1.1 The examination is designed to test the capability of the candidate to be an independent specialist in diagnostic oral pathology.
2. Conduct of the examination
2.1 The examination is held in a pathology department. The candidate may request the use of a microscope from the department or may provide their own microscope.
2.2 The examination is conducted in five sections, designated A, B, C, D and E, with specified objectives. The instructions to candidates for Sections A, B and D are shown in Appendix 1. These are to be provided to the candidates at the same time as the details of individual cases are provided.
2.3 The venue for the examination is selected on the advice of the Chair of the Panel of Examiners in oral pathology.
2.4 Each of the five sections of the examination is scored out of 100 with the pass mark in each section being 50%. The details of the marking system are shown in Appendix 2. The overall pass mark for the examination is 50%. Candidates must pass Section A in order to be eligible for a pass. The aggregation of the scores in the different parts of the examination and any compensation between parts is at the discretion of the three examiners, who will take into account the entire performance of the candidate over the two days in reaching their agreed final decision of pass or fail.
3.1 The examiners are selected by the College from the published lists of oral pathology examiners and taking account of the advice of the Chair of the Panel of Examiners in oral pathology. They comprise the oral pathology examiner at the selected venue, one further oral pathology examiner and an external examiner.
3.2 The external examiner is an experienced medical histopathology examiner. The principle role of the external examiner is to ensure that the standards set are comparable with other histopathology examination standards. The external examiner is consulted about the slide selection for the examination, particularly in Section A. He/she can elect to participate in any or all of the sections of the examination, but is specified as the main examiner in the oral examination (Section E).
4 Examination timetable
4.1 The examination is conducted over two days. Sections A and B are held on the first day and the remaining three sections are on the second day.
4.2 The objective of Section A is to test the candidate’s competence to diagnose a wide range of the lesions which might present to an oral pathologist, taking cognisance of the specifications in the section headed ‘The Scope of oral pathology’. Section A comprises not more than 20 cases for diagnosis. These are mainly H&E sections with one or at most two sections per case. The material includes a spectrum of difficulty, designed to ensure that the candidate can diagnose simple or common lesions accurately as well as including more difficult cases, such as uncommon salivary or odontogenic lesions. Up to two head and neck FNA or cyst aspirates may be included in this section.Candidates are provided with patient details and a brief clinical history to place the material in context. Candidates are expected to write a description of the salient features of the case and provide either a diagnosis or a differential diagnosis. Where appropriate, it will be reasonable to indicate what further tests would be required to reach a definitive diagnosis.The duration of Section A is three hours.
4.3 Section B is of three hours duration. The objective is to test the candidates ability to report complex cases. A small number of cases, not more than six, is used. These may include a large resection, cases with multiple biopsies or cases requiring special stains, immunocytochemistry or molecular biology investigations for diagnosis. Relevant radiographs should be available. The candidate is provided with H&E stained sections in the first instance. Special stains and other investigations, or relevant results, are provided on request. Candidates are to be advised to screen all cases initially, in order that further investigations are made available in good time.The cases selected involve areas where an oral pathologist could reasonably be expected to the relevant specialist. In other words, it is not be appropriate to expect the candidate to make specialist diagnoses in fields such as lymphoreticular pathology or complex soft tissue neoplasms. Candidates will be expected to generate a full histopathological report for each case. Any relevant Standards and Minimum Datasets for Reporting Common Cancers should be available to candidates (downloadable from the Publications page of the College website).
4.4 Section C is conducted on the morning of day 2. It is of not more than 45 minutes duration. The objective is to test the candidate’s ability at specimen dissection, cut-up, selection and preparation of tissue blocks for histopathological examination. Candidates should expect to be required to dissect, at least partially, an appropriate resection specimen as well as smaller biopsy material.
4.5 Section D is of not more than two hours duration. The objective is to assess the candidate’s ability to communicate the results and interpretation of histopathological findings in the context of a consultation using a multiheaded microscope.The candidate is given one hour to examine and prepare to discuss two cases. The candidate is then be asked to present these cases in the manner which might be appropriate for the consultant who submitted the case, including discussing questions which might be asked about interpretation of features, advice on prognosis, further investigations and treatment. The examiners act as the consultant submitting the case. In order not to be too stressful to the candidate, only two of the examiners should participate at one time.
4.6 Section E is the oral examination and should last not more than one hour. The external examiner should take the lead and one of the oral pathology examiners should also participate. The second oral pathology examiner may attend the oral examination as an observer. The subject matter of the oral examination may include any aspect of the examination. It also includes areas not covered earlier in the examination such as health and safety, the regulatory framework of laboratory practice, responsibilities of consultants and aspects of laboratory management.
5.1 All results are confirmed by the Examinations Committee before the candidates are informed. Examiners are instructed not to convey results to candidates at the time of the examination.
6. Reports on unsuccessful candidates
6.1 Examiners are requested to prepare a report on unsuccessful candidates specifying areas of weakness and of strength. Recommendations of additional training or experience which could make good the deficiencies should be made. These should be forwarded to the Examinations Department as soon as possible after completion of the examination and will be used in counselling candidates.
6.2 Examiners may feel, on occasion, that even although a candidate has passed the examination, they would benefit from additional experience in a part of the syllabus in the interval between passing the examination and the designated CCST date. In such cases, this information should be provided to the candidate and also forwarded to the Specialty Adviser in oral pathology who will liaise with the Chairman of the SAC for the Additional Dental Specialties, the candidate’s educational supervisor and the Deanery in taking forward the recommendation.