Dozens Who Were Told They Failed the Pathology Board Exam Actually Passed

Dozens of pathologists who were told they failed their specialty’s board exam over the past 2 years have been alerted that they actually passed.

On October 3, the American Board of Pathology (ABPath) released a statement explaining that after a recent reassessment and rescoring of the primary and subspecialty certification exams, they found that “a small percentage” of people had mistakenly been failed. The affected examinees will receive refunds on their exam fees, corrected results letters, and updated certificates.

An ABPath spokesperson told MedPage Today that, in total, 76 out of 4,059 (1.9%) people who took the primary and subspecialty examinations from 2022 to 2024 were impacted. They did not detail the range of scores for people who were mistakenly told they failed, noting that those who did end up passing “had previously been scored just slightly below the cut-score threshold.”

“We understand how significant this is to our candidates and diplomates and are committed to working closely with those impacted,” the spokesperson said, adding that “ABPath has also implemented improvements to our processes to prevent this issue in the future,” though they did not describe these improvements.

Reddit users on r/pathology posted screenshots of these emails pertaining to the Fall 2022 exam, and one user sent MedPage Today a screenshot of their email concerning the Spring 2023 exam.

ABPath’s email to affected test takers was brief, explaining that a reassessment of the anatomic pathology certification examination “disclosed that your score exceeded the cut-score threshold for a passing score, rather than being slightly below it.”

One Reddit user, walleyealx, said that they were “livid” after receiving that email. “Their mistake definitely cost me LOTS of time, mental anguish, and money,” they wrote. “Please note that there was no apology at all in these emails, which makes me even more angry.”

Another user, Purple_Reagent, wrote that ABPath’s “proposed compensation/refunds seems meager compared to the stress this must have caused” — a sentiment several others shared.

User Idfcwytas also sent MedPage Today a screenshot of an email that ABPath sent yesterday — several days after the initial email — that finally included an apology “for the frustration this has caused.” Idfcwytas said this situation caused them a lot of distress, anxiety, and self-blame.

“Failing a major board hits you hard especially after so many years of training and so much time spent on studying,” they said, noting the situation was “a shock and a disappointment and a betrayal.”

Bryan Carmody, MD, of Eastern Virginia Medical School in Norfolk, who blogs frequently about medical education issues, said that a situation like this decreases trust in the boards themselves, and that being mistakenly failed has financial and career impacts. For instance, he said, “many hospitals require board certification to get hospital privileges or to work there … so if you were applying to an academic job or something, I think it’s going to hurt your application.”

Moreover, people may be deterred from applying to those jobs in the first place if they hadn’t passed their boards yet, he added.

Edernst Noncent, MD, an assistant medical examiner for the state of Maryland, told MedPage Today that in the spring of 2022, he experienced a technical malfunction on the test’s virtual microscopy application that cost him 2 hours, but he was told he had to finish the test.

He failed that test, and retook it in the fall of 2022 — which was when the issue apparently started. At this point, he was out of residency and had begun fellowship. The stakes were high, as he made $30,000 less than he would if he were board certified, and studying for the exam is time intensive.

Again, Noncent didn’t pass, though he was alerted that his score was 10 points higher than what he had previously been told.

Pathologists have 5 years to pass — just 10 tries — and the exam costs between $2,100 and $2,600 each time, he said. “If you do not pass it within those 5 years, you have to go back for a year of training, which means you have to quit your job and go work for a fourth of your usual pay. Your job might not still be there when you get back. And I know multiple people who have had to do exactly that,” Noncent said.

He also said that the content of the test changes every year, making it hard for people to figure out why they’re not passing.

“At the end of the day, nobody knows what’s on the test,” Noncent said, adding that he’ll take the test for the fifth time this week.