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This is only a guide; please refer to the actual application for full details.
The application for primary certification is a 12-page application broken down as follows:

Personal

  • Name
  • Social Security Number
  • Address
  • Gender
  • Date of birth

Medical Licensures
Send a notarized copy (front and back) of your current registration card for where in the US or Canada you are licensed.

Education
List the institutions where you obtained your premedical, medical, and advanced degrees.

Medical School Diploma
Send a notarized copy of your medical school diploma; if it is in a foreign language, it needs to be translated. If you are a US or Canadian graduate, this requirement can be met by a letter from the dean’s office of your medical school certifying that you graduated from medical school.

Undergraduate Fellowship Training in Pathology
List post-pathology course student fellowship that was ABP approved. If you are seeking credit for this activity, submit letter of documentation from director of the training program and medical school stating that credit was not given for such activity toward graduation from medical school.

Advanced Credit
List any advanced credit previously granted to you by the ABP and if it was granted to satisfy a training or credentialing year.

Graduate Medical Education in Pathology

List ACGME accredited training in pathology:

  • Number of hospitals you trained in
  • Bed capacity of the primary training hospital

List the number of months spent in each of the subspecialty areas in AP and/or CP

Professional Responsibility During Pathology Training Program
(Use the Data Collection Templates (Microsoft Excel, 17Kb) to help track this information.)

  • List the number of autopsies (including shared and forensic) done each year of training. Include a separate sheet listing age, sex, primary diagnosis, and date performed; minimum number is 50.
  • List the number of surgical specimens examined by you per year.
  • List the number of cytopathologic specimens examined by you per year.
  • List the number of clinical pathology consultations you participated in per year.

Credentialing Requirement (Pathology, Clinical, or Research)

  • List additional pathology, clinical training necessary to meet the credentialing requirement. Include a letter from program director documenting the dates of service and accreditation status of the program.
  • List research that has clearly defined clinical implications and was performed in the US or Canada. Include a letter from your research supervisor and a letter of support from your program director. Precisely describe your role in the research listed, and provide title and sources of publications.

Other Research
If you have not been granted advanced credit for the flexible year, and you want to use a year of research to satisfy the flexible year, list only the research directly applicable to the practice of pathology in which you have participated in full-time and which was not part of your pathology training. Submit a letter of documentation from the director or supervisor of your research. Your program director must sign this page of the application.

Other Certification
You will have to answer whether you are certified by the ABP or you are a diplomate in any other ABMS Medical Specialty Board.

Intervening Years
Explain any gaps in time between medical school graduation and beginning of pathology training if longer than two years.

Adverse Actions
List any disciplinary actions, license revocations, restrictions, convictions, etc.

References and Signatures
List the name and address of your program director and another ABP certified pathologist. Your program director must sign the application.

You will also need two passport size photographs, both signed by you and your program director.

 

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