communication skills, management skills etc.)

A progress test allows monitoring of individual progress and peer

comparison

…but also inter-program or inter-national comparison

➢ Comprises of 120 MCQ/EM items with stillimages or virtual slides in an on-line approach

➢ Is a follow-up of the Europals test which ran(with EU funding) for 5 consecutive years after2008 (participation varied between 250 and >650 participants)

➢ Has been reintroduced in 2018/2019

➢ Has a content and format similar to the new UEMS Board of Pathology examination (to beopened 2020)

➢ Has been overall evaluated favorably

Test composition according to the blueprintestablished for the UEMS Boards of Pathology examination

Total number of test items 120

Virtual slide based questions 19

Image based questions 38

MCQ’s without image 38

EMQ’s 25

• Participants from 37

countries

• Total participation

(registered, opened

the test and closed it

again) 355

• Total number of tests

completed (all

questions answered)

258

The test contained image based multiple choice questions and text only multiple choice questions. Would you prefer more image based questions?

Prefer more image based questions 94

Prefer more text only based questions 5

Correct balance between image based questions and text based questions 92

The test contained 19 virtual slides and 38 snapshot images. Do you think more virtual slides or snapshot images should be used?

More virtual slides should be used 97

More snapshot images should be used 16

I am happy with the number of virtual slides and snapshot images used 77

What is your opinion on the degree of difficulty of the questions for the histological images?

Too Difficult 17 Difficult but reasonable 160 Too Easy 3

What is your opinion of the other Multiple Choice Questions? Too difficult 40 Difficult but reasonable 147 Too Easy 2

How would you rate the test overall? Please build into your assessment the difficulty of the questions, the spread of questions and the ease of accessing the examination.

Not a helpful way of assessing senior trainees 17 A reasonable test of the skills of a senior trainee 84 Good 58 Very Good 26

1. Content issues • it doesn't reflect the day-to-day practice of a pathologist; too many questions at subspecialty level

• too much emphasis on specialty areas (neuropathology, soft tissue/sarcomas, pediatric pathology); too little dermatopathology

• the test does not reflect the pathology training for residents in our country

• more immunostaining to represent real life

• quite a lot of focus on medical/inflammatory diseases rather than neoplastic

• too many questions about molecular and cellular biology

2. Test organisation• organise the test by organ system

• the test should be available during weekend days, not just week days

3. Many very positive comments • I loved it

• I think that this kind of tests should be done more frequently

• peferct. Keep going!

• thank you for organising the test!

• thank you for this very rewarding exercise. God bless you!

• this was an excellent test! Thank you

➢ Harmonization of training programmes or a single qualifying exit test for pathology in Europe are an illusion• Certifying bodies are at national level• A single exit test is not the optimal approach• Not all learning objectives can be easily tested

➢ A european progress test can contribute to monitor knowledge and (some) skills and thus toharmonization of training outcome• It is operational• It is an anonymous self-evaluation test homologous to the

new European Board of Pathology examination• It is supported by the ESP and UEMS• Take it!!