The dysfunctional federally mandated proficiency test in cytopathology

The American Board of Pathology cytopathology board examination: Personal recollections of the first cytopathology board exam and a brief historical perspective

“…This government mandated cytology PT test was not implemented for 13 years after the regulations were passed due to lack of vendor proposals, but it was very controversial when it was implemented. [4][5][6][7][8][9][10] To my knowledge, passing the far more rigorous ABP board exam was not even considered as a means of demonstrating competence. TDAC members are given guidance from professional statisticians with expertise in testing on how to write a "good question" that can separate competent from not competent examinees.…”

“…As anyone practicing gynecologic cytopathology in the United States knows, one of the components of the CLIA '88 regulations is that we all must take a 10‐slide test annually which has the same 4 multiple choice answers for each of the 10 questions to demonstrate competence to the Center for Medicare and Medicaid Services (CMS). This government mandated cytology PT test was not implemented for 13 years after the regulations were passed due to lack of vendor proposals, but it was very controversial when it was implemented 4–10 . To my knowledge, passing the far more rigorous ABP board exam was not even considered as a means of demonstrating competence.…”

Revision of the Federally Mandated Cytopathology Proficiency Testing System

“…1 Peritoneal spread is common and may be detected in the absence of overt clinical disease by the examination of peritoneal washings obtained during laparoscopy. 2,3 The cytologic features of ductal carcinoma are well described, particularly in fine needle aspiration cytology (FNAC) specimens, 4,5 and therefore malignant effusions secondary to pancreatic carcinoma usually are straightforward diagnostically. However, several histologic variants of pancreatic ductal carcinoma are now recognized, one of which, foamy gland adenocarcinoma (FGA), has been reported to present diagnostic difficulty because of its deceptively…”