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To the Editor.-We read with great interest the editorial "Recent Advances in Anatomic and Clinical Pathology Board Examination Pass Rates" by Brian D. Adkins, MD.1 Historic board pass rates are nicely summarized, and the author speculates on the many reasons for an upward trend in pass rates, although this was only significant when looking at all test takers, but not when breaking out first time and repeat test takers.
We believe that training programs began to place greater emphasis on board pass rates when the Accreditation Council for Graduate Medical Education made board pass rates an outcome for continued accreditation of a training program. We agree there is an increasing number and better quality of tools for board preparation.
Readers may be interested to know that the American Board of Pathology (ABPath) uses criterion referenced tests (CRTs), and not norm-referenced tests (NRTs) for its certification exams. 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 score is determined in advance by a committee of subject matter experts (SMEs) in the field. The candidate's performance (ie, mastery of the subject matter) is compared with the cut score and not to other test takers. Theoretically, all candidates could pass, or all could fail depending on how they performed relative to the passing score. A driver's test is an example of CRTs,...